Table 1. Characteristics of Counties Receiving Opioid Marketing During 2013-2015 and Subsequent Opioid Prescribing and Mortality From Overdoses During 2014-2016a.
| Characteristic | Total Cost of Marketing, $ per 1000 Population, Mean (SD) | Total No. of Payments, per 1000 Population, Mean (SD) | No. of Physicians With ≥1 Payment, per 1000 Population, Mean (SD) | Opioid Prescribing Rate, per 100 Population, Mean (SD) | Overdose Mortality Rate, per 100 000 Person-Years, Mean (SD) |
|---|---|---|---|---|---|
| All counties receiving marketing | 1.57 (5.29) | 0.03 (0.04) | 0.01 (0.01) | 90.0 (42.8) | 7.4 (9.0) |
| Age | |||||
| <15% aged >65 y (n = 1003) | 2.36 (6.16) | 0.04 (0.04) | 0.01 (0.01) | 85.8 (39.4) | 7.4 (8.5) |
| ≥15% aged >65 y (n = 1205) | 1.49 (5.38) | 0.04 (0.04) | 0.02 (0.01) | 93.6 (45.1) | 7.5 (9.3) |
| Race/ethnicityb | |||||
| White non-Hispanic (n = 1983) | 1.88 (5.92) | 0.04 (0.04) | 0.01 (0.01) | 91.3 (41.9) | 7.7 (9.1) |
| Black non-Hispanic (n = 67) | 1.11 (2.19) | 0.04 (0.04) | 0.01 (0.01) | 96.9 (51.9) | 3.9 (8.6) |
| Hispanic (n = 44) | 1.36 (5.53) | 0.02 (0.02) | 0.007 (0.005) | 63.2 (22.7) | 4.6 (7.4) |
| Other (n = 11)c | 2.54 (4.58) | 0.02 (0.01) | 0.07 (0.003) | 38.6 (25.7) | 3.8 (4.6) |
| Mixed (n = 103)d | 3.11 (4.72) | 0.04 (0.03) | 0.01 (0.01) | 76.2 (51.2) | 6.4 (6.9) |
| High school completion | |||||
| Low (<85%) (n = 945) | 1.23 (4.22) | 0.03 (0.04) | 0.01 (0.01) | 104.0 (51.1) | 7.7 (10.4) |
| High (≥85%) (n = 1263) | 2.37 (6.58) | 0.04 (0.04) | 0.02 (0.01) | 79.5 (31.5) | 7.3 (7.7) |
| Unemployment | |||||
| Low (<5%) (n = 140) | 0.98 (2.41) | 0.04 (0.04) | 0.02 (0.02) | 65.4 (34.3) | 3.7 (5.9) |
| High (≥5%) (n = 2068) | 1.97 (5.91) | 0.04 (0.04) | 0.01 (0.01) | 91.7 (42.8) | 7.7 (9.1) |
| Poverty | |||||
| Low (<10%) (n = 370) | 2.65 (7.32) | 0.04 (0.04) | 0.01 (0.01) | 65.1 (27.6) | 6.2 (6.9) |
| High (≥10%) (n = 1838) | 1.77 (5.41) | 0.04 (0.04) | 0.01 (0.01) | 95.0 (43.6) | 7.7 (9.3) |
| Median household income | |||||
| Low (<$60 000) (n = 1922) | 1.70 (5.49) | 0.04 (0.04) | 0.01 (0.01) | 93.9 (43.9) | 7.5 (9.3) |
| High (≥$60 000) (n = 286) | 3.20 (7.18) | 0.04 (0.03) | 0.01 (0.01) | 63.7 (20.3) | 7.2 (6.5) |
| Income inequalitye | |||||
| Low (Gini coefficient <0.4) (n = 242) | 2.04 (5.99) | 0.04 (0.04) | 0.01 (0.01) | 92.4 (43.3) | 6.1 (7.1) |
| High (Gini coefficient ≥0.4) (n = 1966) | 0.92 (3.50) | 0.03 (0.03) | 0.01 (0.01) | 69.81 (31.7) | 7.6 (9.2) |
| Metropolitan area | |||||
| Metropolitan (n = 1033) | 2.81 (6.63) | 0.04 (0.04) | 0.01 (0.01) | 82.5 (34.6) | 8.0 (8.6) |
| Nonmetropolitan (n = 1175) | 0.94 (4.50) | 0.03 (0.04) | 0.01 (0.01) | 96.6 (47.9) | 6.9 (9.3) |
| Census region | |||||
| South (n = 1042) | 1.86 (5.48) | 0.04 (0.04) | 0.01 (0.01) | 104.2 (48.4) | 8.4 (10.4) |
| Midwest (n = 679) | 1.55 (6.31) | 0.04 (0.04) | 0.02 (0.01) | 79.7 (35.1) | 5.5 (7.0) |
| West (n = 280) | 1.66 (4.43) | 0.03 (0.03) | 0.01 (0.01) | 80.3 (30.6) | 6.9 (7.0) |
| Northeast (n = 207) | 3.54 (6.74) | 0.04 (0.04) | 0.01 (0.01) | 66.1 (19.1) | 9.8 (8.2) |
a
N = 2208; counties that did not receive any pharmaceutical industry marketing are not included.
b
Classified according to race/ethnicity exceeding 50% of the county composition.
c
Other counties are those with 50% of individuals or more identified as non-Hispanic Asian, American Indian or Alaskan Native, or Pacific Islander.
d
Mixed counties are those that did not meet a 50% threshold for white, black, Hispanic, or other (non-Hispanic Asian, American Indian or Alaskan Native, or Pacific Islander) race/ethnicity.