Opioid treatment deserts

The latest outcome from our opioid overdose mapping project: we find disparities across neighborhoods and racial groups in access to opioid treatment providers:

Hyder A, Lee J, Dundon A, Southerland LT, All D, Hammond G, and Miller, H.J. (2021) Opioid Treatment Deserts: Concept development and application in a US Midwestern urban county. PLoS ONE 16(5): e0250324. https://doi.org/10.1371/journal.pone.0250324

Abstract

Objectives.  An Opioid Treatment Desert is an area with limited accessibility to medication-assisted treatment and recovery facilities for Opioid Use Disorder. We explored the concept of Opioid Treatment Deserts including racial differences in potential spatial accessibility and applied it to one Midwestern urban county using high resolution spatiotemporal data.
Methods

We obtained individual-level data from one Emergency Medical Services (EMS) agency (Columbus Fire Department) in Franklin County, Ohio. Opioid overdose events were based on EMS runs where naloxone was administered from 1/1/2013 to 12/31/2017. Potential spatial accessibility was measured as the time (in minutes) it would take an individual, who may decide to seek treatment after an opioid overdose, to travel from where they had the overdose event, which was a proxy measure of their residential location, to the nearest opioid use disorder (OUD) treatment provider that provided medically-assisted treatment (MAT). We estimated accessibility measures overall, by race and by four types of treatment providers (any type of MAT for OUD, Buprenorphine, Methadone, or Naltrexone). Areas were classified as an Opioid Treatment Desert if the estimate travel time to treatment provider (any type of MAT for OUD) was greater than a given threshold. We performed sensitivity analysis using a range of threshold values based on multiple modes of transportation (car and public transit) and using only EMS runs to home/residential location types.

Results. A total of 6,929 geocoded opioid overdose events based on data from EMS agencies were used in the final analysis. Most events occurred among 26–35 years old (34%), identified as White adults (56%) and male (62%). Median travel times and interquartile range (IQR) to closest treatment provider by car and public transit was 2 minutes (IQR: 3 minutes) and 17 minutes (IQR: 17 minutes), respectively. Several neighborhoods in the study area had limited accessibility to OUD treatment facilities and were classified as Opioid Treatment Deserts. Travel time by public transit for most treatment provider types and by car for Methadone-based treatment was significantly different between individuals who were identified as Black adults and White adults based on their race.

Conclusions.  Disparities in access to opioid treatment exist at the sub-county level in specific neighborhoods and across racial groups in Columbus, Ohio and can be quantified and visualized using local public safety data (e.g., EMS runs). Identification of Opioid Treatment Deserts can aid multiple stakeholders better plan and allocate resources for more equitable access to MAT for OUD and, therefore, reduce the burden of the opioid epidemic while making better use of real-time public safety data to address a public health epidemic that has turned into a public safety crisis.

Urban transit took a pandemic wallop. Can it bounce back?

I was interviewed for an article in the Christian Science Monitor about the impacts of the COVID pandemic on public transit. The reporter did a nice job of summarizing my thoughts on the role of public transit at this moment in history:

Self-driving cars offer some hope to reduce pollution in the near future. Yet progress has been slow, says Professor Miller, and autonomous vehicles aren’t likely to enter city streets within the decade. Even at their electrified best, he says, cars are still an inefficient form of transportation, and hence an imperfect solution to the climate crisis.

In his opinion, the moment demands a grand shift in thought. If viewed as a foundational piece of urban infrastructure, public transit could expand this decade and cement a larger role in the transportation ecosystem. Permitting residents a larger menu of options when traveling – say biking, walking, or riding buses or subways – would help conserve city space, lower spending, and protect the environment.

Urban transit took a pandemic wallop. Can it bounce back? Christian Science Monitor, 25 Feb 2021

 

Movement analytics for sustainable mobility

New paper: Miller, H.J. (2020) “Movement analytics for sustainable mobility.Journal of Spatial Information Science, 20, 115-123.

Invited essay for 10th anniversary issue

Abstract: Mobility is central to urbanity, and urbanity is central to our common future as the world’s population crowds into urban areas. This is creating a global urban mobility crisis due to the unsustainability of our 20th century transportation systems for an urban world. Fortunately, the science and planning of urban mobility is transforming away from infrastructure as the solution towards a sustainable mobility paradigm that manages rather than encourages travel, diminishes mobility and accessibility inequities, and reduces the harms of mobility to people and environments. In this essay, I discuss the contributions over the past decade of movement analytics to sustainable mobility science and planning. I also highlight two major challenges to sustainable mobility that should be addressed over the next decade.

Keywords: movement analytics, mobility science, animal movement ecology, sustainable mobility, urbanity