Nesoff Elizabeth D, Morrison Christopher, Wiebe Douglas J, Martins Silvia S
Department of Biostatistics, Epidemiology & Informatics, University of Pennsylvania Perelman School of Medicine.
Department of Epidemiology, Columbia University Mailman School of Public Health.
Am J Epidemiol. 2025 Jul 14. doi: 10.1093/aje/kwaf152.
To explore associations between physical and social neighborhood factors and fatal opioid overdose, we remotely visited 2018-2019 fatal opioid overdose locations in New York City (n=2867) and Chicago (n=1677) via Google Street View and used a reliable and valid tool to assess 65 street block characteristics. We compared these locations to a proportional sample of blocks with no 2018-2019 overdoses (New York City n=2093; Chicago n=1148). We used logistic regression to explore associations between block characteristics and odds of an overdose event, controlling for neighborhood-level covariates (poverty, segregation). For both cities, blocks had significantly increased odds (p<0.05) of being overdose case sites if they had apartment buildings, bus stops, street trash, traffic calming features, and warning signs. New York City blocks also had significantly increased overdose odds if they had multifamily homes, commercial businesses, poor sidewalk maintenance, and loitering, and significantly decreased odds if they had single family homes, row homes, and security alarm signs. Chicago blocks with significantly increased overdose odds had vacant lots, abandoned buildings, alleys, restaurants, and adults on the street and significantly decreased odds with landscaping. Findings support neighborhood social and physical characteristics as important risk factors for fatal opioid overdose over and above sociodemographics.
为了探究邻里的物理和社会因素与致命阿片类药物过量之间的关联，我们通过谷歌街景远程访问了纽约市（n = 2867）和芝加哥（n = 1677）2018 - 2019年致命阿片类药物过量事件发生地点，并使用一种可靠且有效的工具评估了65个街区的特征。我们将这些地点与2018 - 2019年无过量用药事件的街区的比例样本进行了比较（纽约市n = 2093；芝加哥n = 1148）。我们使用逻辑回归来探究街区特征与过量用药事件发生几率之间的关联，并控制邻里层面的协变量（贫困、隔离）。对于这两个城市而言，如果街区有公寓楼、公交站、街道垃圾、交通缓和设施和警示标志，那么其成为过量用药案例地点的几率会显著增加（p < 0.05）。纽约市的街区如果有多户住宅、商业企业、人行道维护不佳和有人闲逛，过量用药几率也会显著增加；如果有独栋住宅、联排住宅和安全警报标志，则几率会显著降低。芝加哥街区过量用药几率显著增加的情况包括有闲置地块、废弃建筑、小巷、餐馆以及街上有成年人，而有景观美化则几率显著降低。研究结果支持邻里的社会和物理特征是致命阿片类药物过量的重要风险因素，且超出了社会人口统计学因素的影响。
