The Association of Broadband Internet Use With Drug Overdose Mortality Rates in the United States: Cross-Sectional Analysis.

Ioannis Karakis, Genti Kostandini, Konstantinos Tsamakis, Velma Zahirovic-Herbert
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Abstract

Background: The availability and use of broadband internet play an increasingly important role in health care and public health.

Objective: This study examined the associations between broadband internet availability and use with drug overdose deaths in the United States.

Methods: We linked 2019 county-level drug overdose death data in restricted-access multiple causes of death files from the National Vital Statistics System at the US Centers for Disease Control and Prevention with the 2019 county-level broadband internet rollout data from the Federal Communications Commission and the 2019 county-level broadband usage data available from Microsoft's Airband Initiative. Cross-sectional analysis was performed with the fixed-effects regression method to assess the association of broadband internet availability and usage with opioid overdose deaths. Our model also controlled for county-level socioeconomic characteristics and county-level health policy variables.

Results: Overall, a 1% increase in broadband internet use was linked with a 1.2% increase in overall drug overdose deaths. No significant association was observed for broadband internet availability. Although similar positive associations were found for both male and female populations, the association varied across different age subgroups. The positive association on overall drug overdose deaths was the greatest among Hispanic and Non-Hispanic White populations.

Conclusions: Broadband internet use was positively associated with increased drug overdose deaths among the overall US population and some subpopulations, even after controlling for broadband availability, sociodemographic characteristics, unemployment, and median household income.

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美国宽带互联网使用与吸毒过量死亡率的关系:横断面分析
背景宽带互联网的可用性和使用在医疗保健和公共卫生领域发挥着越来越重要的作用:本研究探讨了宽带互联网的可用性和使用与美国吸毒过量死亡之间的关联:我们将美国疾病控制和预防中心国家生命统计系统中限制访问的多种死因档案中的 2019 年县级药物过量死亡数据与联邦通信委员会提供的 2019 年县级宽带互联网推广数据以及微软 "Airband Initiative "提供的 2019 年县级宽带使用数据联系起来。我们采用固定效应回归法进行了横截面分析,以评估宽带互联网的可用性和使用率与阿片类药物过量死亡之间的关系。我们的模型还控制了县级社会经济特征和县级卫生政策变量:总体而言,宽带互联网使用率每增加 1%,吸毒过量死亡总人数就会增加 1.2%。在宽带互联网可用性方面没有观察到明显的关联。虽然在男性和女性人群中发现了类似的正相关关系,但在不同的年龄分组中,这种关系有所不同。在西班牙裔和非西班牙裔白人群体中,吸毒过量死亡总人数的正相关性最大:即使在控制了宽带可用性、社会人口特征、失业率和家庭收入中位数的情况下,宽带互联网的使用与美国总人口和某些亚人群中吸毒过量死亡人数的增加仍呈正相关。
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