Department of Economics, Finance and Quantitative Analysis, Michael J. Coles College of Business, Kennesaw State University, 560 Parliament Garden Way, Kennesaw, GA, 30144, USA.
Department of Management, H. Wayne Huizenga College of Business and Entrepreneurship, Nova Southeastern University, 3301 College Ave, Davie, FL, 33314, USA.
J Racial Ethn Health Disparities. 2021 Dec;8(6):1395-1405. doi: 10.1007/s40615-020-00901-9. Epub 2020 Nov 2.
To examine the role of individual race/ethnicity and community racial/ethnic mix on the type of opioid-related emergency department (ED) visits in Florida.
The study identifies opioid-related ED visits that involved heroin, non-heroin poisoning, and opioid use disorder (OUD) from the first quarter of 2010 to the second quarter of 2018 in Florida. The trend is depicted by patients' race/ethnicity and racial/ethnic mix of residential communities. Combined with zip code tabulation area data, the study builds a multilevel model and examines how individual-level and community-level covariates relate to the type of opioid-related ED visits.
While opioid-related ED visit rate was highest among white patients, majority-black communities caught up with the majority-white communities in the visit rate. The multilevel model results suggest that the likelihood of an opioid-related ED visit involving heroin, non-heroin poisoning, or OUD differed by patient race/ethnicity as well as community racial/ethnic mix. Opioid-related ED visits among minority patients were more likely to involve non-heroin poisoning than non-Hispanic white patients, whereas patients from minority-dominant communities were more likely to involve heroin poisoning than from majority-white communities. However, community racial/ethnic mix was not significantly or less significantly associated with the likelihood of involving OUD ED visits.
The study highlights the heterogeneity of the opioid overdose problem across racial/ethnic patients and communities with different racial/ethnic mixes. Future policies may consider the effect of living in different racial/ethnic mixed communities in addition to individual race/ethnicity.
研究个体种族/民族和社区种族/民族构成对佛罗里达州阿片类药物相关急诊就诊类型的影响。
本研究从 2010 年第一季度到 2018 年第二季度,确定了佛罗里达州与海洛因、非海洛因中毒和阿片类药物使用障碍(OUD)相关的急诊就诊。患者的种族/民族和居住社区的种族/民族构成描绘了这一趋势。结合邮政编码区数据,本研究构建了一个多层次模型,并研究了个体层面和社区层面的协变量与阿片类药物相关急诊就诊类型的关系。
虽然阿片类药物相关急诊就诊率在白人患者中最高,但以黑人为主的社区在就诊率上赶上了以白人为主的社区。多层次模型结果表明,阿片类药物相关急诊就诊涉及海洛因、非海洛因中毒或 OUD 的可能性因患者的种族/民族以及社区的种族/民族构成而有所不同。少数族裔患者的阿片类药物相关急诊就诊更可能涉及非海洛因中毒,而非西班牙裔白人患者,而来自少数族裔为主的社区的患者比来自以白人为主的社区更有可能涉及海洛因中毒。然而,社区种族/民族构成与 OUD 急诊就诊的可能性没有显著或不太显著相关。
本研究强调了不同种族/民族患者和不同种族/民族构成社区之间阿片类药物过量问题的异质性。未来的政策可能需要考虑居住在不同种族/民族混合社区对个人的影响,除了个人的种族/民族。