识别阿片类药物脆弱性的时空模式：调查残疾、处方阿片类药物与阿片类药物相关死亡率之间的联系
Identifying Spatiotemporal Patterns in Opioid Vulnerability: Investigating the Links Between Disability, Prescription Opioids and Opioid-Related Mortality
AI总结：
本文利用2014–2020年县级数据和新型空间卡尔曼滤波器，预测并识别阿片类死亡、处方调配与残疾的时空热点，揭示阿巴拉契亚风险及2019年后向非法药物的转变。
摘要：
阿片类药物危机仍然是美国最令人畏惧且复杂的公共卫生问题之一。本研究通过分析三个关键因素的脆弱性概况来调查这一全国性流行病：阿片类药物相关死亡率、阿片类药物处方调配率以及残疾排序率。本研究使用了2014年至2020年县级关于阿片类药物相关死亡率、阿片类药物处方调配和残疾率的数据。为了成功估计和预测这些阿片类药物相关因素的趋势，我们用一种新颖的空间成分增强了Kalman Filter（卡尔曼滤波器）。为定义阿片类药物脆弱性概况，我们绘制了该滤波器在全国各县预测率的热力图，并识别热点。在此背景下，热点按年度定义为全国范围内比率处于前5%的县。我们的空间卡尔曼滤波器表现出强大的预测性能。2014年至2018年，这些预测凸显了所有三个因素中一致的时空模式，其中Appalachia（阿巴拉契亚）被识别为全国最脆弱的地区。然而，从2019年开始，调配率概况发生了剧烈且混乱的转变。阿巴拉契亚地区阿片类药物滥用最初的主要驱动因素可能是处方阿片类药物；但现在看来，滥用由非法药物维持。此外，我们发现残疾亚人群可能比一般人群面临更高的阿片类药物相关死亡风险。公共卫生举措必须超越控制处方行为，以应对向非法药物使用的转变及其影响。
英文摘要：
The opioid crisis remains one of the most daunting and complex public health problems in the United States. This study investigates the national epidemic by analyzing vulnerability profiles of three key factors: opioid-related mortality rates, opioid prescription dispensing rates, and disability rank ordered rates. This study utilizes county level data, spanning the years 2014 through 2020, on the rates of opioid-related mortality, opioid prescription dispensing, and disability. To successfully estimate and predict trends in these opioid-related factors, we augment the Kalman Filter with a novel spatial component. To define opioid vulnerability profiles, we create heat maps of our filter's predicted rates across the nation's counties and identify the hotspots. In this context, hotspots are defined on a year-by-year basis as counties with rates in the top 5 percent nationally. Our spatial Kalman filter demonstrates strong predictive performance. From 2014 to 2018, these predictions highlight consistent spatiotemporal patterns across all three factors, with Appalachia distinguished as the nation's most vulnerable region. Starting in 2019 however, the dispensing rate profiles undergo a dramatic and chaotic shift. The initial primary drivers of opioid abuse in the Appalachian region were likely prescription opioids; however, it now appears that abuse is sustained by illegal drugs. Additionally, we find that the disabled subpopulation may be more at risk of opioid-related mortality than the general population. Public health initiatives must extend beyond controlling prescription practices to address the transition to and impact of illicit drug use.
机构、总结、中文摘要均由AI分析而来，可能存在错误，请以论文正文为准。
