Sociodemographic and geographic disparities in excess fatal drug overdoses during the COVID-19 pandemic in California: A population-based study.

Autor:	Kiang MV; Department of Epidemiology and Population Health, Stanford University School of Medicine, 1701 Page Mill Road, Palo Alto, Stanford, CA 94304, USA., Acosta RJ; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA., Chen YH; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA., Matthay EC; Center for Health and Community, University of California, San Francisco, CA, USA., Tsai AC; Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA., Basu S; Research and Development, Station Health, San Francisco, CA, USA., Glymour MM; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA., Bibbins-Domingo K; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.; Department of Medicine, University of California, San Francisco, San Francisco, CA, USA., Humphreys K; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA., Arthur KN; Substance and Addiction Prevention Branch, California Department of Public Health, Sacramento, CA, USA.
Jazyk:	angličtina
Zdroj:	Lancet regional health. Americas [Lancet Reg Health Am] 2022 Jul; Vol. 11, pp. 100237. Date of Electronic Publication: 2022 Mar 19.
DOI:	10.1016/j.lana.2022.100237
Abstrakt:	Background: The coronavirus disease 2019 (COVID-19) pandemic is co-occurring with a drug addiction and overdose crisis. Methods: We fit overdispersed Poisson models, accounting for seasonality and secular trends, to estimate the excess fatal drug overdoses (i.e., deaths greater than expected), using data on all deaths in California from 2016 to 2020. Findings: Between January 5, 2020 and December 26, 2020, there were 8605 fatal drug overdoses-a 44% increase over the same period one year prior. We estimated 2084 (95% CI: 1925 to 2243) fatal drug overdoses were excess deaths, representing 5·28 (4·88 to 5·68) excess fatal drug overdoses per 100,000 population. Excess fatal drug overdoses were driven by opioids (4·48 [95% CI: 4·18 to 4·77] per 100,000), especially synthetic opioids (2·85 [95% CI: 2·56 to 3·13] per 100,000). The non-Hispanic Black and Other non-Hispanic populations were disproportionately affected with 10·1 (95% CI: 7·6 to 12·5) and 13·26 (95% CI: 11·0 to 15·5) excess fatal drug overdoses per 100,000 population, respectively, compared to 5·99 (95% CI: 5.2 to 6.8) per 100,000 population in the non-Hispanic white population. There was a steep, nonlinear educational gradient with the highest rate among those with only a high school degree. There was a strong spatial patterning with the highest levels of excess mortality in the southernmost region and consistently lower levels at progressively more northern latitudes (7·73 vs 1·96 per 100,000). Interpretation: Fatal drug overdoses disproportionately increased in 2020 among structurally marginalized populations and showed a strong geographic gradient. Local, tailored public health interventions are urgently needed to reduce growing inequities in overdose deaths. Funding: US National Institutes of Health and Department of Veterans Affairs. Competing Interests: The authors have no competing interests. (© 2022 The Author(s).)
Databáze:	MEDLINE
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