The ecology of overdose mortality in Philadelphia.

Fatal drug overdose represents a significant public health threat in Philadelphia, but substantial variation exists across its communities. This study uses negative binomial longitudinal regression to model ZIP code overdose fatalities over a seven-year period. Model covariates indicate that structural inequality, police arrest activity, and features of the built environment are associated with increased mortality across ZIP codes. Additionally, fatalities are spatially concentrated in select geographies of the city. These findings emphasize the pertinence of community ecological features in the production of stratified within-city health outcomes, and inform the geographic distribution of harm reduction interventions.