Background: COVID-19 morbidity and mortality has been disproportionately higher in communities with greater social-cultural vulnerabilities. Drug related overdoses increased by nearly 30% since the start of the pandemic. Similar social-cultural vulnerabilities independently confer greater risk for COVID-19 incident and drug overdose deaths. Greater rates of drug overdose have been linked to limited access to healthcare and harm reduction services. There is limited research on the co-location of these risk factors. We examine the geospatial overlap between Social Vulnerability and Overdose Vulnerability indices on COVID-19 incident and drug overdose rates.
Methods: Data from CDC social vulnerabilities index was paired with access to buprenorphine, naloxone, and healthcare services gathered from SAMHSA, National Naloxone Access Map, and North American Industry Classification System (NAICS) Codes for New York State between 2019-2021. Access was defined as population weighted mean distance and time to nearest healthcare or harm reduction service. Spatial regression using spatial lag and spatial error models were conducted.
Results: We found that increase in rates of socioeconomic status vulnerability and increase in the population weighted mean travel time to a freestanding ambulatory surgical and emergency center was associated with increased COVID-19 incident and drug overdose deaths within the same geographical context.
Conclusions: Findings highlight unique avenues for structural interventions to reduce sociocultural disparities to aid in management of epi- and pandemics. Targeting improvements in making timely access to emergency services possible, along with efforts to reduce socioeconomic disparities could aid in managing the morbidity and mortality associated with COVID-19 and drug overdose.
Amar D. Mandavia, MA, Brandy F. Henry, PhD., James Quinn, PhD., Aimee Campbell, PhD., Michael Chaple, PhD., Timothy Hunt, PhD., Caroline Arout, PhD., Elwin Wu, PhD., Harold A. Pincus, MD, Edward V. Nunes, MD, Pat Lincourt, MSW, Frances R. Levin, MD, and Nabila El-Bassel, PhD
Nabila El-Bassel, PhD