William C Goedel1, Traci C Green2, Samara Viner-Brown3, Josiah D Rich4, Brandon D L Marshall5. 1. Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA. 2. Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA; Department of Emergency Medicine, Warren Alpert Medical School, Brown University, Providence, RI, USA; Department of Emergency Medicine, Boston University Medical Center, Boston, Massachusetts, USA. 3. Center for Health Data and Analysis, Rhode Island Department of Health, Providence, RI, USA. 4. Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA; Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI, USA. 5. Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA. Electronic address: brandon_marshall@brown.edu.
Abstract
BACKGROUND: The timing of social service benefit issuance is thought to be associated with increased drug overdose fatalities. However, the extent to which this excess mortality is concentrated in communities with higher levels of benefit receipt has not been studied. We sought to examine if benefit receipt at the neighborhood level was associated with spatiotemporal patterns of overdose fatalities. METHODS: We conducted a retrospective review of all accidental overdose deaths recorded in Rhode Island from 2014 to 2016 (n = 838). Overdose incident locations were geocoded to the census block group level. Clusters of census block groups with excess overdose mortality at the beginning of a month were identified using spatial scan methods. Logistic regression models were fit to identify characteristics associated with the inclusion of a census block group within a cluster. RESULTS: Increased rates of overdose fatalities at the beginning of a month were observed relative to the end of a preceding month (Ratio: 1.17; 95% CI: 1.04, 1.38). The proportions of residents receiving cash public assistance or Supplemental Security Income were not associated with excess mortality at the beginning of a month; however, the proportion of residents living in unaffordable housing was (OR: 1.42; 95% CI: 1.05, 1.91). CONCLUSION: Despite previous research on benefit check issuance and overdose, welfare receipt was not associated with excess overdose mortality at the beginning of a month at the neighborhood level. Future research on housing cost burden and its influence on overdose death risk at the individual level is needed.
BACKGROUND: The timing of social service benefit issuance is thought to be associated with increased drug overdose fatalities. However, the extent to which this excess mortality is concentrated in communities with higher levels of benefit receipt has not been studied. We sought to examine if benefit receipt at the neighborhood level was associated with spatiotemporal patterns of overdose fatalities. METHODS: We conducted a retrospective review of all accidental overdose deaths recorded in Rhode Island from 2014 to 2016 (n = 838). Overdose incident locations were geocoded to the census block group level. Clusters of census block groups with excess overdose mortality at the beginning of a month were identified using spatial scan methods. Logistic regression models were fit to identify characteristics associated with the inclusion of a census block group within a cluster. RESULTS: Increased rates of overdose fatalities at the beginning of a month were observed relative to the end of a preceding month (Ratio: 1.17; 95% CI: 1.04, 1.38). The proportions of residents receiving cash public assistance or Supplemental Security Income were not associated with excess mortality at the beginning of a month; however, the proportion of residents living in unaffordable housing was (OR: 1.42; 95% CI: 1.05, 1.91). CONCLUSION: Despite previous research on benefit check issuance and overdose, welfare receipt was not associated with excess overdose mortality at the beginning of a month at the neighborhood level. Future research on housing cost burden and its influence on overdose death risk at the individual level is needed.
Authors: Alexandria Macmadu; Sivakumar Batthala; Annice M Correia Gabel; Marti Rosenberg; Rik Ganguly; Jesse L Yedinak; Benjamin D Hallowell; Rachel P Scagos; Elizabeth A Samuels; Magdalena Cerdá; Kimberly Paull; Brandon D L Marshall Journal: JAMA Netw Open Date: 2021-09-01
Authors: Jesse L Yedinak; Yu Li; Maxwell S Krieger; Katharine Howe; Colleen Daley Ndoye; Hyunjoon Lee; Anna M Civitarese; Theodore Marak; Elana Nelson; Elizabeth A Samuels; Philip A Chan; Thomas Bertrand; Brandon D L Marshall Journal: Int J Drug Policy Date: 2021-07-31