{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:44:47Z","timestamp":1790729087759,"version":"4.1.0"},"reference-count":33,"publisher":"American Public Health Association","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:p>Objectives. To examine associations of county-level demographic, socioeconomic, and labor market characteristics on overall drug mortality rates and specific classes of opioid mortality.<\/jats:p><jats:p>Methods. We used National Vital Statistics System mortality data (2002\u20132004 and 2014\u20132016) and county-level US Census data. We examined associations between several census variables and drug deaths for 2014 to 2016. We then identified specific classes of counties characterized by different levels and rates of growth in mortality from specific opioid types between 2002 to 2004 and 2014 to 2016. We ran multivariate and multivariable regression models to predict probabilities of membership in each \u201copioid mortality class\u201d on the basis of county-level census measures.<\/jats:p><jats:p>Results. Drug mortality rates overall are higher in counties characterized by more economic disadvantage, more blue-collar and service employment, and higher opioid-prescribing rates. High rates of prescription opioid overdoses and overdoses involving both prescription and synthetic opioids cluster in more economically disadvantaged counties with larger concentrations of service industry workers. High heroin and \u201csyndemic\u201d opioid mortality counties (high rates across all major opioid types) are more urban, have larger concentrations of professional workers, and are less economically disadvantaged. Syndemic opioid counties also have greater concentrations of blue-collar workers.<\/jats:p><jats:p>Conclusions. Census data are essential tools for understanding the importance of place-level characteristics on opioid mortality.<\/jats:p><jats:p>Public Health Implications. National opioid policy strategies cannot be assumed universally applicable. In addition to national policies to combat the opioid and larger drug crises, emphasis should be on developing locally and regionally tailored interventions, with attention to place-based structural economic and social characteristics.<\/jats:p>","DOI":"10.2105\/ajph.2019.305136","type":"journal-article","created":{"date-parts":[[2019,6,20]],"date-time":"2019-06-20T20:02:16Z","timestamp":1561060936000},"page":"1084-1091","source":"Crossref","is-referenced-by-count":98,"title":["Using Census Data to Understand County-Level Differences in Overall Drug Mortality and Opioid-Related Mortality by Opioid Type"],"prefix":"10.2105","volume":"109","author":[{"given":"Shannon M.","family":"Monnat","sequence":"first","affiliation":[{"name":"Shannon M. Monnat is with the Maxwell School of Citizenship and Public Affairs, Lerner Center for Public Health Promotion, Center for Policy Research, and the Department of Sociology, Syracuse University, Syracuse, NY. David J. Peters and Andrew Hochstetler are with the Department of Sociology, Iowa State University, Ames. Mark T. Berg is with the Department of Sociology and Public Policy Center, University of Iowa, Iowa City."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Peters","sequence":"additional","affiliation":[{"name":"Shannon M. Monnat is with the Maxwell School of Citizenship and Public Affairs, Lerner Center for Public Health Promotion, Center for Policy Research, and the Department of Sociology, Syracuse University, Syracuse, NY. David J. Peters and Andrew Hochstetler are with the Department of Sociology, Iowa State University, Ames. Mark T. Berg is with the Department of Sociology and Public Policy Center, University of Iowa, Iowa City."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark T.","family":"Berg","sequence":"additional","affiliation":[{"name":"Shannon M. Monnat is with the Maxwell School of Citizenship and Public Affairs, Lerner Center for Public Health Promotion, Center for Policy Research, and the Department of Sociology, Syracuse University, Syracuse, NY. David J. Peters and Andrew Hochstetler are with the Department of Sociology, Iowa State University, Ames. Mark T. Berg is with the Department of Sociology and Public Policy Center, University of Iowa, Iowa City."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Hochstetler","sequence":"additional","affiliation":[{"name":"Shannon M. Monnat is with the Maxwell School of Citizenship and Public Affairs, Lerner Center for Public Health Promotion, Center for Policy Research, and the Department of Sociology, Syracuse University, Syracuse, NY. David J. Peters and Andrew Hochstetler are with the Department of Sociology, Iowa State University, Ames. Mark T. Berg is with the Department of Sociology and Public Policy Center, University of Iowa, Iowa City."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"844","reference":[{"key":"bib1","volume-title":"Drug Overdose Deaths in the United States, 1999\u20132017","author":"Hedegaard H","year":"2018"},{"key":"bib2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2018.01.040"},{"key":"bib3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jrurstud.2018.12.004"},{"key":"bib4","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2018.04.011"},{"key":"bib5","volume-title":"Drug Poisoning Mortality: United States, 1999\u20132016","author":"Rossen LM","year":"2017"},{"key":"bib6","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.0040"},{"key":"bib7","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2017.06.009"},{"key":"bib8","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0030260"},{"key":"bib9","doi-asserted-by":"crossref","DOI":"10.1353\/book5206","volume-title":"The Sociology of Spatial Inequality","author":"Lobao LM","year":"2007"},{"key":"bib10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1549-0831.2011.00055.x"},{"key":"bib11","doi-asserted-by":"publisher","DOI":"10.1007\/s11113-014-9350-9"},{"key":"bib12","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.92.1.99"},{"key":"bib13","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2018.304787"},{"key":"bib14","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0032930"},{"key":"bib15","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.89.6.893"},{"key":"bib16","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0137832"},{"key":"bib17","doi-asserted-by":"publisher","DOI":"10.1016\/j.apgeog.2017.05.005"},{"key":"bib18","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0153516"},{"key":"bib19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2019.01.001"},{"issue":"19","key":"bib20","first-page":"30018-0","volume":"0955","author":"Ciccarone D","year":"2019","journal-title":"Int J Drug Policy"},{"key":"bib21","doi-asserted-by":"publisher","DOI":"10.1353\/eca.2017.0005"},{"key":"bib22","doi-asserted-by":"publisher","DOI":"10.1002\/0471602396"},{"key":"bib24","doi-asserted-by":"publisher","DOI":"10.1002\/9781119942283"},{"key":"bib25","doi-asserted-by":"publisher","DOI":"10.1080\/10705511.2014.935751"},{"key":"bib26","doi-asserted-by":"publisher","DOI":"10.1080\/10705511.2017.1365304"},{"key":"bib27","doi-asserted-by":"publisher","DOI":"10.1080\/10705511.2012.634701"},{"key":"bib28","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30003-X"},{"key":"bib29","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2013.07.012"},{"key":"bib31","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2013.301709"},{"key":"bib32","volume-title":"Those Who Work, Those Who Don\u2019t: Poverty, Morality, and Family in Rural America","author":"Sherman J.","year":"2009"},{"key":"bib33","volume-title":"Dreamland: The True Tale of America\u2019s Opiate Epidemic","author":"Quinones S","year":"2015"},{"key":"bib34","doi-asserted-by":"publisher","DOI":"10.1007\/s00148-018-0687-y"},{"key":"bib35","volume-title":"Longer, More Optimistic Lives: Historic Optimism and Life Expectancy in the United States","author":"O\u2019Connor KJ","year":"2018"}],"container-title":["American Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ajph.aphapublications.org\/doi\/pdf\/10.2105\/AJPH.2019.305136","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,17]],"date-time":"2023-09-17T16:47:54Z","timestamp":1694969274000},"score":1,"resource":{"primary":{"URL":"https:\/\/ajph.aphapublications.org\/doi\/full\/10.2105\/AJPH.2019.305136"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8]]},"references-count":33,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2019,8]]}},"alternative-id":["10.2105\/AJPH.2019.305136"],"URL":"https:\/\/doi.org\/10.2105\/ajph.2019.305136","relation":{},"ISSN":["0090-0036","1541-0048"],"issn-type":[{"value":"0090-0036","type":"print"},{"value":"1541-0048","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8]]}}}