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Socioeconomic Disparities in Perinatal Substance Use Emergency Department Visits Before and During COVID-19

Ana Daniela González-Alvarez1, Sidath Kapukotuwa1, Larry Hurst1

  • 1School of Public Health, University of Nevada Las Vegas, Las Vegas, Nevada, USA.

Journal of Women'S Health (2002)
|August 22, 2025
PubMed

Insights

The COVID-19 pandemic increased alcohol and cannabis use among pregnant individuals, altering existing racial and insurance disparities. Targeted public health strategies are crucial for addressing substance use during pregnancy, especially amid societal disruptions.

Area of Science:

  • Public Health
  • Maternal Health
  • Substance Use Research

Background:

  • Substance use during pregnancy poses significant risks to maternal and fetal well-being.
  • The COVID-19 pandemic may have influenced substance use patterns and exacerbated existing health disparities among pregnant individuals.

Purpose of the Study:

  • To analyze emergency department visit trends for pregnant individuals with substance use (opioids, cannabis, alcohol, nicotine) from 2019-2021.
  • To assess pandemic-related changes and disparities in substance use by race/ethnicity and insurance status.

Main Methods:

  • Utilized Nationwide Emergency Department Sample data from 2019-2021.
  • Employed a difference-in-differences analysis to evaluate pandemic impacts.
  • Examined substance use (opioids, cannabis, alcohol, nicotine) among pregnant individuals.

Main Results:

  • Alcohol use-related emergency visits increased by 16% and cannabis use by 10% during the pandemic.
  • Pre-pandemic disparities showed higher opioid use in Native American and higher cannabis/nicotine use in African American individuals.
  • Pandemic saw narrowed cannabis use disparities for Hispanic and Native American individuals; uninsured and Medicaid patients consistently had higher odds of opioid, cannabis, and nicotine use.

Conclusions:

  • The pandemic correlated with increased alcohol and cannabis use during pregnancy.
  • Shifting racial and insurance disparities in substance use were observed.
  • Targeted public health interventions are necessary to address substance use in pregnant populations, particularly during societal disruptions.

Keywords:
COVID-19disparityemergency departmentpregnancysocioeconomicsubstance use

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