Suspected heroin-related overdoses incidents in Cincinnati, Ohio: A spatiotemporal analysis
Open Access
- 12 November 2019
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLoS Medicine
- Vol. 16 (11), e1002956
- https://doi.org/10.1371/journal.pmed.1002956
Abstract
Opioid misuse and deaths are increasing in the United States. In 2017, Ohio had the second highest overdose rates in the US, with the city of Cincinnati experiencing a 50% rise in opioid overdoses since 2015. Understanding the temporal and geographic variation in overdose emergencies may help guide public policy responses to the opioid epidemic. We used a publicly available data set of suspected heroin-related emergency calls (n = 6,246) to map overdose incidents to 280 census block groups in Cincinnati between August 1, 2015, and January 30, 2019. We used a Bayesian space-time Poisson regression model to examine the relationship between demographic and environmental characteristics and the number of calls within block groups. Higher numbers of heroin-related incidents were found to be associated with features of the built environment, including the proportion of parks (relative risk [RR] = 2.233; 95% credible interval [CI]: [1.075–4.643]), commercial (RR = 13.200; 95% CI: [4.584–38.169]), manufacturing (RR = 4.775; 95% CI: [1.958–11.683]), and downtown development zones (RR = 11.362; 95% CI: [3.796–34.015]). The number of suspected heroin-related emergency calls was also positively associated with the proportion of male population, the population aged 35–49 years, and distance to pharmacies and was negatively associated with the proportion aged 18–24 years, the proportion of the population with a bachelor's degree or higher, median household income, the number of fast food restaurants, distance to hospitals, and distance to opioid treatment programs. Significant spatial and temporal heterogeneity in the risks of incidents remained after adjusting for covariates. Limitations of this study include lack of information about the nature of incidents after dispatch, which may differ from the initial classification of being related to heroin, and lack of information on local policy changes and interventions. We identified areas with high numbers of reported heroin-related incidents and features of the built environment and demographic characteristics that are associated with these events in the city of Cincinnati. Publicly available information about opiate overdoses, combined with data on spatiotemporal risk factors, may help municipalities plan, implement, and target harm-reduction measures. In the US, more work is necessary to improve data availability in other cities and states and the compatibility of data from different sources in order to adequately measure and monitor the risk of overdose and inform health policies.Funding Information
- National Institute on Drug Abuse (1DP2DA49282-01)
- National Institute on Drug Abuse (2R37DA015612-16)
- National Institute of Mental Health (5R01MH105203-04)
- National Institute of Child Health and Human Development (1DP2HD091799-01)
This publication has 34 references indexed in Scilit:
- Drug use in business bathrooms: An exploratory study of manager encounters in New York CityInternational Journal of Drug Policy, 2016
- Neighborhood-Level and Spatial Characteristics Associated with Lay Naloxone Reversal Events and Opioid Overdose DeathsJournal of Urban Health, 2016
- Relationship between Nonmedical Prescription-Opioid Use and Heroin UseThe New England Journal of Medicine, 2016
- A spatial analysis of the physical and social environmental correlates of discarded needlesHealth & Place, 2011
- Policing and risk of overdose mortality in urban neighborhoodsDrug and Alcohol Dependence, 2011
- Approximate Bayesian Inference for Latent Gaussian models by using Integrated Nested Laplace ApproximationsJournal of the Royal Statistical Society Series B: Statistical Methodology, 2009
- Spatial Analytic Approaches to Explaining the Trends and Patterns of Drug Overdose DeathsPublished by Springer Science and Business Media LLC ,2008
- The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational StudiesAnnals of Internal Medicine, 2007
- Disease mapping and spatial regression with count dataBiostatistics, 2006
- Bayesian image restoration, with two applications in spatial statisticsAnnals of the Institute of Statistical Mathematics, 1991