Characterizing the geographic variability of opioid mortality in North Carolina, 2014-2016

The opioid crisis has proven to be one of the most devastating drug epidemics experienced in the United States. While many studies have associated the rise in opioid mortality rates to overprescribing of opioid painkillers, few have attempted to explore socioeconomic factors that may be drivers in the ongoing crisis. A need exists to ascertain the relationship between socio-economic factors and opioid mortality trends. Here, a multiple regression analysis aids in the exploration of the relationship between opioid mortality in North Carolina and socioeconomic and geographic measures. Several studies have offered key socio-economic measures that may be indicative of higher rates of opioid mortality such as low income, low educational attainment, disability, and recently occupational patterns. While some studies have analyzed the geographic variability of opioid mortality trends, few have attempted to analyze these factors simultaneously. Two multiple regression models are generated for two separate outcomes: total age-adjusted opioid mortality rate and white age-adjusted opioid mortality rate. All models control for age, region, and metropolitan status. County-level mapping of age-adjusted opioid mortality rates reveals regional disparity across three outcomes\; total, white, and non-white age-adjusted opioid mortality. Regions that exhibit extremely high percentages of opioid mortality in the state include the western region for the total opioid mortality, eastern region for white opioid mortality, and central region for non-white opioid mortality. Regression models for total age-adjusted produced an R2 value of .460 and an adjusted R2 value of .371. Regression models for white age-adjusted produced an R2 value of .460 and an adjusted R2 of .386. Total and white-age-adjusted opioid mortality was found to be positively correlated with eastern and western region designation, percent of those with income and benefits of $10,000-$14000, percent of those with a high school diploma or less, and disability. This study demonstrates the necessity to examine regional and socioeconomic factors concerning opioid mortality to generate more effective countermeasures to the ongoing drug crisis