UWM/MCW study reveals granular traits of where opioid overdose mortality occurs in Milwaukee County

two individual head shots-one of a woman and the other a man

Opioid overdose deaths manifest disproportionately across Milwaukee County. So public health officials need to know who the most vulnerable are, but also where they are.

A team of researchers, led by Rina Ghose, professor of industrial engineering, and Professor John Mantsch at the Medical College of Wisconsin, has applied data science that blends spatial mapping with novel statistical analysis to understand conditions that link the “who” data with the “where.”

Using incident reports and mortality data from 2018-2021, the team conducted geospatial and spatiotemporal analyses to confirm that racial disparity exists in overdose mortality rates, with mortality the highest in Hispanic communities and the lowest in white communities.

“Places have effects on our body,” Ghose said, not only in terms of environmental degradation or contamination, but also in terms of location-based conditions, like systemic poverty, that affects a person’s health.”

In a previous study, Ghose and Mantsch found that the effectiveness of strategies targeting opioid overdoses varied across the county, with a disproportionate benefit for white communities.

With UWM graduate student Fahimeh Mohebbi and UWM recent doctoral graduate Amir Forati, the professors wanted to dig deeper into the various characteristics that put communities at risk so that health officials could improve treatment outcomes.

The results have not only confirmed the racial disparities in opioid overdose mortality, but also provided visual proof that shows racial clustering. Milwaukee County is a diverse and segregated urban area ranked eighth nationally in 2022 per capita overdose fatality rates.

A need for place-based data

Ghose is an expert in Geographic Information Systems, or GIS, an innovative computer-based, information technology that analyzes and displays information by location. GIS allows researchers to see all the place-based information together, revealing spatial relationships and patterns.

“Very few studies have integrated individual health data with large categories of place-based variables to examine health inequity,” she said, “yet federal health agencies are seeking such visual data.”

Compared to lower-than-expected risk areas or Milwaukee as a whole, the study found that neighborhoods with unfavorable mortality rates were predominantly Black or Hispanic, younger, less-employed, poorer, less-educated, and had higher incarceration rates, worse mental and physical health, and a higher digital divide index, indicating lower access to digital resources.

Other studies of the problem

With funding from the Foundation for Opioid Response Efforts, Ghose and Mantsch, and their team, have investigated racial disparities in opioid use and overdose deaths in a series of studies, each of which has focused on one dimension of the problem but together form a detailed picture.

For example, the collaborators have studied the effect of the COVID pandemic on overdose deaths and identified emerging hotspots for high mortality risk. They have also detailed the “journey to overdose,” which describes how some users who live in one area of the county, travel to a different location where they overdose.

The researchers collaborated with WisHope, a Wisconsin-based nonprofit organization that advocates for those impacted by addiction and mental health conditions. WisHope will use the findings to guide qualitative assessment of influential factors through its peer network.