Nav: Home

Neighborhood matters for fentanyl-involved overdose deaths

November 21, 2019

Fentanyl overdoses cluster geographically more than non-fentanyl overdoses, according to a study just released by Columbia University Mailman School of Public Health. The findings suggest that fentanyl-involved overdoses are concentrated in resource deprived neighborhoods over and above what data show for opioid and polydrug overdoses. This is one of few studies to examine the local geographic distribution of drug overdoses and associated neighborhood-level risk factors. The results are published online in the American Journal of Public Health.

The researchers examined geographic trends in the distribution of fentanyl-involved overdose deaths in Cook County, Ill, the second most populous county in the U.S. Data were collected from 2014 to 2018 through the County Medical Examiner's office, which includes Chicago and the surrounding suburbs. The Medical Examiner's Office began routinely testing for fentanyl in June 2015.

"Much of the work to date has used large geographic units such as zip codes or counties on a national scale, noted Elizabeth Nesoff, PhD, postdoctoral fellow in the Department of Epidemiology and first author. "Our research using census block group-level data provides a window into the broader neighborhood context not fully explained by demographics."

The odds of a fentanyl-involved overdose were significantly increased for men, Blacks, Latinos, and younger individuals as well as resource deprived neighborhoods. For example, a larger proportion of non-fentanyl overdoses were White, 53% vs. fentanyl: 43.0%), while a larger proportion of fentanyl overdoses were men (78% vs. non-fentanyl, 73%). These findings echo prior studies of risk for crack-cocaine use, which identified socioeconomic disadvantage as a fundamental cause of racial disparities in crack use.

According to Drug Enforcement Administration data, the number of seized drug samples testing positive for fentanyl more than doubled from 2015 to 2016, rising from 14,440 to 34,119; this increase continued into 2017. Potency of fentanyl -- which is increasingly found in counterfeit medications -- has also increased.

While some people who use drugs seek out fentanyl and fentanyl-adulterated drugs, there is evidence that many people who consume fentanyl may be unaware they are consuming fentanyl, the authors note. One theory is that fentanyl is significantly cheaper to produce than heroin.

"Our study provides a unique perspective on overdose locations, and shows that fentanyl does not follow the same geographic distribution as that of the general drug-using population," said Silvia Martins, MD, PhD, associate professor of epidemiology and director of PHIOS (Policies and Health Initiatives on Opioids and Other Substances) at Columbia Mailman School, and senior author. "This finding was supported by the fact that population density was not a significant factor." One area in particular showed notably elevated risk for fentanyl overdoses located in two specific neighborhoods of Chicago.

Earlier research by Department of Epidemiology Chair Charles Branas, PhD, Gelman Endowed Professor, and a study co-author, showed that neighborhood risk factors for drug use could be modified through targeted infrastructure improvements or other community development strategies, such as park-making or building renovation, but this research has not been extended to overdose prevention. "For example, vacant lot remediation has been shown to significantly reduce gun violence and improve residents' mental health in cities; this presents a possible strategy for reducing drug use in resource deprived neighborhoods. We believe that further inquiry into specific aspects of neighborhood deprivation which can be used to create actionable policy and interventions for harm reduction and overdose prevention is warranted."
The work was supported by the National Institute on Drug Abuse (Grant Number T32DA031099).

Columbia University Mailman School of Public Health

Founded in 1922, the Columbia University Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Columbia Mailman School is the third largest recipient of NIH grants among schools of public health. Its over 450 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change & health, and public health preparedness. It is a leader in public health education with over 1,300 graduate students from more than 40 nations pursuing a variety of master's and doctoral degree programs. The Columbia Mailman School is also home to numerous world-renowned research centers, including ICAP and the Center for Infection and Immunity. For more information, please visit

Columbia University's Mailman School of Public Health

Related Public Health Articles:

Pandemic likely to cause long-term health problems, Yale School of Public Health finds
The coronavirus pandemic's life-altering effects are likely to result in lasting physical and mental health consequences for many people--particularly those from vulnerable populations--a new study led by the Yale School of Public Health finds.
The Lancet Public Health: US modelling study estimates impact of school closures for COVID-19 on US health-care workforce and associated mortality
US policymakers considering physical distancing measures to slow the spread of COVID-19 face a difficult trade-off between closing schools to reduce transmission and new cases, and potential health-care worker absenteeism due to additional childcare needs that could ultimately increase mortality from COVID-19, according to new modelling research published in The Lancet Public Health journal.
The Lancet Public Health: Access to identification documents reflecting gender identity may improve trans mental health
Results from a survey of over 20,000 American trans adults suggest that having access to identification documents which reflect their identified gender helps to improve their mental health and may reduce suicidal thoughts, according to a study published in The Lancet Public Health journal.
The Lancet Public Health: Study estimates mental health impact of welfare reform, Universal Credit, in Great Britain
The 2013 Universal Credit welfare reform appears to have led to an increase in the prevalence of psychological distress among unemployed recipients, according to a nationally representative study following more than 52,000 working-age individuals from England, Wales, and Scotland over nine years between 2009-2018, published as part of an issue of The Lancet Public Health journal on income and health.
BU researchers: Pornography is not a 'public health crisis'
Researchers from the Boston University School of Public Health (BUSPH) have written an editorial in the American Journal of Public Health special February issue arguing against the claim that pornography is a public health crisis, and explaining why such a claim actually endangers the health of the public.
The Lancet Public Health: Ageism linked to poorer health in older people in England
Ageism may be linked with poorer health in older people in England, according to an observational study of over 7,500 people aged over 50 published in The Lancet Public Health journal.
Study: Public transportation use linked to better public health
Promoting robust public transportation systems may come with a bonus for public health -- lower obesity rates.
Bloomberg American Health Initiative releases special public health reports supplement
With US life expectancy now on the decline for two consecutive years, the Bloomberg American Health Initiative is releasing a supplement to Public Health Reports, the scholarly journal of the US Surgeon General.
Data does the heavy lifting: Encouraging new public health approaches to promote the health benefits of muscle-strengthening exercise (MSE)
According to a new study in the American Journal of Preventive Medicine, almost 75 percent of US adults do not comply with public health guidelines recommending two or more muscle-strengthening exercise (MSE) sessions a week, with nearly 60 percent of the population doing no MSE at all.
The Lancet Public Health: Moderate carbohydrate intake may be best for health
Low-carb diets that replace carbohydrates with proteins and fats from plant sources associated with lower risk of mortality compared to those that replace carbohydrates with proteins and fat from animal sources.
More Public Health News and Public Health Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: Meditations on Loneliness
Original broadcast date: April 24, 2020. We're a social species now living in isolation. But loneliness was a problem well before this era of social distancing. This hour, TED speakers explore how we can live and make peace with loneliness. Guests on the show include author and illustrator Jonny Sun, psychologist Susan Pinker, architect Grace Kim, and writer Suleika Jaouad.
Now Playing: Science for the People

#565 The Great Wide Indoors
We're all spending a bit more time indoors this summer than we probably figured. But did you ever stop to think about why the places we live and work as designed the way they are? And how they could be designed better? We're talking with Emily Anthes about her new book "The Great Indoors: The Surprising Science of how Buildings Shape our Behavior, Health and Happiness".
Now Playing: Radiolab

The Third. A TED Talk.
Jad gives a TED talk about his life as a journalist and how Radiolab has evolved over the years. Here's how TED described it:How do you end a story? Host of Radiolab Jad Abumrad tells how his search for an answer led him home to the mountains of Tennessee, where he met an unexpected teacher: Dolly Parton.Jad Nicholas Abumrad is a Lebanese-American radio host, composer and producer. He is the founder of the syndicated public radio program Radiolab, which is broadcast on over 600 radio stations nationwide and is downloaded more than 120 million times a year as a podcast. He also created More Perfect, a podcast that tells the stories behind the Supreme Court's most famous decisions. And most recently, Dolly Parton's America, a nine-episode podcast exploring the life and times of the iconic country music star. Abumrad has received three Peabody Awards and was named a MacArthur Fellow in 2011.