Olawole Wuraola, Li Guohua, Zhou Ziqi, Wu Zhixing, Chen Qixuan
Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, 10032, USA.
School of Nursing, Johns Hopkins University, Baltimore, MD, 21205, USA.
Inj Epidemiol. 2024 Nov 22;11(1):65. doi: 10.1186/s40621-024-00548-8.
Overdose mortality increased substantially during the COVID-19 pandemic, but it is unclear to what extent the COVID-19 mortality had contributed to this increase at the neighborhood level.
This was an ecological study based on New York City United Hospital Fund (NYC UHF) neighborhood-level data from 2019 to 2021, split into two time-windows: pre-COVID (2019) and during-COVID (2020 and 2021). Linear regression models were used to estimate the effect of cumulative COVID-19 mortality on the increase in drug overdose mortality from the pre-COVD to during-COVID periods at the neighborhood level, with and without adjusting for neighborhood characteristics.
Drug overdose mortality rate increased from 21.3 to 33.4 deaths per 100,000 person-years across NYC UHF neighborhoods from pre-COVID to during-COVID. For each additional COVID-19 death per 1,000 person-years at the neighborhood level, the increase in drug overdose mortality rose 2.4 (95% CI: 1.7, 3.3) times. Furthermore, neighborhoods with a higher percentage of Hispanic residents, a higher percentage of single-person households, and a higher percentage of residents with health insurance experienced significantly larger increases in drug overdose mortality. In contrast, neighborhoods with a higher percentage of residents aged 75 and older had a smaller increase in drug overdose mortality.
NYC neighborhoods with higher cumulative COVID-19 mortality experienced a greater increase in drug overdose mortality during the first two years of the COVID-19 pandemic.
在新冠疫情期间，过量用药死亡率大幅上升，但尚不清楚新冠死亡率在社区层面上对这一增长的贡献程度。
这是一项基于纽约市联合医院基金（NYC UHF）2019年至2021年社区层面数据的生态学研究，分为两个时间窗口：新冠疫情前（2019年）和新冠疫情期间（2020年和2021年）。使用线性回归模型估计社区层面从新冠疫情前到疫情期间，累计新冠死亡率对药物过量死亡率增加的影响，同时调整和不调整社区特征。
在NYC UHF社区中，药物过量死亡率从新冠疫情前的每10万人年21.3例死亡增加到疫情期间的33.4例死亡。在社区层面，每1000人年新增1例新冠死亡，药物过量死亡率的增加就上升2.4（95%CI：1.7，3.3）倍。此外，西班牙裔居民比例较高、单人家庭比例较高以及有医疗保险的居民比例较高的社区，药物过量死亡率的增幅明显更大。相比之下，75岁及以上居民比例较高的社区，药物过量死亡率的增幅较小。
在新冠疫情的头两年，新冠累计死亡率较高的纽约市社区，药物过量死亡率的增幅更大。
