Geographic Patterns of Fatal Overdose Mortality and Harm Reduction and Treatment Service Availability in Tennessee
Abstract
Drug overdose mortality represents an ongoing and unevenly distributed public health burden across Tennessee. Service availability of harm reduction and opioid treatment services may shape how overdose deaths are distributed. Our study used descriptive geospatial mapping to identify counties with high fatal overdose rates and limited availability of harm reduction and treatment services. County-level fatal overdose data in Tennessee from 2018 to 2023 were obtained from the Tennessee Department of Health and combined with county-level data on Syringe Service Programs (SSPs), Opioid Treatment Programs (OTPs), and Office-Based Opioid Treatment (OBOT) providers. For each county, we calculated the average fatal overdose rate per 100,000 population and the average number of services per 100,000 population across the study period. SSP and OTP availability were categorized as binary indicators (yes/no), whereas OBOT provider density was classified into four levels: none, low, medium, and high. Bivariate choropleth maps were created to visually identify counties with high overdose mortality and low service availability, and chi-square tests were performed to examine associations between fatal overdose tertiles and service availability categories. Statistical analyses were conducted using SAS version 9.4, and geo-mapping were performed using ArcGIS Pro. SSP availability differed significantly across fatal overdose tertiles (p < 0.03), increasing from 3.2% of counties in the low tertile to 12.5% in the medium tertile and 21.9% in the high tertile. OTP availability showed a similar increasing pattern, from 6.5% in low-overdose counties to 18.8% in medium and 21.9% in high-overdose counties, but differences were not statistically significant (p = 0.07). OBOT provider density did not significantly differ across fatal overdose tertiles (p = 0.29), with most counties reporting any OBOT access in all categories (low: 64.5%, medium: 59.4%, high: 59.4%). Our results demonstrate the need for targeted expansion of harm reduction and treatment services to address service deserts.
Start Time
15-4-2026 1:30 PM
End Time
15-4-2026 2:30 PM
Room Number
311
Presentation Type
Oral Presentation
Presentation Subtype
Grad/Comp Orals
Presentation Category
Health
Student Type
Graduate
Faculty Mentor
Billy Brooks
Geographic Patterns of Fatal Overdose Mortality and Harm Reduction and Treatment Service Availability in Tennessee
311
Drug overdose mortality represents an ongoing and unevenly distributed public health burden across Tennessee. Service availability of harm reduction and opioid treatment services may shape how overdose deaths are distributed. Our study used descriptive geospatial mapping to identify counties with high fatal overdose rates and limited availability of harm reduction and treatment services. County-level fatal overdose data in Tennessee from 2018 to 2023 were obtained from the Tennessee Department of Health and combined with county-level data on Syringe Service Programs (SSPs), Opioid Treatment Programs (OTPs), and Office-Based Opioid Treatment (OBOT) providers. For each county, we calculated the average fatal overdose rate per 100,000 population and the average number of services per 100,000 population across the study period. SSP and OTP availability were categorized as binary indicators (yes/no), whereas OBOT provider density was classified into four levels: none, low, medium, and high. Bivariate choropleth maps were created to visually identify counties with high overdose mortality and low service availability, and chi-square tests were performed to examine associations between fatal overdose tertiles and service availability categories. Statistical analyses were conducted using SAS version 9.4, and geo-mapping were performed using ArcGIS Pro. SSP availability differed significantly across fatal overdose tertiles (p < 0.03), increasing from 3.2% of counties in the low tertile to 12.5% in the medium tertile and 21.9% in the high tertile. OTP availability showed a similar increasing pattern, from 6.5% in low-overdose counties to 18.8% in medium and 21.9% in high-overdose counties, but differences were not statistically significant (p = 0.07). OBOT provider density did not significantly differ across fatal overdose tertiles (p = 0.29), with most counties reporting any OBOT access in all categories (low: 64.5%, medium: 59.4%, high: 59.4%). Our results demonstrate the need for targeted expansion of harm reduction and treatment services to address service deserts.
