Spatial Trends in Opiate Overdose Death in North Carolina: 1999-2015

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  • February 26, 2019
Creator
  • Cordes, John
    • Affiliation: College of Arts and Sciences, Department of Geography
Abstract
  • The United States has experienced a serious and growing opiate epidemic over the past 20 years. North Carolina has been identified as a state of particular concern along with other Southern and Appalachian states. This study characterizes the opiate epidemic in North Carolina along three axes: space, time, and drug type. Using data from the North Carolina State Center for Health Statistics, I calculated county-level mortality rates for prescription opioids, methadone, synthetic opioids, and heroin for each year from 1999 to 2015. Then I performed mean center, cluster, and spatial regression analyses to identify areas of high and low mortality rates and associated socioeconomic correlates. My results show that mortality due to prescription opioids in North Carolina increased by 612 percent and heroin increased by 800 percent over the study period. Average mortality rates from prescription opioids were highest in the western, Appalachian counties, while the highest rates for heroin mortality occurred in urban counties along the Piedmont Crescent and in Wilmington. Mean center analysis by year showed prescription mortality rates were pulled to the west during the entire study period with a notable trend east in 2014 and 2015. Heroin mortality rate mean centers were consistently east of the unweighted mean center, although they also showed a higher variance. Discrete Poisson-based cluster models in SaTScan identified high clusters of mortality rates for both drug types in similar areas as the descriptive analysis, however it also determined intraregional hotspots including Richmond and Carteret counties for prescription opioid mortality. Regression models for average mortality rate by county for the entire study period for prescription opioids and heroin produced R squared values of 0.62 and 0.36 respectively. Prescription opioid mortality increased with percent with disability and decreased with percent Black and percent Hispanic. Heroin mortality increased with urbanity and decreased with percent holding a college degree. This study confirms trends in the opiate epidemic with high rates of prescription opioid mortality among White, rural, Appalachian counties and heroin mortality in urban areas. Policymakers and intervention workers can use these findings to develop appropriate measures to combat this epidemic and target their work based on place and drug type.
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  • In Copyright
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  • Funding: None
Advisor
  • Martin, Nina
Degree
  • Bachelor of Arts
Academic concentration
  • Geography
Honors level
  • Honors
Degree granting institution
  • University of North Carolina at Chapel Hill
Graduation year
  • 2017
Language
  • English

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