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Lopez AA, Luebke JM, Redner R, Abusbaitan H, Tarima S. Substance Use Overdose Deaths Among Black and Indigenous Women in Wisconsin: A Review of Death Certificate Data From 2018 to 2020. J Addict Med 2024; 18:153-159. [PMID: 38180867 PMCID: PMC10939923 DOI: 10.1097/adm.0000000000001260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
Abstract
OBJECTIVES We are in the midst of an overdose epidemic that has grown during the concurrent COVID-19 pandemic. In Wisconsin, overdose deaths increased 11-fold from 2000 to 2020, with over 1200 deaths in 2020. Because of disparities in substance use initiation, relapse, and treatment success among racially minoritized women, this study's purpose was to investigate overdose death rates among Black and Indigenous women in Wisconsin from 2018 to 2020. METHODS Overdose death rates were examined under the following parameters: sex, race (Black, Indigenous, White), age, year, and manner of death. Logistic regression analysis was also conducted looking at death count data, with race, age, and year as potential predictor variables. RESULTS Death rates (per 100,000) in 2018 were 14.1 (12.6-15.5) for White women, 20.8 (14.7-26.9) for Black women, and 26.5 (10.0-42.9) for Indigenous women; these rates increased in 2020 to 16.4 (14.8-17.9), 32.5 (25.0-40.0), and 59.9 (35.8-84.0) for White, Black, and Indigenous women, respectively. Regression findings illustrated that being Black or Indigenous and aged 15 to 44 or 45 to 64 years were significantly more likely to die from most causes of death (any drug, any opioid, prescription opioid, heroin, synthetic opioids, and cocaine; adjusted odds ratios > 1.25, P s < 0.001). CONCLUSIONS This study confirms that deaths in Wisconsin are disproportionately higher in female minoritized populations. Understanding the complex intricacies between the impacts of the COVID-19 pandemic coupled with barriers to treatment access or acceptability in these populations is urgently needed. It will take a multipronged approach to address the overdose epidemic and better serve these marginalized, vulnerable populations.
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Affiliation(s)
- Alexa A. Lopez
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | | | - Ryan Redner
- Behavior Analysis and Therapy, Southern Illinois University, Carbondale, IL, USA
| | - Hanan Abusbaitan
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Sergey Tarima
- Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WI, USA
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Jones A, Santos-Lozada A, Perez-Brumer A, Latkin C, Shoptaw S, El-Bassel N. Age-specific disparities in fatal drug overdoses highest among older black adults and American Indian/Alaska native individuals of all ages in the United States, 2015-2020. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 114:103977. [PMID: 36863284 PMCID: PMC10050114 DOI: 10.1016/j.drugpo.2023.103977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 02/08/2023] [Accepted: 02/14/2023] [Indexed: 03/04/2023]
Abstract
INTRODUCTION Increasing disparities within and between racial/ethnic groups in overdose deaths underscore the need to identify drivers and patterns to optimize overdose prevention strategies. We assess age-specific mortality rates (ASMR) in drug overdose deaths by race/ethnicity in 2015-2019 and 2020. METHODS Data were from the CDC Wonder, and included information for N = 411,451 deceased individuals in the United States (2015-2020) with a drug overdose-attributed cause of death (ICD-10 codes: X40-X44, X60-X64, X85, Y10-Y14). We compiled overdose death counts by age, race/ethnicity, and population estimates to derive ASMRs, mortality rate ratios (MRR), and cohort effects. RESULTS The ASMRs for Non-Hispanic Black adults (2015-2019) followed a different pattern than other racial/ethnic groups-low ASMRs among young individuals and peaking between 55-64 years-a pattern exacerbated in 2020. Younger Non-Hispanic Black individuals had lower MRRs than young Non-Hispanic White individuals, yet, older Non-Hispanic Black adults had much higher MRRs than older Non-Hispanic White adults (45-54yrs:126%, 55-64yrs:197%; 65-74yrs:314%; 75-84:148%) in 2020. American Indian/Alaska Native adults had higher MRRs than Non-Hispanic White adults in death counts compiled from pre-pandemic years (2015-2019); however, MRRs increased in 2020 (15-24yrs:134%, 25-34yrs:132%, 35-44yrs:124%, 45-54yrs:134%, 55-64yrs:118%). Cohort analyses suggested a bimodal distribution of increasing fatal overdose rates among Non-Hispanic Black individuals aged 15-24 and 65-74. CONCLUSIONS AND RELEVANCE Overdose fatalities unprecedently impact older Non-Hispanic Black adults and American Indian/Alaska Native populations of all ages, deviating from the pattern found for Non-Hispanic White individuals. Findings highlight the need for targeted naloxone and low-threshold buprenorphine programs to reduce racial disparities.
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Affiliation(s)
- Abenaa Jones
- Department of Human Development and Family Studies, Pennsylvania State University, USA.
| | - Alexis Santos-Lozada
- Department of Human Development and Family Studies, Pennsylvania State University, USA
| | | | - Carl Latkin
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, USA
| | - Steve Shoptaw
- Department of Family Medicine, David Geffen School of Medicine, University of California Los Angeles, USA
| | - Nabila El-Bassel
- Social Intervention Group, Columbia University School of Social Work, USA
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3
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O'Connell KL, Jacobson SV, Ton AT, Law KC. Association between race and socioeconomic factors and suicide-related 911 call rate. Soc Sci Med 2022; 306:115106. [PMID: 35700551 DOI: 10.1016/j.socscimed.2022.115106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 05/03/2022] [Accepted: 05/31/2022] [Indexed: 11/26/2022]
Abstract
The American 911 emergency call system fulfills a unique role in preventing suicide and is universally available to all residents suffering a mental health crisis. Previous studies have found disparities between socioeconomic and racial groups in mental health treatment and in help-seeking behaviors. However, very few studies have analyzed disparities in the use of the 911 system for mental health or suicidal crises. The present study conducted negative binomial regression analyses to determine if an increase in suicide-related 911 call rate is associated with race and socioeconomic characteristics in Western King County, Washington. We used the geographic locations of 4823 suicide-related calls from January 2019 to June 2020 to contrast against 2019 demographic data from the Census Bureau. We found increased percentage of Black, Indigenous and People of Color (BIPOC), residents relying on private health insurance, and lower education levels were associated with a decreased suicide-related 911 call rate. We found residents relying on public health insurance to be associated with an increased suicide-related 911 call rate. Future research should explore how residents use 911 in mental health crises to further improve public suicide prevention efforts. Our findings demonstrate how areas with poor health care options may rely more on the 911 system amidst a suicidal crisis.
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Affiliation(s)
| | | | - Andrew T Ton
- Uniformed Services University of the Health Sciences, USA
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Milam AJ, Furr-Holden D, Wang L, Simon KM. Health Data Disparities in Opioid-Involved Overdose Deaths From 1999 to 2018 in the United States. Am J Public Health 2021; 111:1627-1635. [PMID: 34185576 PMCID: PMC8589046 DOI: 10.2105/ajph.2021.306322] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2021] [Indexed: 01/09/2023]
Abstract
Objectives. To examine temporal trends in the classification of opioid-involved overdose deaths (OODs) and racial variation in the classification of specific types of opioids used. Methods. We analyzed OODs coded as other or unspecified narcotics from 1999 to 2018 in the United States using data from the National Vital Statistics System and the Centers for Disease Control and Prevention. Results. The total proportion of OODs from unspecified narcotics decreased from 32.4% in 1999 to 1.9% in 2018. The proportion of OODs from unspecified narcotics among African American persons was approximately 2-fold greater than that of non-Hispanic White persons until 2012. Similarly, the proportion of OODs from unspecified narcotics among Hispanic persons was greater than that of White persons until 2015. After we controlled for death investigation system, African American persons had a higher incidence rate of OODs from unspecified narcotics compared with White persons. Conclusions. There have been significant improvements in the specification OODs over the past 20 years, and there has been significant racial disparity in the classification of OODs until about 2015. The findings suggest a health data disparity; the excessive misclassification of OODs is likely attributable to the race/ethnicity of the decedent.
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Affiliation(s)
- Adam J Milam
- Adam J. Milam is with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, and Anesthesiology Institute, Cleveland Clinic Foundation, Cleveland, OH. Debra Furr-Holden is with the Division of Public Health, College of Human Medicine, Michigan State University, Flint, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health. Ling Wang is with Department of Medicine, College of Human Medicine, Michigan State University, East Lansing. Kevin M. Simon is with Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, and Adolescent Substance Use and Addiction Program, Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA
| | - Debra Furr-Holden
- Adam J. Milam is with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, and Anesthesiology Institute, Cleveland Clinic Foundation, Cleveland, OH. Debra Furr-Holden is with the Division of Public Health, College of Human Medicine, Michigan State University, Flint, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health. Ling Wang is with Department of Medicine, College of Human Medicine, Michigan State University, East Lansing. Kevin M. Simon is with Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, and Adolescent Substance Use and Addiction Program, Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA
| | - Ling Wang
- Adam J. Milam is with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, and Anesthesiology Institute, Cleveland Clinic Foundation, Cleveland, OH. Debra Furr-Holden is with the Division of Public Health, College of Human Medicine, Michigan State University, Flint, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health. Ling Wang is with Department of Medicine, College of Human Medicine, Michigan State University, East Lansing. Kevin M. Simon is with Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, and Adolescent Substance Use and Addiction Program, Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA
| | - Kevin M Simon
- Adam J. Milam is with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, and Anesthesiology Institute, Cleveland Clinic Foundation, Cleveland, OH. Debra Furr-Holden is with the Division of Public Health, College of Human Medicine, Michigan State University, Flint, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health. Ling Wang is with Department of Medicine, College of Human Medicine, Michigan State University, East Lansing. Kevin M. Simon is with Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, and Adolescent Substance Use and Addiction Program, Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA
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Abstract
Inequities and the resulting disparities that exist in mental health for a variety of socially disadvantaged groups have roots in the history and ongoing processes of medical and mental health research, as well as in persisting implicit bias in our society and health care system. The inclusion of historically excluded communities in the research to practice pipeline is vital to ensuring that treatments and interventions are developed to increase equity in mental health. A research framework is proposed based on the integration of community-based participatory research and human-centered design as an avenue for removing inequities and barriers in mental health.
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Affiliation(s)
- Quianta Moore
- Center for Health and Biosciences, Rice University's Baker Institute for Public Policy, 6100 Main Street, MS-40, PO Box 1892, Houston, TX 77251-1892, USA.
| | - Patrick S Tennant
- Center for Health and Biosciences, Rice University's Baker Institute for Public Policy, 6100 Main Street, MS-40, PO Box 1892, Houston, TX 77251-1892, USA. https://twitter.com/Tennant_PS
| | - Lisa R Fortuna
- Zuckerberg San Francisco General Hospital and Trauma Center, University of California San Francisco, 1001 Potrero Avenue, 7M16, UCSF Campus Box 0852, San Francisco, CA 94110, USA. https://twitter.com/fortuna_lisa
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