The journey to overdose: Using spatial social network analysis as a novel framework to study geographic discordance in overdose deaths

Forati, Amir Masoud; Ghose, Rina; Mohebbi, Fahimeh; Mantsch, John R.

doi:10.1016/j.drugalcdep.2023.109827

Cited by 6 publications

(4 citation statements)

References 46 publications

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“…Intensifying Hot Spots had disproportionately high compositions of Hispanic and immigrant community members. This is consistent with local [2] and national [23] trends in overdoses in Hispanic community members and is likely exacerbated by our observation that many non-Hispanic community members are traveling to and overdosing in Milwaukee's Hispanic communities [24]. While it is possible that overdoses in Hispanic immigrants are increasing, it has been reported that, historically, overdoses are much higher among whites relative to Hispanic immigrant populations and lower in rst-versus second-and third-generation Hispanic immigrants [25].…”

Section: Characteristics Of Overdose Hot Spot Communitiessupporting

confidence: 88%

“…It should not be assumed that differential OMRs in neighborhoods classi ed according to racial demographic majorities translate to similar OMRs in members of those communities or in community members of the same racial demographics. Indeed, we have previously reported that many overdose deaths, particularly in Hispanicmajority neighborhoods, are geographically discordant (i.e., overdosing individuals are traveling from other communities of residence; [24]). Nonetheless, the ndings are consistent with previous research documenting disparities in access to health care and social determinants of health across racial and ethnic communities [16].…”

Section: Geographic Racial Disparities In Overdose Mortality Riskmentioning

confidence: 99%

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Using Precision Epidemiology to Identify Racialized Disparities in Overdose Mortality

Forati,

Ghose,

Mohebbi

et al. 2024

Preprint

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Efforts to understand and respond to the opioid crisis have focused on overdose fatalities. Overdose mortality rates (ratios of overdoses resulting in death) are rarely examined though they are important indicators of harm reduction effectiveness. Factors that vary across urban communities likely determine which community members are receiving the resources needed to reduce fatal overdose risk. Identifying communities with higher risk for overdose mortality and understanding influential factors is critical for guiding responses and saving lives. Using incident reports and mortality data from 2018-2021 we defined overdose mortality ratios across Milwaukee at the census tract level. To identify neighborhoods displaying higher mortality than predicted, we used Integrated Nested Laplace Approximation to define standardized mortality ratios (SMRs) for each tract. Geospatial and spatiotemporal analyses were used to identify emerging hotspots for high mortality risk. Overall, mortality was highest in Hispanic and lowest in White communities. Communities with unfavorable SMRs were predominantly Black or Hispanic, younger, less employed, poorer, less educated, and had higher incarceration rates and worse mental and physical health. Communities identified as hotspots for overdoses were predominantly non-White, poorer, and less employed and educated with worse mental and physical health, higher incarceration rates, and less housing stability. The findings demonstrate that overdose mortality rates vary across urban communities and are influenced by racial disparities. A framework that enables identification of challenged communities and guides community responses is needed.

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Section: Characteristics Of Overdose Hot Spot Communitiessupporting

confidence: 88%

Section: Geographic Racial Disparities In Overdose Mortality Riskmentioning

confidence: 99%

Using Precision Epidemiology to Identify Racialized Disparities in Overdose Mortality

Forati,

Ghose,

Mohebbi

et al. 2024

Preprint

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“…In criminology, the "journey to crime" (committing a crime away from one's residential neighbourhood) is associated with victimization and law enforcement outcomes (Donnelly et al, 2021;Luo et al, 2021). This theory has been applied to substance use research in which the "journey to overdose" (overdosing in a neighbourhood that is not one's own neighbourhood) was found to result in more accidental deaths than if individuals overdosed at home (Forati et al, 2023). To extend this theory further, "journey to sexual behaviour" -having sex in neighbourhoods away from home -may be associated with greater rates of sexual behaviours that increase the risk of HIV transmission (Cassels et al, 2020;Dharma et al, 2023).…”

Section: Examination Of Multidimensional Geographic Mobility and Sexu...mentioning

confidence: 99%

“…This study aims to combine survey and GPS methods to comprehensively describe different mobility dimensions and explore their associations with sexual behaviours, enhancing the understanding of contextual determinants of HIV risk. Applying "journey to" theory (Forati et al, 2023;Luo et al, 2021), i.e., journey to sexual behaviour, this study aims to examine multiple dimensions of geographic mobility using GPS and survey measures and their associations with sexual behaviours that may increase HIV transmission risk in a well-characterized sample of Chicagoan BSMM. We leverage individual-level GPS data uniquely linked with survey data from the Neighbourhood and Networks (N2) Cohort Study in Chicago to measure mobility more granularly -including across sex and socializing areas -to deepen understanding about the associations between mobility and sexual behaviour.…”

Section: Examination Of Multidimensional Geographic Mobility and Sexu...mentioning

confidence: 99%

Examination of multidimensional geographic mobility and sexual behaviour among Black cisgender sexually minoritized men in Chicago

Khalifa,

Kim,

Regan

et al. 2024

Geospat Health

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Black sexually minoritized men (BSMM) are the most likely to acquire HIV in Chicago- a racially segregated city where their daily travel may confer different HIV-related risks. From survey and GPS data among participants of the Neighbourhoods and Networks Cohort Study, we examined spatial (proportion of total activity space away from home), temporal (proportion of total GPS points away from home), and motivation-specific (discordance between residential and frequented sex or socializing neighbourhoods) dimensions of mobility. To identify potential drivers of BSMM’s risk, we then examined associations between mobility and sexual behaviours known to cause HIV transmission: condomless anal sex, condomless anal sex with a casual partner, transactional sex, group sex, and sex-drug use. Multivariable logistic regression models assessed associations. Of 269 cisgender BSMM, most were 20-29 years old, identified as gay, and lowincome. On average, 96.9% (Standard Deviation: 3.7%) of participants’ activity space and 53.9% (Standard Deviation: 38.1%) of participants’ GPS points occurred outside their 800m home network buffer. After covariate adjustment, those who reported sex away from home were twice as likely to report condomless sex (Odds Ratio: 2.02, [95% Confidence Interval (CI): 1.08, 3.78]). Those who reported socializing away from home were four times more likely to have condomless sex with a casual partner (Odds Ratio: 4.16 [CI: 0.99, 29.0]). BSMM are on the move in Chicago, but only motivation-specific mobility may increase HIV transmission risk. Multidimensional investigations of mobility can inform place-based strategies for HIV service delivery.

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Applied risk mapping and spatial analysis of address-level decedent data to inform opioid overdose interventions: The Massachusetts HEALing Communities Study

Pustz,

Srinivasan,

Shrestha

et al. 2023

Drug and Alcohol Dependence

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The journey to overdose: Using spatial social network analysis as a novel framework to study geographic discordance in overdose deaths

Cited by 6 publications

References 46 publications

Using Precision Epidemiology to Identify Racialized Disparities in Overdose Mortality

Using Precision Epidemiology to Identify Racialized Disparities in Overdose Mortality

Examination of multidimensional geographic mobility and sexual behaviour among Black cisgender sexually minoritized men in Chicago

Applied risk mapping and spatial analysis of address-level decedent data to inform opioid overdose interventions: The Massachusetts HEALing Communities Study

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