Rural risk environments, opioid-related overdose, and infectious diseases: A multidimensional, spatial perspective

Marynia A. Kolak, Yen Tyng Chen, Sam Joyce, Kaitlin Ellis, Kali Defever, Colleen McLuckie, Sam Friedman, Mai T. Pho

Research output: Contribution to journalArticlepeer-review


Background: Much remains unknown in rural risk environments, despite a growing crisis in these areas. We adapt a risk environment framework to characterize rural southern Illinois and describe the relations of risk environments, opioid-related overdose, HIV, Hepatitis C, and sexually transmitted infection rates between 2015 and 2017. Methods: Over two dozen risk environment variables are summarized across zip-code (n = 128) or county levels (n = 16) based on availability and theoretical relevance. We calculate data attribute associations and characterize spatial and temporal dimensions of longitudinal health outcomes and the rural risk environment. We then use a “regional typology analysis” to generate data-driven risk regions and compare health outcomes. Results: Pervasive risk hotspots were identified in more populated locales with higher rates of overdose and HCV incidence, whereas emerging risk areas were isolated to more rural locales that had experienced an increase in analgesic opiate overdoses and generally lacked harm-reduction resources. At-risk areas were characterized with underlying socioeconomic vulnerability but in differing ways, reflecting a nuanced and shifting structural risk landscape. Conclusions: Rural risk environment vulnerabilities and associated opioid-related health outcomes are multifaceted and spatially heterogeneous. More research is needed to better understand how refining geographies to more precisely define risk can support intervention efforts and further enrich investigations of the opioid epidemic.

Original languageEnglish (US)
Article number102727
JournalInternational Journal of Drug Policy
StatePublished - Nov 2020
Externally publishedYes


  • Opioid overdose
  • Regionalization
  • Rural risk environment
  • Spatial analysis

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health Policy


Dive into the research topics of 'Rural risk environments, opioid-related overdose, and infectious diseases: A multidimensional, spatial perspective'. Together they form a unique fingerprint.

Cite this