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APHA Scientific Session and Event Listing

Zhao Wu, PhD, Obstetrics and Gynecology 0587, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0587, 409-772-1021, zhwu@utmb.edu and Karl Eschbach, PhD, Internal Medicine/Geriatrics 0460, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-0460.

Purpose: To investigate economic and other contextual determinants of substance-use related mortality for race and gender groups. We focus on economic markers, but also investigate effects of factors including racial segregation and economic inequality. Data: Vital records of 14,284 substance-use-related deaths of persons ages 15 to 49 in California and Texas for 1999-2001. Counts are linked to population denominators and socio-economic characteristics for census tract of residence at death. We use Poisson-family models to investigate contextual correlates of differences in mortality for Black, Latino/a, and White men and women. Results: The standardized substance-use mortality rate per million for the study population was 192 for all identified causes, 69 for alcohol and 55 for narcotics. Census tract poverty was strongly associated with deaths from both alcohol and narcotics. Rate ratios comparing high to low quartile poverty tracts were 3.37 (95% CI: 3.07,3.68) for alcohol and 3.42 (CI: 3.10,3.78) for narcotics. However the effects are sharply different by race. For narcotics, high vs. low tract poverty increased the mortality rate ratio by 8.10 for blacks, 3.85 for whites, and just 1.82 for Latino/as. These effects were stronger for women than men: Black women in more affluent tracts had lower narcotics-related mortality than do white women (RR=0.71), while those in the poorest tracts had higher mortality (RR=1.30). Tract poverty had no effect on Latina narcotics mortality. Results were similar but less pronounced for alcohol-related deaths. Significance: Racial differences in substance-use mortality vary by gender and neighborhood economic status.

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

• Describe substance-use mortality patterns for racial and gender groups for Texas and California
• Identify 3 primary neighborhood contextual risks for substance-use mortality;
• Compare the relationship between neighborhood economic environment and substance-use mortality for race and gender groups.

Keywords: Substance Abuse, Mortality

Presenting author's disclosure statement:

Not Answered