Spatial and racial disparities in risk of opioid abuse diagnosis in Michigan: 2009-2012

Authors: Breaunté Jesse Brown*, Michigan State University Department of Geography, Envrionment, and Spatial Sciences, Ashton Shortridge, Michigan State University Department of Geography, Envrionment, and Spatial Sciences, Amber Pearson, Michigan State University Department of Geography, Envrionment, and Spatial Sciences
Topics: Medical and Health Geography, Health and Medical
Keywords: black populations, relative risk, health geography, substance misuse
Session Type: Virtual Paper
Day: 4/8/2021
Start / End Time: 1:30 PM / 2:45 PM
Room: Virtual 19
Presentation File: No File Uploaded


Opioids are substances used primarily as pain killers, but certain types are highly addictive. This study identifies spatial trends in diagnoses of opioid dependence versus abuse in Michigan counties during the years 2009-2012. Additionally, this study evaluates relative risk and incidence rates of opioid abuse versus dependence diagnosis in relationship to black and white sub-populations. Hospitalization records were collected from the Michigan In-patient Database (MIDB) using the World Health Organization (WHO) International Classification of Diseases, 9th Revision (ICD-9) diagnosis codes. Dependence was defined in the ICD-9 as “a physiological need to have the drug”, whereas abuse was defined as “a desire to have the drug”. Given the overlap of these diagnosis definitions and the negative, punitive associations with the term "abuse", this research is motivated by concern that racial disparities in diagnosis rate may occur. County-level Census (2010) data were used as an approximation of Michigan county populations and demographics through the study period. During the study period, Michigan opioid diagnosis rates steadily increased for most subpopulations. Results indicated that six counties, including the most populous, Wayne County, had higher opioid abuse diagnosis rates among black people. Statewide, black patients in 2009 and 2011 experienced particularly high relative risk and incidence of opioid abuse diagnosis, RR= 1.37 and 1.41 respectively. Understanding disparities in opioid diagnoses is essential when considering implications towards legal issues, treatment, and socio-economic conditions and how public health efforts can be deployed in the most affected counties.

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