Rethinking urban-rural designations in public health surveillance of the overdose crisis and crafting an agenda for future monitoring
Year: 2023
Type: article
Abstract: Rurality has served as a key concept in popular and scientific understandings of the US overdose crisis, with White, rural, and low-income areas thought to be most heavily affected. However, we observe that overdose trends have risen nearly uniformly across the urban-rural designations employed in most research, implying that their importance has likely been overstated or incorrectly conceptualized. Nevertheless, urbanicity/rurality does serve as a key axis to understand inequalities in overdose mortality when assessed with more nuanced modalities-employing a more granular analysis of geography at the sub-county level, and intersecting rurality sociodemographic indices such as race/ethnicity. Using national overdose data from 1999-2021, we illustrate the intersectional importance of rurality for overdose surveillance. Finally, we offer recommendations for integrating these insights into drug overdose surveillance moving forward.
Institutions: University of California, Los Angeles, University of Pennsylvania, Centre National de la Recherche Scientifique, Inserm, Centre d'étude des mouvements sociaux, École des hautes études en sciences sociales, Gulu University, Pennsylvania State University, Yale University, University of California, San Francisco
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,070
OpenAlex ID: W4380853415