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The spatio-temporal distribution of naloxone administration events in rural Ohio 2010-16.
Drug and Alcohol Dependence ( IF 4.2 ) Pub Date : 2020-02-29 , DOI: 10.1016/j.drugalcdep.2020.107950
Holly Thurston 1 , Bridget Freisthler 2
Affiliation  

INTRODUCTION In 2017, Ohio had the second highest rate of drug overdose deaths in the United States. Current opioid related epidemiologic literature has begun to uncover the environmental level influences on the opioid epidemic and how the end results may ultimately manifest over space and time. This work is still nascent however, with most clustering research conducted at a spatial unit such as county level, which (1) can obscure differences between urban and rural communities, (2) does not consider dynamics that cross county lines, and (3) is difficult to interpret directly into strategic and localized intervention efforts. We address this gap by describing, at the Census block level, the spatial-temporal clustering of opioid related events in rural Ohio. METHODS We use the outcome of the administration of naloxone emergency medical service (EMS) calls in rural Ohio Census blocks during 2010-16 in a Poisson model of spatial scan statistics. RESULTS We found that naloxone event clustering in rural Ohio in the recent decade was widely dispersed over time and space, with clusters that average 17 times the risk of having an event compared to areas outside the cluster. Many of the larger spatial clusters crossed administrative boundaries (i.e., county lines) suggesting that opioid misuse may be less responsive to county level policies than to other factors. DISCUSSION Timely identification of localized overdose event clustering can guide affected communities toward rapid interventions aimed at minimizing the morbidity and mortality resulting from contagious opioid misuse.

中文翻译:

俄亥俄州农村地区纳洛酮给药事件的时空分布2010-16。

引言2017年,俄亥俄州的药物过量死亡率是美国第二高。当前与阿片类药物有关的流行病学文献已开始揭示环境水平对阿片类药物流行的影响以及最终结果如何随时间和空间最终显现。但是,这项工作仍处于起步阶段,大多数聚类研究都是在诸如县级这样的空间单位上进行的,该研究(1)可以掩盖城乡社区之间的差异,(2)不考虑跨越县界的动态,以及(3)很难直接解释为战略性和局部干预措施。我们通过在人口普查区块水平上描述俄亥俄州农村地区阿片类药物相关事件的时空聚集来解决这一差距。方法我们在空间扫描统计的Poisson模型中,使用2010-16年俄亥俄州俄亥俄州人口普查区的纳洛酮紧急医疗服务(EMS)呼叫的管理结果。结果我们发现,近十年来,俄亥俄州农村地区的纳洛酮事件聚类在时间和空间上广泛分散,与该聚类外的区域相比,该聚类的平均发生事件的风险是其17倍。许多较大的空间集群都跨越了行政边界(即县线),这表明阿片类药物滥用可能对县级政策的反应要比对其他因素的响应要少。讨论及时识别局部用药过量事件聚类可以指导受影响的社区采取快速干预措施,以最大程度地减少因接触性阿片类药物滥用引起的发病率和死亡率。
更新日期:2020-03-02
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