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Association between county-level sociodemographic characteristics and county-level differences in opioid dispensing
Laura J Cremer1,2, Natasha Underwood1, Amber Robinson1
1Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
County-level poverty, lower education, and lack of health insurance correlate with higher opioid dispensing. Rural areas and minority populations show lower opioid prescribing rates, highlighting the need for targeted overdose prevention strategies.
Area of Science:
- Public Health
- Epidemiology
- Health Services Research
Background:
- Opioid prescribing rates vary significantly across US counties despite overall decreases.
- Social determinants of health are suspected to influence opioid prescribing but haven't been studied at the county level.
- Understanding these county-level factors is crucial for effective opioid prescribing and overdose prevention.
Purpose of the Study:
- To investigate the association between county-level sociodemographic characteristics and opioid dispensing.
- To identify specific economic, social, housing, healthcare, and population factors linked to opioid prescribing variations.
Main Methods:
- Cross-sectional study utilizing data from 2,881 US counties (2017-2018).
- Opioid dispensing measured as morphine milligram equivalents (MME) per capita.
- Spatial error models employed to account for spatial autocorrelation.
Main Results:
- Higher MME per capita associated with increased poverty, lower educational attainment, and lack of health insurance.
- Increased single-parent families, separation/divorce rates, and disability prevalence also linked to higher MME.
- Conversely, minority racial/ethnic composition and rural populations correlated with lower opioid dispensing.
Conclusions:
- County-level sociodemographic factors demonstrate varied associations with opioid dispensing patterns.
- Identifying and addressing specific county-level determinants is essential for improving opioid prescribing practices.
- Tailored overdose prevention strategies addressing these sociodemographic factors are recommended.
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