Economic decline, incarceration, and mortality from drug use disorders in the USA between 1983 and 2014: an observational analysis Elias Nosrati, PhD,

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Economic decline, incarceration, and mortality from drug use disorders in the USA between 1983 and 2014: an observational analysis Elias Nosrati, PhD, Jacob Kang-Brown, PhD, Prof Michael Ash, PhD, Prof Martin McKee, MD, Prof Michael Marmot, MD, Prof Lawrence P King, PhD The Lancet Public Health Volume 4, Issue 7, Pages e326-e333 (July 2019) DOI: 10.1016/S2468-2667(19)30104-5 Copyright © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Terms and Conditions

Figure 1 Drug deaths per 100 000 county residents, 1980–2014 Boxes show 50% of observations, lines show median, whiskers show IQR, and dots show individual counties. The Lancet Public Health 2019 4, e326-e333DOI: (10.1016/S2468-2667(19)30104-5) Copyright © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Terms and Conditions

Figure 2 Drug deaths per 100 000 county residents by median household income, 1983–2014 The Lancet Public Health 2019 4, e326-e333DOI: (10.1016/S2468-2667(19)30104-5) Copyright © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Terms and Conditions

Figure 3 Estimated differences in county-level mortality rates from drug use disorders by incarceration rate Expected overdose mortality rate by incarceration rate, where T=0 denotes counties with incarceration rates 1 SD below the global mean (A) and T=1 denotes counties with incarceration rates 1 SD above the global mean (B), and expected difference in overdose mortality rate between countries with high and low levels of incarceration (C). The Lancet Public Health 2019 4, e326-e333DOI: (10.1016/S2468-2667(19)30104-5) Copyright © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Terms and Conditions

Figure 4 Schematic diagram of potential interactions between socioeconomic factors, incarceration, and drug-related mortality The Lancet Public Health 2019 4, e326-e333DOI: (10.1016/S2468-2667(19)30104-5) Copyright © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Terms and Conditions