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Open AccessArticle

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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Illinois Department of Public Health, Chicago, IL 60603, USA
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School of Public Health, University of Illinois at Chicago, Chicago, IL 60607, USA
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Section of Infectious Diseases and Global Health, Department of Medicine, University of Chicago Medicine, Chicago, IL 60637, USA
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Pritzker School of Medicine, University of Chicago Medicine, Chicago, IL 60637, USA
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Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
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Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, IL 62794, USA
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Center for Spatial Data Science, University of Chicago, Chicago, IL 60637, USA
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Department of Public Health, Department of Medicine, University of Chicago, Chicago, IL 60637, USA
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Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(6), 989; https://doi.org/10.3390/ijerph16060989
Received: 31 January 2019 / Revised: 13 March 2019 / Accepted: 15 March 2019 / Published: 19 March 2019
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. View Full-Text
Keywords: opioid use disorder (OUD); persons who inject drugs (PWID); human immunodeficiency virus (HIV); hepatitis C virus (HCV); resource analysis; harm reduction; local health department (LHD); rural health; bivariate mapping; geographic information system (GIS) opioid use disorder (OUD); persons who inject drugs (PWID); human immunodeficiency virus (HIV); hepatitis C virus (HCV); resource analysis; harm reduction; local health department (LHD); rural health; bivariate mapping; geographic information system (GIS)
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McLuckie, C.; Pho, M.T.; Ellis, K.; Navon, L.; Walblay, K.; Jenkins, W.D.; Rodriguez, C.; Kolak, M.A.; Chen, Y.-T.; Schneider, J.A.; Zahnd, W.E. Identifying Areas with Disproportionate Local Health Department Services Relative to Opioid Overdose, HIV and Hepatitis C Diagnosis Rates: A Study of Rural Illinois. Int. J. Environ. Res. Public Health 2019, 16, 989.

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