IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v301y2022ics0277953622002775.html
   My bibliography  Save this article

County social isolation and opioid use disorder among older adults: A longitudinal analysis of Medicare data, 2013–2018

Author

Listed:
  • Yang, Tse-Chuan
  • Shoff, Carla
  • Kim, Seulki
  • Shaw, Benjamin A.

Abstract

This study aims to fill three knowledge gaps: (1) unclear role of ecological factors in shaping older adults' risk of opioid use disorder (OUD), (2) a lack of longitudinal perspective in OUD research among older adults, and (3) underexplored racial/ethnic differences in the determinants of OUD in older populations. This study estimates the effects of county-level social isolation, concentrated disadvantage, and income inequality on older adults' risk of OUD using longitudinal data analysis. We merged the 2013–2018 Medicare population (aged 65+) data to the American Community Survey 5-year county-level estimates to create a person-year dataset (N = 47,291,217 person-years) and used conditional logit fixed-effects modeling to test whether changes in individual- and county-level covariates alter older adults' risk of OUD. Moreover, we conducted race/ethnicity-specific models to compare how these associations vary across racial/ethnic groups. At the county-level, a one-unit increase in social isolation (mean = −0.197, SD = 0.511) increased the risk of OUD by 5.5 percent (OR = 1.055; 95% CI = [1.018, 1.094]) and a one-percentage-point increase in the working population employed in primary industry decreases the risk of OUD by 1 percent (OR = 0.990; 95% CI = [0.985, 0.996]). At the individual-level, increases in the Medicare Hierarchical Condition Categories risk score, physical comorbidity, and mental comorbidity all elevate the risk of OUD. The relationship between county-level social isolation and OUD is driven by non-Hispanic whites, while Hispanic beneficiaries are less sensitive to the changes in county-level factors than any other racial ethnic groups. Between 2013 and 2018, US older adults’ risk of OUD was associated with both ecological and individual factors, which carries implications for intervention. Further research is needed to understand why associations of individual factors with OUD are comparable across racial/ethnic groups, but county-level social isolation is only associated with OUD among non-Hispanic white beneficiaries.

Suggested Citation

  • Yang, Tse-Chuan & Shoff, Carla & Kim, Seulki & Shaw, Benjamin A., 2022. "County social isolation and opioid use disorder among older adults: A longitudinal analysis of Medicare data, 2013–2018," Social Science & Medicine, Elsevier, vol. 301(C).
    • Handle: RePEc:eee:socmed:v:301:y:2022:i:c:s0277953622002775
    DOI: 10.1016/j.socscimed.2022.114971
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953622002775
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2022.114971?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Ying Huang & Scott J. South & Amy Spring, 2017. "Racial Differences in Neighborhood Attainment: The Contributions of Interneighborhood Migration and In Situ Change," Demography, Springer;Population Association of America (PAA), vol. 54(5), pages 1819-1843, October.
    2. John R. Beard & Shannon Blaney & Magda Cerda & Victoria Frye & Gina S. Lovasi & Danielle Ompad & Andrew Rundle & David Vlahov, 2009. "Neighborhood Characteristics and Disability in Older Adults," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 64(2), pages 252-257.
    3. Yang, Tse-Chuan & Shoff, Carla & Kim, Seulki, 2022. "Social isolation, residential stability, and opioid use disorder among older Medicare beneficiaries: Metropolitan and non-metropolitan county comparison," Social Science & Medicine, Elsevier, vol. 292(C).
    4. Moritz Kuhn & José-Víctor Ríos-Rull, 2016. "2013 Update on the U.S. Earnings, Income, and Wealth Distributional Facts: A View from Macroeconomics," Quarterly Review, Federal Reserve Bank of Minneapolis, issue April, pages 1-75.
    5. Arcaya, Mariana C. & Tucker-Seeley, Reginald D. & Kim, Rockli & Schnake-Mahl, Alina & So, Marvin & Subramanian, S.V., 2016. "Research on neighborhood effects on health in the United States: A systematic review of study characteristics," Social Science & Medicine, Elsevier, vol. 168(C), pages 16-29.
    6. Case, A.C. & Katz, L.F., 1991. "The Company You Keep: The Effects Of Family And Neighborhood On Disadvantaged Younths," Harvard Institute of Economic Research Working Papers 1555, Harvard - Institute of Economic Research.
    7. Bell, Andrew & Jones, Kelvyn, 2015. "Explaining Fixed Effects: Random Effects Modeling of Time-Series Cross-Sectional and Panel Data," Political Science Research and Methods, Cambridge University Press, vol. 3(1), pages 133-153, January.
    8. Won, Jaewoong & Lee, Chanam & Forjuoh, Samuel N. & Ory, Marcia G., 2016. "Neighborhood safety factors associated with older adults' health-related outcomes: A systematic literature review," Social Science & Medicine, Elsevier, vol. 165(C), pages 177-186.
    9. Eschbach, K. & Ostir, G.V. & Patel, K.V. & Markides, K.S. & Goodwin, J.S., 2004. "Neighborhood context and mortality among older Mexican Americans: Is there a barrio advantage?," American Journal of Public Health, American Public Health Association, vol. 94(10), pages 1807-1812.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Bjorklund, Eric, 2023. "The needle and the damage done: Deaths of despair, economic precarity, and the white working-class," Social Science & Medicine, Elsevier, vol. 333(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Gutiérrez-Romero, Roxana & Ahamed, Mostak, 2021. "COVID-19 response needs to broaden financial inclusion to curb the rise in poverty," World Development, Elsevier, vol. 138(C).
    2. Maria De Paola & Vincenzo Scoppa, 2010. "Peer group effects on the academic performance of Italian students," Applied Economics, Taylor & Francis Journals, vol. 42(17), pages 2203-2215.
    3. Grossmann, Volker & Larin, Benjamin & Löfflad, Hans Torben & Steger, Thomas, 2021. "Distributional consequences of surging housing rents," Journal of Economic Theory, Elsevier, vol. 196(C).
    4. Todd D. Gerarden & Richard G. Newell & Robert N. Stavins, 2017. "Assessing the Energy-Efficiency Gap," Journal of Economic Literature, American Economic Association, vol. 55(4), pages 1486-1525, December.
    5. Sékou Samadoulougou & Laurence Letarte & Alexandre Lebel, 2022. "Association between Neighbourhood Deprivation Trajectories and Self-Perceived Health: Analysis of a Linked Survey and Health Administrative Data," IJERPH, MDPI, vol. 20(1), pages 1-14, December.
    6. Feng, Yao, 2011. "Local spillovers and learning from neighbors: Evidence from durable adoptions in rural China," MPRA Paper 33924, University Library of Munich, Germany.
    7. Adnan Q. Khan & Steven F. Lehrer, 2013. "The Impact of Social Networks on Labour Market Outcomes: New Evidence from Cape Breton," Canadian Public Policy, University of Toronto Press, vol. 39(s1), pages 1-24, May.
    8. Wu, Yu & Mullan, Katrina & Biggs, Trent & Caviglia-Harris, Jill L. & Harris, Daniel & Sills, Erin O., 2018. "Do Forests Provide Watershed Services to Local Populations in the Humid Tropics? Evidence from the Brazilian Amazon," 2018 Annual Meeting, August 5-7, Washington, D.C. 274012, Agricultural and Applied Economics Association.
    9. Garfield O. Blake, 2015. "Using Increases in Criminal Deportees from the US to Estimate the Effect of Crime on Economic Growth and Development in Latin America and the Caribbean," Laws, MDPI, vol. 4(4), pages 1-18, November.
    10. Clarke, Philippa & Ailshire, Jennifer A. & Lantz, Paula, 2009. "Urban built environments and trajectories of mobility disability: Findings from a national sample of community-dwelling American adults (1986-2001)," Social Science & Medicine, Elsevier, vol. 69(6), pages 964-970, September.
    11. Machikita, Tomohiro, 2006. "Are Job Networks Localized in a Developing Economy? Search Methods for Displaced Workers in Thailand," IDE Discussion Papers 84, Institute of Developing Economies, Japan External Trade Organization(JETRO).
    12. Francesco Agostinelli & Matthias Doepke & Giuseppe Sorrenti & Fabrizio Zilibotti, 2020. "It Takes a Village: The Economics of Parenting with Neighborhood and Peer Effects," Cowles Foundation Discussion Papers 2228, Cowles Foundation for Research in Economics, Yale University.
    13. Alvarez, Camila H. & Evans, Clare Rosenfeld, 2021. "Intersectional environmental justice and population health inequalities: A novel approach," Social Science & Medicine, Elsevier, vol. 269(C).
    14. Eric Maurin & Julie Moschion, 2009. "The Social Multiplier and Labor Market Participation of Mothers," American Economic Journal: Applied Economics, American Economic Association, vol. 1(1), pages 251-272, January.
    15. Katherine M. O'Regan & John M. Quigley, 1996. "Teenage Employment and the Spatial Isolation of Minority and Poverty Households," Journal of Human Resources, University of Wisconsin Press, vol. 31(3), pages 692-702.
    16. Moritz Kuhn & Moritz Schularick & Ulrike I. Steins, 2020. "Income and Wealth Inequality in America, 1949–2016," Journal of Political Economy, University of Chicago Press, vol. 128(9), pages 3469-3519.
    17. Tse-Chuan Yang & Stephen A Matthews, 2015. "Death by Segregation: Does the Dimension of Racial Segregation Matter?," PLOS ONE, Public Library of Science, vol. 10(9), pages 1-26, September.
    18. repec:zbw:rwidps:0002 is not listed on IDEAS
    19. Kasraian, Dena & Maat, Kees & van Wee, Bert, 2018. "Urban developments and daily travel distances: Fixed, random and hybrid effects models using a Dutch pseudo-panel over three decades," Journal of Transport Geography, Elsevier, vol. 72(C), pages 228-236.
    20. Bruno S. Frey & Anthony Gullo, 2021. "Does Sports Make People Happier, or Do Happy People More Sports?," Journal of Sports Economics, , vol. 22(4), pages 432-458, May.
    21. Indra de Soysa, 2022. "Economic freedom vs. egalitarianism: An empirical test of weak & strong sustainability, 1970–2017," Kyklos, Wiley Blackwell, vol. 75(2), pages 236-268, May.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:301:y:2022:i:c:s0277953622002775. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.