Income distribution and risk of fatal drug overdose in New York City neighborhoods

Sandro Galea, Jennifer Ahern, David Vlahov, Phillip O. Coffin, Crystal Fuller, Andrew C. Leon, Kenneth Tardiff

    Research output: Contribution to journalArticle

    Abstract

    Accidental drug overdose is a substantial cause of mortality for drug users. Neighborhood-level factors, such as income distribution, may be important determinants of overdose death independent of individual-level factors. We used data from the Office of the Chief Medical Examiner to identify all cases of accidental deaths in New York City (NYC) in 1996 and individual-level covariates. We used 1990 US Census data to calculate the neighborhood-level income distribution. This multi-level case-control study included 725 accidental overdose deaths (cases) and 453 accidental deaths due to other causes (controls) in 59 neighborhoods in NYC. Overdose deaths were more likely in neighborhoods with higher levels of drug use and with more unequal income distribution. In multi-level models, income maldistribution was significantly associated with risk of overdose independent of individual-level variables (age, race, and sex) and neighborhood-level variables (income, drug use, and racial composition). The odds of death due to drug overdose were 1.63-1.88 in neighborhoods in the least equitable decile compared with neighborhoods in the most equitable decile. Disinvestment in social and economic resources in unequal neighborhoods may explain this association. Public health interventions related to overdose risk should pay particular attention to highly unequal neighborhoods.

    Original languageEnglish (US)
    Pages (from-to)139-148
    Number of pages10
    JournalDrug and alcohol dependence
    Volume70
    Issue number2
    DOIs
    StatePublished - May 21 2003

    Keywords

    • Drug overdose
    • Economics
    • Epidemiology
    • Income distribution
    • Income inequality
    • Multi-level

    ASJC Scopus subject areas

    • Toxicology
    • Pharmacology
    • Psychiatry and Mental health
    • Pharmacology (medical)

    Fingerprint Dive into the research topics of 'Income distribution and risk of fatal drug overdose in New York City neighborhoods'. Together they form a unique fingerprint.

  • Cite this

    Galea, S., Ahern, J., Vlahov, D., Coffin, P. O., Fuller, C., Leon, A. C., & Tardiff, K. (2003). Income distribution and risk of fatal drug overdose in New York City neighborhoods. Drug and alcohol dependence, 70(2), 139-148. https://doi.org/10.1016/S0376-8716(02)00342-3