Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #113374

Angela Bucciarelli, MPH¹, Sandro Galea, MD, MPH¹, Tinka Markham Piper, MPH, CSW², Steven Messner, PhD³, Ramiro Martinez, PhD⁴, Kenneth J. Tardiff, MD, MPH⁵, and David Vlahov, PhD². (1) Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029, 212.419.3583, abucciarelli@nyam.org, (2) Center for Urban Epidemiologic Studies (CUES), New York Academy of Medicine, 55 West 125th Street, 13th Floor, New York, NY 10027, (3) Sociology, State University of New York at Albany, 1400 Washington Ave, Arts & Sciences 351, Albany, NY 12222, (4) School of Policy and Management, Florida International University, ECS 431, 11200 S.W. 8th Street, Miami, FL 33199, (5) Department of Psychiatry, New York Presbyterian Hosptial, 525 East 68th Street Box 140, New York, NY 10021

Accidental drug overdose is one of the top five leading causes of death among 15 to 54 year olds in both New York City (NYC) and Miami-Dade County. Characteristics of the urban environment may contribute to the risk of accidental drug overdose death. We used data on all accidental deaths that occurred from 1995-2000 in both NYC and Miami-Dade to assess the relation between neighborhood poverty and risk of drug overdose. We used 59 community districts in NYC and 32 municipalities in Miami-Dade as units of the urban environment of interest. Among 4094 (of 5009) overdose deaths in NYC and 293 (of 546) in Miami who were able to link to neighborhood of residence, the overdose mortality rate in NYC in high poverty was 80 and in low poverty neighborhoods 40 per 100,000 and 7.2 and 236 in high and low poverty neighborhoods in Miami-Dade. In multivariable models adjusting for age, race/ethnicity, gender, and year of death, the risk of fatal accidental drug overdose was found to be 1.8 times (CI 95: 1.6, 2.0) higher in neighborhoods characterized by high poverty compared to low poverty neighborhoods in NYC (p<0.001). In contrast, neighborhood poverty was not associated with risk of overdose (OR 0.8; CI 95: 0.6, 1.2) in Miami-Dade. These results suggest that characteristics of the urban environment may be determinants of drug overdose death in some, but not all urban areas. Mechanisms underlying the observed relations in both NYC and Miami-Dade will need to be more closely examined.

Learning Objectives: At the conclusion of the session, the participant will be able to

• Describe contextual factors associated with fatal drug overdose in both New York City and Miami-Dade County, Florida.
• Discuss individual-level factors associated with fatal drug overdose, but also compare and contrast variation in these factors observed in New York City and Miami-Dade County, Florida.
• Assess the importance of analyzing both individual- and contextual-factors when identifying risk of fatal drug overdose.

Keywords: Injury Risk, Urban Health

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.