Key Points Question Does the association of community vulnerability to disasters and pandemics with access to medications for opioid use disorder vary across urban and rural communities? Findings In this cross-sectional study of 32 604 zip codes tabulation area across the continental United States, communities with greater social vulnerability did not have greater geographic access to medications, and the mismatch was greatest in suburban communities. Rural communities had poor geographic access regardless of vulnerability. Meaning These findings suggest that disaster preparedness planning should include anticipation of access to medications for opioid use disorder and better match the location of services to communities with greater vulnerability to prevent inequities in opioid overdose deaths.

Distributed spatial infrastructures leveraging cloud computing technologies can tackle issues of disparate data sources and address the need for data‐driven knowledge discovery and more sophisticated spatial analysis central to the COVID‐19 pandemic. We implement a new, open source spatial middleware component (libgeoda) and system design to scale development quickly to effectively meet the need for surveilling county‐level metrics in a rapidly changing pandemic landscape. We incorporate, wrangle, and analyze multiple data streams from volunteered and crowdsourced environments to leverage multiple data perspectives. We integrate explorative spatial data analysis (ESDA) and statistical hotspot standards to detect infectious disease clusters in real time, building on decades of research in GIScience and spatial statistics. We scale the computational infrastructure to provide equitable access to data and insights across the entire USA, demanding a basic but high‐quality standard of ESDA techniques. Finally, we engage a research coalition and incorporate principles of user‐centered design to ground the direction and design of Atlas application development.

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