Structural factors associated with drug overdose mortality in Northern Appalachia

Abstract

This thesis aims to examine factors associated with drug overdose mortality in the northern portion of the Appalachian Mountain Region of the United States and to investigate what protective factors, if any, may serve to decrease rates of mortality. It uses linear regression to examine the demographic and socioeconomic characteristics of Appalachian counties in Ohio, Pennsylvania, and West Virginia. Findings reveal that among all states, higher structural disadvantage, a larger percentage of residents reporting having a checkup with a healthcare provider in the past year, and a higher percentage of nonwhite residents are all associated with increased overdose mortality rates. A higher proportion of male residents and a higher median age were associated with decreased overdose mortality rates. Analysis of each state individually reveals that different forces may be driving drug overdose mortality in different locations: structural disadvantage, past year checkups, and demographics are associated with overdose mortality in West Virginia. However, only past year checkups are associated with overdose mortality in Pennsylvania, and only structural disadvantage was found to be important in Ohio.