Examination of racial-ethnic and geographic variations in opioid overdose trends in sociodemographically diverse counties in New York state

Description

Background: Based on national data, the highest increases in opioid-related overdose (OD) rates are occurring among young to middle aged white adults in non-urban geographic areas. However, these trends may differ at the state level, and sociodemographically when differences in the rate of increase in opioid-related OD are explored. Objective: To investigate racial-ethnic and geographic differences in opioid-related OD in New York (NY). Methods: Patient demographics from ED visits involving opioid-related poisoning and behavioral health diagnoses were obtained from NY State Department of Health Statewide Planning and Research Cooperative System representing diverse NY counties (Erie, Onondaga, Monroe, and Kings/Brooklyn) from 2010-2015. We used generalized linear mixed models to assess changes in opioid-related ED visits over time and interaction of time trend differences by race-ethnicity and geographic area. Results: Like national trends, NY experienced exponential increases in opioid overdose ED visits between 2010-2015. In terms of sociodemographics, whites had higher rates of opioid OD as a proportion of ED visits than blacks and Hispanics, however, the rate of increase was higher in Hispanics compared to blacks or whites, p<0.001. This association persisted in adjusted analysis, with Hispanics having an 18% and 8% steeper increase in risk of opioid OD than blacks and whites, respectively. Geographically, upstate NY had higher opioid OD rates than New York City (Brooklyn), p<0.001, but the rate of increase did not differ by region. Regarding behavioral health, areas with higher rates of ED visits for mood, anxiety, or alcohol use disorders experienced greater rates of opioid-related OD. Conclusions: These data highlight the importance of geographic and racial-ethnic differences in opioid-related OD trends which require place-based public health strategies. Mental health significantly contributes to opioid-related OD and calls for integrated prevention and treatment for behavioral health conditions that may be facilitated in ED settings.

Period	Nov 2 2019 → Nov 6 2019
Event title	American Public Health Association Annual Conference: Creating the Healthiest Nation: For science. For action. For health
Event type	Conference
Location	Philadelphia, United States
Degree of Recognition	National