期刊
AMERICAN JOURNAL OF PREVENTIVE MEDICINE
卷 54, 期 5, 页码 611-619出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.amepre.2018.01.040
关键词
-
资金
- U.S. Department of Agriculture Economic Research Service [58-6000-6-0028]
- Institute for New Economic Thinking [INO17-00003]
- Lerner Center for Public Health Promotion at Syracuse University
- Center for Policy Research at Syracuse University
- U.S. Department of Agriculture Agricultural Experiment Station Multistate Research Project: Social, Economic, and Environmental Causes and Consequences of Demographic Change in Rural America [W4001]
Introduction: Over the past 2 decades, drug-related deaths have grown to be a major U.S. public health problem. County-level differences in drug-related mortality rates are large. The relative contributions of social determinants of health to this variation, including the economic, social, and healthcare environments, are unknown.& para;& para;Methods: Using data from the U.S. Centers for Disease Control and Prevention Multiple-Cause of Death Files (2006-2015, analyzed in 2017); U.S. Census Bureau; U.S. Department of Agriculture Economic Research Service; Agency for Healthcare Research and Quality; and Northeast Regional Center for Rural Development, this paper modeled associations between county-level drug-related mortality rates and economic, social, and healthcare environments. Spatial autoregressive models controlled for state fixed effects and county demographic characteristics.& para;& para;Results: The average county-level age-adjusted drug-related mortality rate was 16.6 deaths per 100,000 population (2006-2015), but there were substantial geographic disparities in rates. Controlling for county demographic characteristics, average mortality rates were significantly higher in counties with greater economic and family distress and in counties economically dependent on mining. Average mortality rates were significantly lower in counties with a larger presence of religious establishments, a greater percentage of recent in-migrants, and counties with economies reliant on public (government) sector employment. Healthcare supply factors did not contribute to between-county disparities in mortality rates.& para;& para;Conclusions: Drug-related mortality rates are not randomly distributed across the U.S. Future research should consider the specific pathways through which economic, social, and healthcare environments are associated with drug-related mortality. (C) 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据