94% of researchers rate our articles as excellent or good
Learn more about the work of our research integrity team to safeguard the quality of each article we publish.
Find out more
ORIGINAL RESEARCH article
Front. Epidemiol.
Sec. Occupational and Environmental Epidemiology
Volume 5 - 2025 | doi: 10.3389/fepid.2025.1567257
This article is part of the Research Topic Mapping the Unseen: Advancements and Innovations in Spatial Epidemiology for Disease Dynamics and Public Health Interventions View all 5 articles
Association between Residence at Birth and Addiction Service Utilization: A Spatial Analysis on the Massachusetts Birth Record Cohort
Provisionally accepted- University of California, Irvine, Irvine, United States
Substance use disorders impact a significant portion of the US population. Exposure to neighborhood environment early in life may contribute to disparities in policing, health outcomes and access to treatment for substance use disorders. Although many studies have examined the relationship between neighborhood context and substance use, few studies have accounted for the spatial distribution of substance use and social environment. The current study examined the association between birth address and substance addiction service utilization of individuals born in communities around the New Bedford Harbor Superfund site in southeast Massachusetts that face potential racial, socioeconomic, and environmental stressors. The analysis utilized birth record data between January 1992 and December 1998 (N = 12,151) from the Registry of Vital Records and Statistics with follow-up for substance addiction service utilization through June 2022 by the Bureau of Substances Addiction Services within the Massachusetts Department of Public Health (MADPH). We used generalized additive models (GAM) with a smooth for location to estimate local odds ratios (ORs) and 95% confidence intervals (CI) of substance addiction service utilization while adjusting for sociodemographic risk factors to identify important contributors to geographic disparities. We found that birth addresses were significantly associated with substance addiction service utilization as a young adult (p = 0.037), with the highest statistically significant risk located closest to the harbor (OR=1.42, 95% CI: 1.00, 2.02). Family education and prenatal care payer were significant predictors (p < 0.001) of substance addiction services use and strong spatial confounders, which suggests that sociodemographic factors contributed to this geographic variation.
Keywords: Epidemiology, substance use disorders, generalized additive models, addiction service utilization, spatial analysis
Received: 26 Jan 2025; Accepted: 13 Feb 2025.
Copyright: © 2025 Xia, Villanueva and Vieira. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Verónica Vieira, University of California, Irvine, Irvine, United States
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.