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Suspected heroin-related overdoses incidents in Cincinnati, Ohio: A spatiotemporal analysis.
PLOS Medicine ( IF 10.5 ) Pub Date : 2019-11-12 , DOI: 10.1371/journal.pmed.1002956 Zehang Richard Li 1 , Evaline Xie 2 , Forrest W Crawford 1, 3, 4, 5 , Joshua L Warren 1 , Kathryn McConnell 6 , J Tyler Copple 7 , Tyler Johnson 7 , Gregg S Gonsalves 7, 8
PLOS Medicine ( IF 10.5 ) Pub Date : 2019-11-12 , DOI: 10.1371/journal.pmed.1002956 Zehang Richard Li 1 , Evaline Xie 2 , Forrest W Crawford 1, 3, 4, 5 , Joshua L Warren 1 , Kathryn McConnell 6 , J Tyler Copple 7 , Tyler Johnson 7 , Gregg S Gonsalves 7, 8
Affiliation
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BACKGROUND
Opioid misuse and deaths are increasing in the United States. In 2017, Ohio had the second highest overdose rates in the US, with the city of Cincinnati experiencing a 50% rise in opioid overdoses since 2015. Understanding the temporal and geographic variation in overdose emergencies may help guide public policy responses to the opioid epidemic.
METHODS AND FINDINGS
We used a publicly available data set of suspected heroin-related emergency calls (n = 6,246) to map overdose incidents to 280 census block groups in Cincinnati between August 1, 2015, and January 30, 2019. We used a Bayesian space-time Poisson regression model to examine the relationship between demographic and environmental characteristics and the number of calls within block groups. Higher numbers of heroin-related incidents were found to be associated with features of the built environment, including the proportion of parks (relative risk [RR] = 2.233; 95% credible interval [CI]: [1.075-4.643]), commercial (RR = 13.200; 95% CI: [4.584-38.169]), manufacturing (RR = 4.775; 95% CI: [1.958-11.683]), and downtown development zones (RR = 11.362; 95% CI: [3.796-34.015]). The number of suspected heroin-related emergency calls was also positively associated with the proportion of male population, the population aged 35-49 years, and distance to pharmacies and was negatively associated with the proportion aged 18-24 years, the proportion of the population with a bachelor's degree or higher, median household income, the number of fast food restaurants, distance to hospitals, and distance to opioid treatment programs. Significant spatial and temporal heterogeneity in the risks of incidents remained after adjusting for covariates. Limitations of this study include lack of information about the nature of incidents after dispatch, which may differ from the initial classification of being related to heroin, and lack of information on local policy changes and interventions.
CONCLUSIONS
We identified areas with high numbers of reported heroin-related incidents and features of the built environment and demographic characteristics that are associated with these events in the city of Cincinnati. Publicly available information about opiate overdoses, combined with data on spatiotemporal risk factors, may help municipalities plan, implement, and target harm-reduction measures. In the US, more work is necessary to improve data availability in other cities and states and the compatibility of data from different sources in order to adequately measure and monitor the risk of overdose and inform health policies.
中文翻译：
俄亥俄州辛辛那提疑似海洛因相关过量事件：时空分析。
背景技术 在美国，阿片类药物滥用和死亡人数正在增加。2017 年，俄亥俄州的用药过量率位居美国第二，其中辛辛那提市的阿片类药物过量用药自 2015 年以来增加了 50%。了解过量紧急情况的时间和地理变化可能有助于指导公共政策应对阿片类药物流行病。方法和结果我们使用了疑似海洛因相关紧急呼叫的公开数据集（n = 6,246）将过量事件映射到2015年8月1日至2019年1月30日期间辛辛那提的280个人口普查街区组。我们使用贝叶斯空间-时间泊松回归模型，用于检查人口和环境特征与块组内呼叫数量之间的关系。研究发现，海洛因相关事件的数量较多与建筑环境的特征有关，包括公园的比例（相对风险 [RR] = 2.233；95% 可信区间 [CI]：[1.075-4.643]）、商业（ RR = 13.200；95% CI：[4.584-38.169]）、制造业（RR = 4.775；95% CI：[1.958-11.683]）和市中心开发区（RR = 11.362；95% CI：[3.796-34.015] ）。疑似海洛因相关紧急呼叫数量还与男性人口比例、35-49岁人口比例、到药店的距离呈正相关，与18-24岁人口比例、人口比例呈负相关。拥有学士学位或更高学位、家庭收入中位数、快餐店数量、距医院的距离以及距阿片类药物治疗项目的距离。调整协变量后，事件风险仍然存在显着的空间和时间异质性。这项研究的局限性包括缺乏有关调度后事件性质的信息（这可能与与海洛因相关的最初分类不同），以及缺乏有关当地政策变化和干预措施的信息。结论 我们确定了辛辛那提市海洛因相关事件报告数量较多的地区以及与这些事件相关的建筑环境特征和人口特征。有关阿片类药物过量的公开信息，结合时空风险因素的数据，可能有助于市政当局规划、实施和确定减少危害的措施。在美国，需要开展更多工作来提高其他城市和州的数据可用性以及不同来源数据的兼容性，以便充分衡量和监测用药过量风险并为卫生政策提供信息。
更新日期：2019-12-03
中文翻译：
俄亥俄州辛辛那提疑似海洛因相关过量事件：时空分析。
背景技术 在美国，阿片类药物滥用和死亡人数正在增加。2017 年，俄亥俄州的用药过量率位居美国第二，其中辛辛那提市的阿片类药物过量用药自 2015 年以来增加了 50%。了解过量紧急情况的时间和地理变化可能有助于指导公共政策应对阿片类药物流行病。方法和结果我们使用了疑似海洛因相关紧急呼叫的公开数据集（n = 6,246）将过量事件映射到2015年8月1日至2019年1月30日期间辛辛那提的280个人口普查街区组。我们使用贝叶斯空间-时间泊松回归模型，用于检查人口和环境特征与块组内呼叫数量之间的关系。研究发现，海洛因相关事件的数量较多与建筑环境的特征有关，包括公园的比例（相对风险 [RR] = 2.233；95% 可信区间 [CI]：[1.075-4.643]）、商业（ RR = 13.200；95% CI：[4.584-38.169]）、制造业（RR = 4.775；95% CI：[1.958-11.683]）和市中心开发区（RR = 11.362；95% CI：[3.796-34.015] ）。疑似海洛因相关紧急呼叫数量还与男性人口比例、35-49岁人口比例、到药店的距离呈正相关，与18-24岁人口比例、人口比例呈负相关。拥有学士学位或更高学位、家庭收入中位数、快餐店数量、距医院的距离以及距阿片类药物治疗项目的距离。调整协变量后，事件风险仍然存在显着的空间和时间异质性。这项研究的局限性包括缺乏有关调度后事件性质的信息（这可能与与海洛因相关的最初分类不同），以及缺乏有关当地政策变化和干预措施的信息。结论 我们确定了辛辛那提市海洛因相关事件报告数量较多的地区以及与这些事件相关的建筑环境特征和人口特征。有关阿片类药物过量的公开信息，结合时空风险因素的数据，可能有助于市政当局规划、实施和确定减少危害的措施。在美国，需要开展更多工作来提高其他城市和州的数据可用性以及不同来源数据的兼容性，以便充分衡量和监测用药过量风险并为卫生政策提供信息。
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