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

Abstract #117620

Melissa Tracy, BA¹, Angela Bucciarelli, MPH¹, Ramiro Martinez, PhD², Tinka Markham Piper, MPH, CSW¹, David Vlahov, PhD³, Kenneth J. Tardiff, MD, MPH⁴, and Sandro Galea, MD, MPH¹. (1) Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029, 212.419.3583, abucciarellli@nyam.org, (2) School of Policy and Management, Florida International University, ECS 431, 11200 S.W. 8th Street, Miami, FL 33199, (3) Center for Urban Epidemiologic Studies (CUES), New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029, (4) Department of Psychiatry, New York Presbyterian Hosptial, 525 East 68th Street Box 140, New York, NY 10021

Death rates from accidental drug overdose have been increasing throughout the United States over the past decade. In order to identify and compare characteristics of urban environments that may be associated with overdose mortality, we assessed neighborhood-level determinants of overdose death rates in NYC and Miami-Dade County, Florida. We collected data from the Chief Medical Examiner Offices of NYC and Miami-Dade for all accidental fatal drug overdoses occurring during 1995-2000 and geocoded overdose deaths to the decedent's residential community district (in NYC; n=59) or municipality (in Miami-Dade; n=32). Population counts from the 1990 U.S. Census were used to calculate overdose death rates in each neighborhood for each year under study. We conducted ecological analyses to evaluate the association between neighborhood overdose death rates and demographic and socio-economic characteristics, including neighborhood racial/ethnic distribution, educational attainment, and poverty. For NYC, in a multivariable model also adjusted for the percent of residents who were Black and Hispanic and the year of death, a larger percent of residents with a high school diploma or more education (p=0.0002) and a larger percent of residents living below the poverty level (p<0.0001) were significantly associated with higher overdose death rates. However, for Miami-Dade, none of the neighborhood-level characteristics assessed were associated with neighborhood overdose death rates. These findings suggest that characteristics of the urban environment may influence overdose mortality differently in NYC and Miami-Dade. A better understanding of the relation between different neighborhood characteristics and overdose mortality is needed to inform targeted interventions in different cities.

Learning Objectives:

• To discuss differences in the relation between neighborhood characteristics and overdose mortality in New York City and Miami-Dade County, Florida.
• To consider implications of these differences and identify avenues for further research to clarify the impact of neighborhood characteristics on overdose so that informed interventions at the neighborhood level may be developed to reduce overdose mortality.

Keywords: Drug Use, 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.