阿片类药物处方率与经证实的儿童虐待和忽视风险：贝叶斯时空分析。
Opioid prescription rates and risk for substantiated child abuse and neglect: A Bayesian spatiotemporal analysis.
机构信息
Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.
Department of Social Psychology and Methodology, Autonomous University of Madrid, Madrid, Spain.
出版信息
Drug Alcohol Depend. 2019 Dec 1;205:107623. doi: 10.1016/j.drugalcdep.2019.107623. Epub 2019 Oct 17.
OBJECTIVES
To determine the association between opioid prescribing rates and substantiated abuse and neglect across Tennessee counties during an 11-year period.
METHODS
We adopted a Bayesian spatiotemporal approach to determine the association between opioid prescribing and rates of substantiated child abuse and neglect over and above environmental and population-level covariates. Annual county-level data for Tennessee (2006-2016) included rates of substantiated child abuse and neglect, rates of drug and non-drug crime incidents, racial and Hispanic composition, per capita income, child poverty and teen birth rates, and vacant housing.
RESULTS
Higher opioid prescribing rates were associated with greater risk for substantiated child abuse and neglect across Tennessee counties. Risk for substantiated child abuse and neglect was positively associated with vacant housing, child poverty, teen birth rates, and rates of both drug and non-drug criminal incidents - including stimulant arrests. Risk for substantiated child abuse and neglect was negatively associated with percentages of African Americans.
CONCLUSIONS
Results underscore the importance of opioid prescribing and crime rates as independent determinants of spatial and temporal variation in risk for substantiated child abuse and neglect. Policies that regulate and reduce opioid prescribing have the potential to reduce risk for child abuse and neglect.
目的
在 11 年期间，确定田纳西州各县阿片类药物处方率与经证实的滥用和忽视之间的关联。
方法
我们采用贝叶斯时空方法，确定阿片类药物处方与经证实的儿童虐待和忽视率之间的关联，超过了环境和人口水平的协变量。田纳西州（2006-2016 年）的年度县一级数据包括经证实的儿童虐待和忽视率、药物和非药物犯罪事件率、种族和西班牙裔构成、人均收入、儿童贫困和青少年出生率以及空置住房率。
结果
田纳西州各县阿片类药物处方率较高与经证实的儿童虐待和忽视风险增加有关。经证实的儿童虐待和忽视风险与空置住房、儿童贫困、青少年出生率以及药物和非药物犯罪事件（包括兴奋剂逮捕）率呈正相关。经证实的儿童虐待和忽视风险与非裔美国人的百分比呈负相关。
结论
研究结果强调了阿片类药物处方和犯罪率作为经证实的儿童虐待和忽视风险的空间和时间变化的独立决定因素的重要性。规范和减少阿片类药物处方的政策有可能降低儿童虐待和忽视的风险。
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