Using a combination of data derived from the U.S. Census Bureau, the Substance Abuse and Mental Health Service Administration’s Behavioral Health Systems Locator and the Boston Police Department’s Incident Reports, this study examines the spatio-temporal distribution of calls for medical assistance following a heroin-related injury between 2015 and 2018. As well, an examination is conducted regarding the accessibility of Health Care Centers (HCCs) in relation to individuals in need of medical assistance. Distance-based measures of spatial association, including nearest neighbor and K-function analysis, were used to determine the clustering of calls at various spatial scales. Structural neighborhood characteristics (i.e., distance to the closest HCC) and physical and social vulnerability were used to predict the rate of calls for a heroin-related injury per 1,000 persons in the city of Boston using a spatial autoregressive model. HCC catchment areas for the set of medical emergency calls were created using Voronoi tessellations. Results showed that the average nearest neighbor distance (NND) of each call for medical assistance was approximately 187 m or .12 miles. Calls for assistance became more probable and increasingly more spatially concentrated over the study period. The K-function analysis revealed that the calls clustered at different spatial scales and in proximity to HCCs. Average distance to the nearest HCC and Household/Disability vulnerability were significantly associated with the census tract call rate per 1,000 persons. The average travel distance between the calls for medical assistance and the nearest HCC was 941 m, or just over a half-mile. Policy implications for the provision, through HCCs, of a focused and comprehensive community-based support system in a large urban city for individuals with serious drug problems are discussed in context.

中文翻译：

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马萨诸塞州波士顿与海洛因有关的紧急医疗服务和社区卫生中心呼叫的时空分析

结合美国人口普查局，药物滥用和心理健康服务管理局的行为健康系统定位器以及波士顿警察局的事件报告得出的数据，本研究调查了与海洛因相关的医疗救助电话的时空分布在2015年至2018年之间造成伤害。此外，还针对需要医疗救助人员的医疗保健中心（HCC）的可及性进行了检查。使用基于距离的空间关联度量（包括最近邻居和K函数分析）来确定各种空间尺度上的呼叫聚类。结构邻里特征（即 距离最近的HCC的距离）以及身体和社会的脆弱性，使用空间自回归模型来预测波士顿市每1000人中与海洛因相关的伤害的发生率。使用Voronoi镶嵌创建了用于医疗急救电话的HCC服务区域。结果表明，每次求助电话的平均最近邻居距离（NND）约为187 m或.12英里。在研究期间，寻求帮助的呼声越来越高，而且在空间上的关注越来越集中。K函数分析表明，这些呼叫聚集在不同的空间尺度上，并且靠近HCC。到最近的HCC和家庭/残障弱点的平均距离与每1000人的人口普查区域呼叫率显着相关。寻求医疗救助与最近的HCC之间的平均行进距离为941 m，或刚刚超过半英里。本文通过背景讨论了在大型城市中通过HCC提供集中和全面的社区支持系统的政策含义。