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首页> 美国卫生研究院文献>International Journal of Environmental Research and Public Health >Identifying Areas with Disproportionate Local Health Department Services Relative to Opioid Overdose HIV and Hepatitis C Diagnosis Rates: A Study of Rural Illinois
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Identifying Areas with Disproportionate Local Health Department Services Relative to Opioid Overdose HIV and Hepatitis C Diagnosis Rates: A Study of Rural Illinois

机译：确定与阿片类药物过量HIV和丙型肝炎诊断率相关的地方卫生部门服务不相称的地区：农村伊利诺伊州研究

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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.
机译：背景：美国农村人口受到阿片类药物使用综合症（OUD）的综合症以及与之相关的用药过量和丙型肝炎病毒（HCV）和人类免疫缺陷病毒（HIV）传播风险的相关增加。地方卫生部门（LHD）在应对这种疾病的过程中可以发挥关键作用。我们利用两种地理空间方法来确定LHD服务可用性与疾病负担之间的不一致区域，以告知农村地区服务的优先级。方法：我们调查了伊利诺伊州农村地区的LHD，以评估其与OUD相关的服务，并计算了县级阿片类药物过量，HIV和丙型肝炎的诊断率。创建了双变量猪圈图，以显示相对于伊利诺伊州农村县疾病负担的LHD服务提供。结果：尽管许多农村地区的LHD提供HIV和HCV检测，但大多数农村地区的LHD提供的OUD相关服务有限。双变量制图显示，农村县的OUD治疗和艾滋病服务有限，并且相应的较高的结果/疾病发生率分散在整个伊利诺伊州。此外，LHD提供的丙型肝炎服务有限且丙型肝炎诊断率较高的农村县在地理上集中在伊利诺伊州南部。结论：通过确定相对于疾病负担而言低LHD服务水平较低的地区，双变量制图可以使资源的地理定位解决阿片类药物危机和相关的传染病。

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