Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA.
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.
Drug Alcohol Depend. 2019 Apr 1;197:49-55. doi: 10.1016/j.drugalcdep.2018.12.024. Epub 2019 Feb 12.
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.
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.
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).
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.
据认为，社会服务福利发放的时间与药物过量致死人数的增加有关。然而，尚未研究这种额外死亡人数是否集中在福利领取水平较高的社区。我们试图研究邻里层面的福利领取是否与过量死亡的时空模式有关。
我们对 2014 年至 2016 年期间在罗德岛记录的所有意外药物过量死亡进行了回顾性审查（n=838）。过量事件地点被地理编码到普查块组级别。使用空间扫描方法确定月初超额过量死亡的普查块组集群。拟合逻辑回归模型以确定与包含在集群内的普查块组相关的特征。
与前一个月结束时相比，月初的药物过量死亡率较高（比率：1.17；95%置信区间：1.04，1.38）。领取现金公共援助或补充保障收入的居民比例与月初的超额死亡率无关；然而，居住在负担不起住房的居民比例较高（OR：1.42；95%置信区间：1.05，1.91）。
尽管之前有关于福利支票发放和过量的研究，但邻里层面的福利领取与月初过量死亡无关。需要对住房成本负担及其对个人层面的过量死亡风险的影响进行进一步研究。
