Qeadan Fares, Madden Erin F, English Kevin, Venner Kamilla L, Tingey Benjamin, Egbert Jamie, Hipol Feli Anne S
Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL, USA.
Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, USA.
J Racial Ethn Health Disparities. 2024 Aug 14. doi: 10.1007/s40615-024-02084-z.
This study evaluated the prevalence and incidence of opioid use disorder (OUD), rates of opioid overdose (OD), and rates of non-fatal (NF) OD in American Indian/Alaskan Native (AI/AN) populations.
We used de-identified patient data from Oracle Cerner Real-World Data™. Rates were estimated over time, and stratified by sex, age, marital status, insurance, and region. Mann-Kendall trend tests and Theil-Sen slopes assessed changes over time for each group while autoregressive modeling assessed differences between groups.
The study identified trends in OUD and OD among 700,225 AI/AN patients aged 12 and above. Between 2012 and 2022, there was a significant upward trend in both OUD and OD rates (p < 0.05) , with OUD diagnosed in 1.75% and OD in 0.38% of the population. The Western region of the US exhibited the highest rates of OUD and OD. The 35-49 age group showed the highest rates of OUD, while the 12-34 age group had the highest rates of OD. Marital status analysis revealed higher rates of OUD and OD among separated, widowed, or single patients. Additionally, individuals with Medicare or Medicaid insurance demonstrated the highest rates of OUD and OD.
Results show that rates of OUD, OD, and NF OD continue to rise among AI/AN individuals, with some regional and demographic variation. Our study provides foundational estimates of key AI/AN populations bearing greater burdens of opioid-related morbidity that federal, state, and tribal organizations can use to direct and develop targeted resources that can improve the health and well-being of AI/AN communities.
本研究评估了美国印第安人/阿拉斯加原住民(AI/AN)人群中阿片类物质使用障碍(OUD)的患病率和发病率、阿片类物质过量(OD)率以及非致命(NF)OD率。
我们使用了来自甲骨文Cerner真实世界数据™的去识别化患者数据。对一段时间内的比率进行了估计,并按性别、年龄、婚姻状况、保险和地区进行了分层。Mann-Kendall趋势检验和Theil-Sen斜率评估了每组随时间的变化,而自回归模型评估了组间差异。
该研究确定了700225名12岁及以上AI/AN患者中OUD和OD的趋势。2012年至2022年期间,OUD和OD率均呈显著上升趋势(p<0.05),人群中OUD诊断率为1.75%,OD率为0.38%。美国西部地区的OUD和OD率最高。35 - 49岁年龄组的OUD率最高,而12 - 34岁年龄组的OD率最高。婚姻状况分析显示,分居、丧偶或单身患者的OUD和OD率更高。此外,拥有医疗保险或医疗补助保险的个体的OUD和OD率最高。
结果表明,AI/AN个体中OUD、OD和NF OD率持续上升,存在一些地区和人口统计学差异。我们的研究提供了关键AI/AN人群的基础估计数据,这些人群承受着更大的阿片类物质相关发病负担,联邦、州和部落组织可利用这些数据来指导和开发有针对性的资源,以改善AI/AN社区的健康和福祉。