Measuring network dynamics of opioid overdose deaths in the United States.

Autor: Tiwari K; Department of Industrial Engineering, University of Pittsburgh, Pittsburgh, USA. kut20@pitt.edu., Rahimian MA; Department of Industrial Engineering, University of Pittsburgh, Pittsburgh, USA. rahimian@pitt.edu., Roberts MS; Department of Health Policy and Management, University of Pittsburgh, Pittsburgh, USA., Kumar P; Department of Health Policy and Management, University of Pittsburgh, Pittsburgh, USA., Buchanich JM; Department of Biostatistics and Health Data Science, University of Pittsburgh, Pittsburgh, USA.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2024 Nov 28; Vol. 14 (1), pp. 29563. Date of Electronic Publication: 2024 Nov 28.
DOI: 10.1038/s41598-024-80627-4
Abstrakt: The US opioid overdose epidemic has been a major public health concern in recent decades. There has been increasing recognition that its etiology is rooted in part in the social contexts that mediate substance use and access; however, reliable statistical measures of social influence are lacking in the literature. We use Facebook's social connectedness index (SCI) as a proxy for real-life social networks across diverse spatial regions that help quantify social connectivity across different spatial units. This is a measure of the relative probability of connections between localities that offers a unique lens to understand the effects of social networks on health outcomes. We use SCI to develop a variable, called "deaths in social proximity", to measure the influence of social networks on opioid overdose deaths (OODs) in US counties. Our results show a statistically significant effect size for deaths in social proximity on OODs in counties in the United States, controlling for spatial proximity, as well as demographic and clinical covariates. The effect size of standardized deaths in social proximity in our cluster-robust linear regression model indicates that a one-standard-deviation increase, equal to 11.70 more deaths per 100,000 population in the social proximity of ego counties in the contiguous United States, is associated with thirteen more deaths per 100, 000 population in ego counties. To further validate our findings, we performed a series of robustness checks using a network autocorrelation model to account for social network effects, a spatial autocorrelation model to capture spatial dependencies, and a two-way fixed-effect model to control for unobserved spatial and time-invariant characteristics. These checks consistently provide statistically robust evidence of positive social influence on OODs in US counties. Our analysis provides a pathway for public health interventions informed by social network structures. The statistical robustness of our primary variable of interest, deaths in social proximity, supports the hypothesis of a social network effect on OODs. Using agent-based modeling (ABM) to simulate social networks can offer an effective method to design interventions that incorporate the dynamics of social networks for maximum impact.
Competing Interests: Competing interests: K.T. has been an associate specialist at Merck Sharp & Dohme LLC from May to August 2023. M.A.R. has served on the advisory committee of a vaccine confidence fund created by Meta and Merck; some of his research has also been funded by Meta. The other authors declare no competing interests.
(© 2024. The Author(s).)
Databáze: MEDLINE
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