An Investigation into The Epidemiologic Landscape of Drug Overdose Mortality, Georgia, 2000 to 2020 Open Access

Abstract

This study examines the escalating Georgia drug overdose health crisis, which has been steadily worsening over time, affecting communities statewide. Opioids and substance misuse increased in the late ‘90s and early 2000s but skyrocketed in 2010 and 2013 with the influx of heroin and fentanyl. In 2017, the Department of Health and Human Services declared the opioid crisis a national public health emergency. Despite ongoing national recognition of the crisis, overdose fatalities continue to rise. Using Georgia Department of Public Health (DPH) data, containing multiple cause of death information, the study utilized statistical and spatial analysis to identify demographic and geographic variation in Georgia fatal drug overdoses from 2000 to 2020. Analyzing the relationship between Social Determinants of Health (SDOH) and 2015 to 2020 drug overdose mortality data using aspatial and spatial error models and Moran’s I and Hausman statistical test, revealed associations between SDOH and mortality. Overdose mortality rates were at their lowest in 2000 and peaked in 2020, shifting from 4.68 deaths to 18.13 per 100,000 individuals in this period. Unintentional drug overdose was the leading cause of overdose death in Georgia, making up 86.8% of all overdose deaths, followed by suicides making up 9.7%. The north and southeast regions of Georgia were of particular concern, containing the majority of counties at high risk of overdose fatalities. The analysis revealed that several SDOH themes, such as housing composition, minority status & language, and housing & transportation, were positively associated with overdose mortality, indicating that as these factors increase overdose fatalities increase. The socioeconomic theme was the only SDOH theme that was negatively associated with overdose mortality, indicating a decrease in deaths as socioeconomic conditions improve. This study contributed to a deeper understanding of the drug overdose landscape in Georgia, offering insight into demographic, geographic, and socioeconomic implications on overdose mortality. The results emphasize the need for targeted public health interventions and policy approaches that address the shifting overdose landscape.

Table of Contents

INTRODUCTION ……………………………………………………………………………….. 1

Social determinants of health …………………………………………………………..….. 2

Understanding drug overdose mortality ………………………………………………….. 3

METHODS ……………………………………………………………………………………….. 4

Data source ……………………………………………………………………………………... 4

Study population ………………………………………………………………………………. 5

Variables and definitions …………………………………………………………………….. 5

Statistical analysis …………………………………………………………………………….. 6

RESULTS ……………………………………………………………………………………….... 7

DISCUSSION …………………………………………………………………………………... 19

REFERENCES ………………………………………………………………………………….. 24

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology Health Sciences, Public Health
Keyword	Stimulants Substance use SUD Drug overdose Social determinants of health Opioid Social Vulnerability Substance use disorder
Committee Chair / Thesis Advisor	Michael Kramer, Emory University

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