Effects of the Opioid Epidemic on Fertility, Marriage, and Family Structure

阿片类药物流行对生育力、婚姻和家庭结构的影响

• 批准号: 10042516
• 负责人: MONICA LISETTE CAUDILLO
• 金额: $ 7.73万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-11 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10042516
• 关键词: Accounting; Affect; Age; American; Area; Categories; Child; Child Rearing; Communities; Community Surveys; Data; Data Set; Databases; Death Rate; Drug Addiction; Economic Conditions; Education; Educational Background; Employment; Epidemic; Ethnic Origin; Family; Fentanyl; Fertility; Fertility Rates; Health; Heterogeneity; Hispanics; Household; Illicit Drugs; Individual; Link; Marital Fertility; Marriage; Marriage and Family; Measures; Mediating; Mediator of activation protein; Mental Health; Methodology; Modeling; Nature; Not Hispanic or Latino; Opiate Addiction; Opioid; Outcome; Parents; Pattern; Pattern Formation; Personal Satisfaction; Pharmacologic Substance; Policies; Population; Probability; Public Health; Public Policy; Race; Records; Research; Sales; Sampling; Social Conditions; Structure; Testing; Time; Touch sensation; United States; United States Centers for Medicare and Medicaid Services; United States Substance Abuse and Mental Health Services Administration; Unmarried Mother; Vital Statistics; Woman; aged; child bearing; drug market; family structure; health economics; innovation; instrument; interest; intergenerational; nonmarital childbearing; opioid abuse; opioid epidemic; opioid misuse; opioid mortality; opioid overdose; overdose death; payment; prescription opioid; social

Project Summary Opioid abuse is one of the most pressing public health challenges facing the United States today. It touches the lives of millions of people nationwide either directly or indirectly. In 2017, more than 11 million people misused some type of opioid, accounting for nearly 5% of the total population aged 12 or older. But the opioid epidemic also affects millions of other individuals indirectly by altering the lives of those living in the same households and communities. Despite a growing body of research examining the health and economic consequences of opioid misuse, we still know little about its effects on childbearing, family formation, and family reconfiguration patterns in the United States. Our study will be the first to examine the effect of the opioid epidemic on these important demographic outcomes using a nationally-representative dataset. Assessing the impact of the opioid epidemic on family formation and reconfiguration patterns is important because it can help inform policies to mitigate the detrimental consequences of the epidemic, and to reduce its negative repercussions for the health and wellbeing of women and children. To measure the intensity of the opioid epidemic at the local level each year we will use the opioid-overdose death rate computed from restricted vital statistics records, and prescribed grams of opioids per capita estimated from a database of all opioid medication sales nationwide. These two measures of the opioid epidemic will be linked with aggregate and individual-level indicators of marital and nonmarital fertility, marriage, and household structure. Our analysis will explore the mechanisms mediating the effect of the opioid epidemic on family formation and reconfiguration, such as employment conditions and barriers to marriage. We will also examine whether the effect of the epidemic varied by race and ethnicity. Finally, our study will compare the effect of different types of opioids, and specifically evaluate the impact of the introduction of fentanyl to the U.S. illicit drug market in recent years. Our proposed study incorporates two important methodological innovations to overcome estimation problems. First, to better isolate the causal effect of the increase in local opioid abuse on the outcomes of interest we will use an instrumental variables approach. The total annual payments to local doctors by pharmaceutical companies per thousand residents available from the Centers for Medicare and Medicaid Services will be used as an instrument. Second, our models will account for spatial autocorrelation in the estimation of the effect of local opioid abuse.

项目摘要 阿片类药物滥用是当今美国面临的最紧迫的公共卫生挑战之一。它 直接或间接地影响着全国数百万人的生活。2017年，超过1100万 滥用某种阿片类药物的人占12岁以上总人口的近5%。但 阿片类药物的流行还间接影响了数百万其他人，改变了生活在这些地区的人的生活。 同样的家庭和社区。尽管越来越多的研究调查了健康和经济状况， 阿片类药物滥用的后果，我们仍然不知道它对生育，家庭形成， 美国的家庭重组模式我们的研究将是第一个检查的影响， 阿片类药物流行对这些重要的人口统计结果使用全国代表性的数据集。 评估类阿片流行病对家庭形成和重组模式的影响十分重要 因为它可以帮助制定政策，减轻疫情的有害后果， 对妇女和儿童的健康和福祉产生负面影响。 为了衡量每年地方一级阿片类药物流行的强度，我们将使用阿片类药物过量 根据有限的人口动态统计记录计算的死亡率，以及人均阿片类处方克数 根据全国所有阿片类药物销售数据库估计。这两种阿片类药物 流行病将与婚姻和非婚姻生育率的总体和个人指标挂钩， 婚姻和家庭结构。我们的分析将探讨介导阿片类药物作用的机制 流行病对家庭组成和重组的影响，如就业条件和婚姻障碍。我们 还将研究该流行病的影响是否因种族和族裔而异。最后，我们的研究将 比较不同类型的阿片类药物的效果，并具体评估采用 近年来，芬太尼进入美国非法毒品市场。 我们提出的研究结合了两个重要的方法创新，以克服估计 问题首先，为了更好地分离当地阿片类药物滥用增加对治疗结果的因果影响， 有趣的是，我们将使用工具变量方法。每年支付给当地医生的总金额， 医疗保险和医疗补助中心提供的每千名居民的制药公司 服务将被用作工具。其次，我们的模型将考虑空间自相关性， 估计当地阿片类药物滥用的影响。