{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T02:40:36Z","timestamp":1792636836544,"version":"4.5.0"},"reference-count":35,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi260731-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Previous research has shown neighborhood environmental interventions can improve health and safety for residents. It is unknown whether these interventions impact opioid overdose outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260731-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the association of neighborhood environmental interventions with opioid overdose rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260731-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This quasi-experimental nonrandomized trial used a continuous treatment difference-in-differences design and was conducted in a single neighborhood of Philadelphia, Pennsylvania, between January 1, 2019, and December 31, 2021. The quasi-experimental design used nonrandomized comparator groups to evaluate the associations of neighborhood environmental interventions with opioid overdose rates since randomization was not possible. Data analysis took place between May 2022 and February 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260731-7\">\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Community trash pickups, vacant lot cleanups, and abandoned house remediation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260731-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Outcomes of interest were nonfatal and fatal opioid overdoses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260731-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 1667 individual blocks (median household income, $37\u202f821) included in the study geography, 622 blocks (37.3%) received at least 1 intervention during the study period. Among 59\u202f590 residents in the study area, there were 1179 Asian residents (2.0%), 9951 Black residents (16.7%), 23\u202f261 White residents (39.0%), 5016 residents (8.4%) who identified as 2 or more races, and 19\u202f903 residents (33.4%) who identified as another race; 30\u202f286 residents (50.8%) were Hispanic or Latinx. A total of 763 community trash pickups, 483 abandoned house remediations, and 855 vacant lot cleanups were included in analysis. In aggregate, the interventions were associated with a significant reduction in fatal opioid overdoses (change, \u22126.6%; 95% CI, \u221210.5% to \u22122.4%), with no measurable association for nonfatal opioid overdoses (change, \u22120.0%; 95% CI, \u22123.4% to 3.5%). Abandoned house remediation was associated with a significant reduction in both fatal (change, \u221217.6%; 95% CI, \u221226.2% to \u22127.9%) and nonfatal (change, \u221211.5%; 95% CI, \u221219.0% to \u22123.3%) opioid overdoses. Community trash pickup was not associated with rates of fatal or nonfatal overdoses. Vacant lot cleanup was not associated with rates of fatal overdoses but was associated with a significant increase in nonfatal overdoses (change, 11.7%; 95% CI, 4.0% to 20.0%). No significant displacement associations were found in other locations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260731-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>In this study of the association of neighborhood environmental interventions with opioid overdose rates, interventions analyzed in aggregate were associated with reduced fatal opioid overdoses outcomes, with no association with nonfatal outcomes. Abandoned house remediation was significantly associated with reduced fatal and nonfatal opioid overdose rates and should be considered along with other essential interventions that provide treatment and harm reduction to individuals with substance use disorder.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.26634","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T15:30:23Z","timestamp":1785511823000},"page":"e2626634","source":"Crossref","is-referenced-by-count":1,"title":["Neighborhood Environmental Interventions and Opioid Overdose Rates"],"prefix":"10.1001","volume":"9","author":[{"given":"Eugenia C.","family":"South","sequence":"first","affiliation":[{"name":"Penn Medicine Center for Health Justice, University of Pennsylvania Perelman School of Medicine, Philadelphia"},{"name":"Center for Emergency Care Policy and Research, Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia"},{"name":"Penn Injury Science Center, University of Pennsylvania Perelman School of Medicine, Philadelphia"},{"name":"Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Seeburger","sequence":"additional","affiliation":[{"name":"Penn Medicine Center for Health Justice, University of Pennsylvania Perelman School of Medicine, Philadelphia"},{"name":"Center for Emergency Care Policy and Research, Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia"},{"name":"Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abby","family":"Dolan","sequence":"additional","affiliation":[{"name":"Penn Medicine Center for Health Justice, University of Pennsylvania Perelman School of Medicine, Philadelphia"},{"name":"Center for Emergency Care Policy and Research, Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia"},{"name":"Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg","family":"Ridgeway","sequence":"additional","affiliation":[{"name":"Department of Criminology and Sociology, University of Pennsylvania, Philadelphia"},{"name":"Department of Statistics and Data Science, University of Pennsylvania, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoshana","family":"Aronowitz","sequence":"additional","affiliation":[{"name":"Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles C.","family":"Branas","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanmarie","family":"Perrone","sequence":"additional","affiliation":[{"name":"Center for Addiction Medicine and Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia"},{"name":"Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"MacDonald","sequence":"additional","affiliation":[{"name":"Department of Criminology and Sociology, University of Pennsylvania, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Wiebe","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Mandell","sequence":"additional","affiliation":[{"name":"Center for Mental Health, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kehinde","family":"Oyekanmi","sequence":"additional","affiliation":[{"name":"Penn Medicine Center for Health Justice, University of Pennsylvania Perelman School of Medicine, Philadelphia"},{"name":"Center for Emergency Care Policy and Research, Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia"},{"name":"Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Thomas","sequence":"additional","affiliation":[{"name":"Penn Medicine Center for Health Justice, University of Pennsylvania Perelman School of Medicine, Philadelphia"},{"name":"Penn Injury Science Center, University of Pennsylvania Perelman School of Medicine, Philadelphia"},{"name":"Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary F.","family":"Meisel","sequence":"additional","affiliation":[{"name":"Center for Emergency Care Policy and Research, Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia"},{"name":"Penn Injury Science Center, University of Pennsylvania Perelman School of Medicine, Philadelphia"},{"name":"Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"zoi260731r4","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthplace.2022.102792","article-title":"Understanding the role of urban social and physical environment in opioid overdose events using found geospatial data.","volume":"75","author":"Li","year":"2022","journal-title":"Health Place"},{"key":"zoi260731r5","doi-asserted-by":"publisher","DOI":"10.1016\/j.compenvurbsys.2021.101599","article-title":"Incorporating space and time into random forest models for analyzing geospatial patterns of drug-related crime incidents in a major U.S. metropolitan area.","volume":"87","author":"Xia","year":"2021","journal-title":"Comput Environ Urban Syst"},{"issue":"2","key":"zoi260731r6","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1016\/j.healthplace.2004.02.005","article-title":"The urban built environment and overdose mortality in New York City neighborhoods.","volume":"11","author":"Hembree","year":"2005","journal-title":"Health Place"},{"issue":"3","key":"zoi260731r7","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1080\/00952990600753966","article-title":"Neighborhood ecology and drug dependence mortality: an analysis of New York City census tracts.","volume":"32","author":"Hannon","year":"2006","journal-title":"Am J Drug Alcohol Abuse"},{"issue":"3","key":"zoi260731r8","doi-asserted-by":"publisher","first-page":"467","DOI":"10.2105\/AJPH.93.3.467","article-title":"Neighborhood physical conditions and health.","volume":"93","author":"Cohen","year":"2003","journal-title":"Am J Public Health"},{"issue":"3","key":"zoi260731r9","doi-asserted-by":"publisher","first-page":"371","DOI":"10.15288\/jsad.2011.72.371","article-title":"The growth of neighborhood disorder and marijuana use among urban adolescents: a case for policy and environmental interventions.","volume":"72","author":"Furr-Holden","year":"2011","journal-title":"J Stud Alcohol Drugs"},{"issue":"2","key":"zoi260731r10","doi-asserted-by":"publisher","first-page":"230","DOI":"10.2105\/AJPH.90.2.230","article-title":"\u201cBroken windows\u201d and the risk of gonorrhea.","volume":"90","author":"Cohen","year":"2000","journal-title":"Am J Public Health"},{"issue":"10","key":"zoi260731r11","doi-asserted-by":"publisher","first-page":"904","DOI":"10.1136\/jech.2004.027060","article-title":"Block observations of neighbourhood physical disorder are associated with neighbourhood crime, firearm injuries and deaths, and teen births.","volume":"59","author":"Wei","year":"2005","journal-title":"J Epidemiol Community Health"},{"issue":"9","key":"zoi260731r12","doi-asserted-by":"publisher","first-page":"1664","DOI":"10.2105\/AJPH.2007.125138","article-title":"Neighborhood psychosocial hazards and cardiovascular disease: the Baltimore Memory Study.","volume":"98","author":"Augustin","year":"2008","journal-title":"Am J Public Health"},{"issue":"1","key":"zoi260731r13","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1146\/annurev.publhealth.031308.100158","article-title":"Geographic life environments and coronary heart disease: a literature review, theoretical contributions, methodological updates, and a research agenda.","volume":"30","author":"Chaix","year":"2009","journal-title":"Annu Rev Public Health"},{"issue":"2","key":"zoi260731r14","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1056\/NEJM200107123450205","article-title":"Neighborhood of residence and incidence of coronary heart disease.","volume":"345","author":"Diez Roux","year":"2001","journal-title":"N Engl J Med"},{"issue":"11","key":"zoi260731r15","doi-asserted-by":"publisher","first-page":"940","DOI":"10.1136\/jech.2007.066605","article-title":"Are neighbourhood characteristics associated with depressive symptoms: a review of evidence.","volume":"62","author":"Mair","year":"2008","journal-title":"J Epidemiol Community Health"},{"key":"zoi260731r16","article-title":"Vacant properties and violence in neighborhoods.","volume":"2012","author":"Branas","year":"2013","journal-title":"ISRN Public Health"},{"issue":"6","key":"zoi260731r17","doi-asserted-by":"publisher","first-page":"S234","DOI":"10.1016\/j.amepre.2007.02.023","article-title":"Direct and indirect associations of neighborhood disorder with drug use and high-risk sexual partners.","volume":"32","author":"Latkin","year":"2007","journal-title":"Am J Prev Med"},{"issue":"3","key":"zoi260731r18","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1016\/j.socscimed.2006.02.001","article-title":"What explains the association between neighborhood-level income inequality and the risk of fatal overdose in New York City?","volume":"63","author":"Nandi","year":"2006","journal-title":"Soc Sci Med"},{"issue":"5","key":"zoi260731r19","doi-asserted-by":"publisher","first-page":"965","DOI":"10.1016\/j.socscimed.2004.12.027","article-title":"Neighborhood disorder, psychological distress, and heavy drinking.","volume":"61","author":"Hill","year":"2005","journal-title":"Soc Sci Med"},{"issue":"4","key":"zoi260731r20","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1093\/aje\/kwp416","article-title":"Neighborhood poverty and injection cessation in a sample of injection drug users.","volume":"171","author":"Nandi","year":"2010","journal-title":"Am J Epidemiol"},{"issue":"1-2","key":"zoi260731r21","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1002\/ajcp.12802","article-title":"Community-engaged crime prevention through environmental design and reductions in violent and firearm crime.","volume":"76","author":"Rupp","year":"2025","journal-title":"Am J Community Psychol"},{"issue":"2-3","key":"zoi260731r22","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1016\/j.drugalcdep.2009.08.007","article-title":"Environmental conditions, political economy, and rates of injection drug use in large US metropolitan areas 1992-2002.","volume":"106","author":"Roberts","year":"2010","journal-title":"Drug Alcohol Depend"},{"key":"zoi260731r23","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthplace.2020.102430","article-title":"The ecology of overdose mortality in Philadelphia.","volume":"66","author":"Johnson","year":"2020","journal-title":"Health Place"},{"issue":"3","key":"zoi260731r24","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1007\/s11524-012-9782-7","article-title":"More than just an eyesore: local insights and solutions on vacant land and urban health.","volume":"90","author":"Garvin","year":"2013","journal-title":"J Urban Health"},{"issue":"12","key":"zoi260731r25","doi-asserted-by":"publisher","first-page":"2946","DOI":"10.1073\/pnas.1718503115","article-title":"Citywide cluster randomized trial to restore blighted vacant land and its effects on violence, crime, and fear.","volume":"115","author":"Branas","year":"2018","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"3","key":"zoi260731r26","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.0298","article-title":"Effect of greening vacant land on mental health of community-dwelling adults: a cluster randomized trial.","volume":"1","author":"South","year":"2018","journal-title":"JAMA Netw Open"},{"issue":"1","key":"zoi260731r27","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1001\/jamainternmed.2022.5460","article-title":"Effect of abandoned housing interventions on gun violence, perceptions of safety, and substance use in Black neighborhoods: a citywide cluster randomized trial.","volume":"183","author":"South","year":"2023","journal-title":"JAMA Intern Med"},{"issue":"7","key":"zoi260731r28","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.17067","article-title":"Association between structural housing repairs for low-income homeowners and neighborhood crime.","volume":"4","author":"South","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"11","key":"zoi260731r29","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1097\/01.NAJ.0001081740.74815.20","article-title":"An Introduction to Types of Quasi-Experimental Designs.","volume":"124","author":"Capili","year":"2024","journal-title":"Am J Nurs"},{"issue":"3","key":"zoi260731r31","doi-asserted-by":"publisher","first-page":"1464","DOI":"10.1214\/19-AOAS1241","article-title":"The classification permutation test: a flexible approach to testing for covariate imbalance in observational studies.","volume":"13","author":"Gagnon-Bartsch","year":"2019","journal-title":"Ann Appl Stat"},{"key":"zoi260731r34","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthplace.2022.102959","article-title":"Drug overdoses, geographic trajectories, and the influence of built environment and neighborhood characteristics.","volume":"79","author":"Piza","year":"2023","journal-title":"Health Place"},{"issue":"1","key":"zoi260731r35","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.34878","article-title":"Racial\/ethnic disparities in unintentional fatal and nonfatal emergency medical services-attended opioid overdoses during the COVID-19 pandemic in Philadelphia.","volume":"4","author":"Khatri","year":"2021","journal-title":"JAMA Netw Open"},{"key":"zoi260731r1","unstructured":"Centers for Disease Control and Prevention. Drug overdose deaths. August 22, 2023. Accessed November 2, 2023. https:\/\/www.cdc.gov\/nchs\/hus\/topics\/drug-overdose-deaths.htm"},{"key":"zoi260731r2","unstructured":"The PEW Charitable Trusts. Philadelphia 2022: the state of the city. Accessed November 2, 2023. https:\/\/www.pewtrusts.org\/-\/media\/assets\/2022\/04\/philadelphia-2022-the-state-of-the-city.pdf"},{"key":"zoi260731r3","unstructured":"City of Philadelphia Department of Public Health. Philadelphia records more than 1,400 overdose deaths in 2022; deaths among Black residents rose nearly 20%. News release. October 11, 2023. Accessed November 2, 2023. https:\/\/www.phila.gov\/2023-10-02-philadelphia-records-more-than-1400-overdose-deaths-in-2022-deaths-among-black-residents-rose-nearly-20\/"},{"key":"zoi260731r30","unstructured":"City of Philadelphia Office of the Mayor. Philadelphia Resilience Project archives. Updated November 10, 2022. Accessed November 2, 2023. https:\/\/www.phila.gov\/documents\/philadelphia-resilience-project-archives\/"},{"key":"zoi260731r32","unstructured":"Turner? H, Firth? D, Ripley? B, Venables? B, Bates? DM, Maechler? M. gnm: generalized nonlinear models. Published online September 16, 2023. Accessed February 16, 2024. https:\/\/cran.r-project.org\/web\/packages\/gnm\/index.html"},{"key":"zoi260731r33","unstructured":"Wang? HL. 1 In 7 people are \u201csome other race\u201d on the U.S. Census\u2014that\u2019s a big data problem. NPR. September 30, 2021. Accessed February 16, 2024. https:\/\/www.npr.org\/2021\/09\/30\/1037352177\/2020-census-results-by-race-some-other-latino-ethnicity-hispanic"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2852333\/south_2026_oi_260731_1784843199.39985.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T15:30:24Z","timestamp":1785511824000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2852333"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,31]]},"references-count":35,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2026.26634","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,31]]}}}