Department of Kinesiology, University of Texas at Arlington, Arlington, TX 76019, USA.
School of Social Work, Arizona State University, Phoenix, AZ 85008, USA.
Int J Environ Res Public Health. 2022 Dec 5;19(23):16261. doi: 10.3390/ijerph192316261.
We aimed at examining whether county-level economic changes were associated with changes in county-level drug mortality rates since the Great Recession and whether the association is equally distributed across major sociodemographic subgroups. Using the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (2004-2019), combined with census data, we conducted fixed effects analyses by including county-level economic changes as primary exposures and county-level drug-related mortality rates (per 100,000 people) from 2004-2007 (i.e., prior to the recession) to 2008-2011, 2012-2015, and 2016-2019 as an outcome variable based on 1833 counties. Our findings showed that drug mortality rates increased from 13.9 (2004-2007) to 16.0 (2008-2011), 18.0 (2012-2015), and 23.0 (2016-2019). Counties experiencing smaller median household income growth during and/or after the recession were associated with greater increase in drug mortality than counties experiencing larger median household income growth among the total population and all sociodemographic subgroups. Counties experiencing larger increases in unemployment rates and percentage of vacant housing units were associated with greater increase in drug mortality than counties experiencing smaller or no increase in unemployment rates and percentage of vacant housing units among certain sociodemographic subgroups. Findings suggest the importance of local economic contexts in understanding drug mortality risk since the recession. Drug overdose prevention polices need to be formulated by taking local economic changes following a major recession into consideration.
我们旨在研究自大衰退以来，县级经济变化是否与县级药物死亡率的变化有关，以及这种关联是否在主要社会人口统计学亚组中均匀分布。使用疾病控制和预防中心的广泛在线流行病学研究数据（2004-2019 年），结合人口普查数据，我们通过包括县级经济变化作为主要暴露因素，并将 2004-2007 年（即衰退前）至 2008-2011 年、2012-2015 年和 2016-2019 年的每 10 万人的县级药物相关死亡率（作为因变量），对 1833 个县进行了固定效应分析。我们的研究结果表明，药物死亡率从 13.9（2004-2007 年）上升到 16.0（2008-2011 年）、18.0（2012-2015 年）和 23.0（2016-2019 年）。在衰退期间和/或之后经历中等家庭收入增长较小的县与经历中等家庭收入增长较大的县相比，药物死亡率的增长更大，在所有社会人口统计学亚组中都是如此。与失业率和空置房屋单元百分比增长较小或没有增长的县相比，失业率和空置房屋单元百分比增长较大的县的药物死亡率增长更大，在某些社会人口统计学亚组中也是如此。研究结果表明，地方经济背景在理解衰退后药物死亡率风险方面的重要性。需要制定药物过量预防政策，考虑到大衰退后地方经济的变化。
