Center for Health Systems Analytics, UTHealth Houston School of Biomedical Informatics, Houston, TX 77030, USA.
Int J Environ Res Public Health. 2022 Oct 24;19(21):13796. doi: 10.3390/ijerph192113796.
Prior to the COVID-19 pandemic, the United States was facing an epidemic of opioid overdose deaths, clouding accurate inferences about the impact of the pandemic at the population level. We sought to determine the existence of increases in the trends of opioid-related overdose (ORO) deaths in the Greater Houston metropolitan area from January 2015 through December 2021, and to describe the social vulnerability present in the geographic location of these deaths. We merged records from the county medical examiner's office with social vulnerability indexes (SVIs) for the region and present geospatial locations of the aggregated ORO deaths. Time series analyses were conducted to determine trends in the deaths, with a specific focus on the years 2019 to 2021. A total of 2660 deaths were included in the study and the mean (standard deviation, SD) age at death was 41.04 (13.60) years. Heroin and fentanyl were the most frequent opioids detected, present in 1153 (43.35%) and 1023 (38.46%) ORO deaths. We found that ORO deaths increased during the years 2019 to 2021 (-value ≤ 0.001) when compared with 2015. Compared to the year 2019, ORO deaths increased for the years 2020 and 2021 (-value ≤ 0.001). The geographic locations of ORO deaths were not associated with differences in the SVI. The COVID-19 pandemic had an impact on increasing ORO deaths in the metropolitan Houston area; however, identifying the determinants to guide targeted interventions in the areas of greatest need may require other factors, in addition to community-level social vulnerability parameters.
在 COVID-19 大流行之前，美国正面临阿片类药物过量死亡的流行，这使得人们难以准确推断大流行对人群的影响。我们试图确定 2015 年 1 月至 2021 年 12 月期间休斯顿大都市区阿片类药物相关过量用药（ORO）死亡趋势是否增加，并描述这些死亡地点的社会脆弱性。我们将县法医办公室的记录与该地区的社会脆弱性指数（SVI）合并，并呈现聚集的 ORO 死亡的地理空间位置。我们进行了时间序列分析，以确定死亡趋势，特别关注 2019 年至 2021 年。研究共纳入 2660 例死亡，死亡时的平均（标准差，SD）年龄为 41.04（13.60）岁。海洛因和芬太尼是最常见的阿片类药物，在 1153（43.35%）和 1023（38.46%）例 ORO 死亡中被检出。我们发现，与 2015 年相比，2019 年至 2021 年 ORO 死亡人数增加（-值≤0.001）。与 2019 年相比，2020 年和 2021 年 ORO 死亡人数增加（-值≤0.001）。ORO 死亡的地理位置与 SVI 没有差异。COVID-19 大流行对休斯顿大都市区 ORO 死亡人数的增加产生了影响；然而，要确定指导最需要地区的有针对性干预措施的决定因素，可能需要除社区级社会脆弱性参数之外的其他因素。
