Identifying areas with disproportionate local health department services relative to opioid overdose, HIV and hepatitis C diagnosis rates: A study of rural Illinois

Colleen McLuckie, Mai T. Pho, Kaitlin Ellis, Livia Navon, Kelly Walblay, Wiley D. Jenkins, Christofer Rodriguez, Marynia A. Kolak, Yen Tyng Chen, John A. Schneider, Whitney E. Zahnd

Research output: Contribution to journalArticlepeer-review

Abstract

Background: U.S. rural populations have been disproportionately affected by the syndemic of opioid-use disorder (OUD) and the associated increase in overdoses and risk of hepatitis C virus (HCV) and human immunodeficiency virus (HIV) transmission. Local health departments (LHDs) can play a critical role in the response to this syndemic. We utilized two geospatial approaches to identify areas of discordance between LHD service availability and disease burden to inform service prioritization in rural settings. Methods: We surveyed rural Illinois LHDs to assess their OUD-related services, and calculated county-level opioid overdose, HIV, and hepatitis C diagnosis rates. Bivariate choropleth maps were created to display LHD service provision relative to disease burden in rural Illinois counties. Results: Most rural LHDs provided limited OUD-related services, although many LHDs provided HIV and HCV testing. Bivariate mapping showed rural counties with limited OUD treatment and HIV services and with corresponding higher outcome/disease rates to be dispersed throughout Illinois. Additionally, rural counties with limited LHD-offered hepatitis C services and high hepatitis C diagnosis rates were geographically concentrated in southern Illinois. Conclusions: Bivariate mapping can enable geographic targeting of resources to address the opioid crisis and related infectious disease by identifying areas with low LHD services relative to high disease burden.

Original languageEnglish (US)
Article number989
JournalInternational journal of environmental research and public health
Volume16
Issue number6
DOIs
StatePublished - Mar 2 2019
Externally publishedYes

Keywords

  • Bivariate mapping
  • Geographic information system (GIS)
  • Harm reduction
  • Hepatitis C virus (HCV)
  • Human immunodeficiency virus (HIV)
  • Local health department (LHD)
  • Opioid use disorder (OUD)
  • Persons who inject drugs (PWID)
  • Resource analysis
  • Rural health

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

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