City streetscapes and neighborhood characteristics of fatal opioid overdoses among people experiencing homelessness who use drugs in New York City, 2017-2019.
City streetscapes and neighborhood characteristics of fatal opioid overdoses among people experiencing homelessness who use drugs in New York City, 2017-2019.
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DOI：
10.1016/j.drugpo.2022.103904
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发表时间：
2022-12
影响因子：
4.4
通讯作者：
Martins, Silvia S.
中科院分区：
文献类型：
--
作者：
Nesoff, Elizabeth D.;Wiebe, Douglas J.;Martins, Silvia S.
虽然住房是非处方阿片类药物过量的关键社会决定因素，但对于使用公共与私人领域以外药物的无家可归者（PEH）来说，地点如何影响致命的过量，我们知之甚少。本研究调查了PEH致死性过量用药地点的社区环境特征模式。我们远程访问了纽约市首席法医办公室提供的2017-2019年阿片类药物致死过量的地点（n = 3276），使用谷歌街景，并使用系统的社会观察来评估与药物暴露相关的街区特征。我们将家庭住址与城市庇护所和支持性住房进行交叉比对，以确定PEH （n = 503）。利用空间点格局和核比值函数图中K函数的差异来识别地理集群。然后，我们使用逻辑回归来识别显著的个体、街区和社区水平的协变量（社区剥夺、隔离、人口密度）。PEH中超过一半（55.9%,n = 281）的致命过量发生在支持性住房或庇护所，15.5% （n = 78）发生在公共场所（如公园）。空间分析确定了曼哈顿、南布朗克斯和布鲁克林的PEH致命过量集中区域。我们确定了几个重要的生理和社会秩序和混乱指标，这些指标与致命过量服用时无家可归的几率增加有关，包括建筑/翻新、涂鸦、交通平静特征和闲逛。减少伤害服务应设在为PEH服务的设施内，并以具有身体和社会障碍指标的街区为目标。虽然支持性住房是预防PEH中致命阿片类药物过量的关键步骤，但确定提供干预服务的社区和为PEH提供减少伤害的推广是必要的。
While housing is a critical social determinant of nonprescription opioid overdose, little is known about how place impacts fatal overdose for people experiencing homelessness (PEH) who use drugs beyond the public versus private domains. This study investigated patterns of neighborhood environment features at locations of fatal overdoses among PEH. We remotely visited locations of opioid-involved fatal overdoses provided by the New York City Office of the Chief Medical Examiner, 2017–2019 (n = 3276), with Google Street View and used systematic social observation to assess characteristics of the street block related to drug exposures. We cross-referenced home address with city shelters and supportive housing to identify PEH (n = 503). We used the differences of K functions from the spatial point patterns and kernel ratio function maps to identify geographic clusters. We then used logistic regression to identify significant individual-, block-, and neighborhood-level covariates (neighborhood deprivation, segregation, population density). Over half (55.9%, n = 281) of fatal overdoses among PEH occurred in supportive housing or shelters, and 15.5% (n = 78) occurred in public spaces (e.g., parks). Spatial analyses identified areas of significant concentrated fatal overdoses among PEH in Manhattan, the South Bronx, and Brooklyn. We identified several significant indicators of physical and social order and disorder associated with increased odds of experiencing homelessness at time of fatal overdose, including construction/renovation, graffiti, traffic calming features, and loitering. Harm reduction services should be co-located in facilities that serve PEH and targeted to street blocks with indicators of physical and social disorder. While supportive housing is a crucial step in preventing fatal opioid overdoses among PEH, identifying neighborhoods for intervention services delivery and harm reduction outreach for PEH is necessary.
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影响因子：
3.5
作者：
Furr-Holden, C. D. M.;Smart, M. J.;Pokorni, J. L.;Ialongo, N. S.;Leaf, P. J.;Holder, H. D.;Anthony, J. C.
通讯作者：
Anthony, J. C.
影响因子：
0.9
作者：
Furr-Holden CD;Campbell KD;Milam AJ;Smart MJ;Ialongo NA;Leaf PJ
通讯作者：
Leaf PJ
影响因子：
6
作者：
Darke, S;Kaye, S;Ross, J
通讯作者：
Ross, J
影响因子：
12.7
作者：
Cerda, Magdalena;Ransome, Yusuf;Galea, Sandro
通讯作者：
Galea, Sandro
影响因子：
2.9
作者：
Darrah-Okike, Jennifer;Soakai, Sarah;Umemoto, Karen
通讯作者：
Umemoto, Karen