Spatial epidemiology of nonfatal overdose in a community-based cohort of marginalized women in Vancouver, British Columbia (2014-2022).

The current overdose crisis has had a significant impact on marginalized women, particularly in terms of nonfatal overdose incidents. A recent study conducted in Vancouver, Canada, aimed to investigate the spatial epidemiology of overdose among women, focusing on the changes in spatiotemporal clustering of overdose over time, as well as the association between residential proximity to overdose clusters and recent nonfatal overdose. The study utilized questionnaire data from a community-based cohort of marginalized women who use drugs, collected between 2014 and 2022. The analysis revealed that among the 650 participants, 37.2% experienced a nonfatal overdose at least once during the 8-year study period. Furthermore, the annual period prevalence of nonfatal overdose increased substantially, from 9.1% in 2014-15 to 25.6% in 2021-2022. The study also employed emerging hotspot analysis and kernel density estimation to visualize the spatiotemporal distribution of nonfatal overdose clustering. The results showed that the highest-density clusters of nonfatal overdose were concentrated in Vancouver's Downtown Eastside/Strathcona neighborhoods, where clusters became larger and more dispersed from 2016 onwards. Notably, residential proximity to these overdose clusters was associated with higher odds of recent nonfatal overdose. Additionally, the study found that 'risk environment' features, such as unstable housing, unsafe sleeping environments, and physical violence, were linked to elevated odds of residential proximity to overdose clusters. These findings suggest that marginalized women face a high and rising burden of nonfatal overdose, which is influenced by the environments in which they reside. To address this issue, the study highlights the need for scale-up of geographically tailored overdose prevention services, harm reduction, and programs that address violence and housing. By targeting these specific risk environments, it may be possible to reduce the incidence of nonfatal overdose among marginalized women and improve their overall well-being. Link: https://pubmed.ncbi.nlm.nih.gov/40381596/