Rethinking urban-rural designations in public health surveillance of the overdose crisis and crafting an agenda for future monitoring.

Journal: The International journal on drug policy

Volume: 118

Issue: 

Year of Publication: 2023

Affiliated Institutions:  University of California Los Angeles, Medical Scientist Training Program; UCLA Department of Anthropology; Center for Social Medicine, Department of Psychiatry, UCLA, Westwood Plaza Suite B-, Los Angeles, CA, -. Electronic address: laurentextor@gmail.com. University of California Los Angeles, Medical Scientist Training Program. Center for Social Medicine, Department of Psychiatry, UCLA, Westwood Plaza Suite B-, Los Angeles, CA, -. University of Pennsylvania School of Nursing. National Survivors Union, Grove St., Greensboro, NC, ; Whose Corner Is It Anyway, Northampton St., Holyoke, MA, ; NC Survivors Union, Grove St., Greensboro, NC, . Centre d'Étude des Mouvements Sociaux (Inserm U/CNRS UMR /EHESS), Paris, France. Department of Mental Health Faculty of Medicine Gulu University, P.o.Box , Gulu, Uganda. The Pennsylvania State University, Oswald Tower University Park, PA, . Program in Addiction Medicine at Yale University. Department of Humanities and Social Sciences University of California, San Francisco. Professor of Psychiatry and Chair of Research Theme in Translational Social Science and Health Equity at David Geffen School of Medicine, UCLA; Interim Chair, Department of Psychiatry and Biobehavioral Sciences, UCLA; Interim Director, UCLA Semel Institute for Neuroscience and Human Behavior at DGSOM; Interim Physician-in-Chief, Resnick Neuropsychiatric Hospital, UCLA.

Abstract summary 

Rurality has served as a key concept in popular and scientific understandings of the US overdose crisis, with White, rural, and low-income areas thought to be most heavily affected. However, we observe that overdose trends have risen nearly uniformly across the urban-rural designations employed in most research, implying that their importance has likely been overstated or incorrectly conceptualized. Nevertheless, urbanicity/rurality does serve as a key axis to understand inequalities in overdose mortality when assessed with more nuanced modalities-employing a more granular analysis of geography at the sub-county level, and intersecting rurality sociodemographic indices such as race/ethnicity. Using national overdose data from 1999-2021, we illustrate the intersectional importance of rurality for overdose surveillance. Finally, we offer recommendations for integrating these insights into drug overdose surveillance moving forward.

Authors & Co-authors:  Textor Lauren L Friedman Joseph J Bourgois Philippe P Aronowitz Shoshana S Simon Caty C Jauffret-Roustide Marie M Namirembe Sarah S Brothers Sarah S McNeil Ryan R Knight Kelly Ray KR Hansen Helena H

Study Outcome 

Source Link: Visit source

Statistics
Citations :  Benjamin R. (2017). Cultura Obscura: Race, Power, and “Culture Talk” in the Health Sciences. American Journal of Law & Medicine, 43(2–3), 225–238. 10.1177/0098858817723661
Authors :  11
Identifiers
Doi : 10.1016/j.drugpo.2023.104072
SSN : 1873-4758
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
Ethnography;Inequality;Opioids;Overdose;Rural urban categories;Surveillance
Study Design
Cross Sectional Study
Study Approach
Country of Study
Publication Country
Netherlands