Geospatial Determinants and Spatial Heterogeneity of Opioid Overdose Mortality in Arizona

The opioid overdose crisis remains a significant public health challenge in the USA. While existing research has established connections between socioeconomic conditions and opioid overdose mortality, relatively limited attention has been given to the spatial heterogeneity of these relationships, particularly at fine geographic scales. This study examines the spatial distribution of opioid overdose mortality in Arizona and assesses how local socioeconomic and healthcare-related factors shape overdose risk. Using 2020 data on opioid overdose deaths, we analyzed mortality patterns across 1765 census tracts in Arizona using multiscale geographically weighted regression (MGWR) and examined spatially varying relationships between overdose mortality rates and a range of socioeconomic and demographic factors. MGWR findings reveal substantial geographic disparities in opioid overdose mortality across Arizona, with several predictors varying spatially in both the direction and magnitude of their associations. The percentage of Black and Hispanic populations was positively associated with overdose mortality at the global level, while the effect of Native American populations was more localized, with strong associations concentrated in suburban Phoenix. Poverty showed spatial clustering effects, with stronger associations observed in central urban tracts, particularly downtown Phoenix. In contrast, the presence of children in households was generally associated with lower mortality, though the strength of this association varied regionally. These findings underscore the critical role of geographic analysis in studying opioid overdose mortality and highlight the need for place-based public health interventions and policies that account for geographic disparities in opioid overdose risk.