Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Intersectional inequalities and the U.S. opioid crisis: challenging dominant narratives and revealing heterogeneities

Persmark, Anna LU orcid ; Wemrell, Maria LU orcid ; Evans, Clare ; Subramanian, S. V. ; Leckie, George LU and Merlo, Juan LU orcid (2020) In Critical Public Health 30(4). p.398-414
Abstract
Dominant narratives of prescription opioid misuse (POM) in the U.S. have portrayed it as an issue primarily affecting White communities. In this study we explore POM as reported in data from the 2015 National Survey on Drug Use and Health, using an intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA). We map the risk of POM through a series of multilevel models with individuals (N = 43,409) nested within strata formed by the intersections of gender, race/ethnicity, income, and age. We find meaningful heterogeneity between and within strata. The ten strata with the greatest risk for POM were comprised of individuals identifying as White, African American, and non-White Hispanic, and included... (More)
Dominant narratives of prescription opioid misuse (POM) in the U.S. have portrayed it as an issue primarily affecting White communities. In this study we explore POM as reported in data from the 2015 National Survey on Drug Use and Health, using an intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA). We map the risk of POM through a series of multilevel models with individuals (N = 43,409) nested within strata formed by the intersections of gender, race/ethnicity, income, and age. We find meaningful heterogeneity between and within strata. The ten strata with the greatest risk for POM were comprised of individuals identifying as White, African American, and non-White Hispanic, and included individuals of low, medium, and high income. We uncover intersections of social position with high risk for POM that are often excluded from dominant narratives, including young high-income African American women. Intersectional approaches are essential for advancing our understanding of health inequalities and unfolding epidemics such as that of POM in the U.S. (Less)
Please use this url to cite or link to this publication:
author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Critical Public Health
volume
30
issue
4
pages
17 pages
publisher
Taylor & Francis
external identifiers
  • scopus:85067626522
ISSN
0958-1596
DOI
10.1080/09581596.2019.1626002
language
English
LU publication?
yes
id
be2c6f68-ca36-4781-9270-85299289eaaf
date added to LUP
2019-06-19 16:15:53
date last changed
2022-04-26 01:40:36
@article{be2c6f68-ca36-4781-9270-85299289eaaf,
  abstract     = {{Dominant narratives of prescription opioid misuse (POM) in the U.S. have portrayed it as an issue primarily affecting White communities. In this study we explore POM as reported in data from the 2015 National Survey on Drug Use and Health, using an intersectional multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA). We map the risk of POM through a series of multilevel models with individuals (N = 43,409) nested within strata formed by the intersections of gender, race/ethnicity, income, and age. We find meaningful heterogeneity between and within strata. The ten strata with the greatest risk for POM were comprised of individuals identifying as White, African American, and non-White Hispanic, and included individuals of low, medium, and high income. We uncover intersections of social position with high risk for POM that are often excluded from dominant narratives, including young high-income African American women. Intersectional approaches are essential for advancing our understanding of health inequalities and unfolding epidemics such as that of POM in the U.S.}},
  author       = {{Persmark, Anna and Wemrell, Maria and Evans, Clare and Subramanian, S. V. and Leckie, George and Merlo, Juan}},
  issn         = {{0958-1596}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{398--414}},
  publisher    = {{Taylor & Francis}},
  series       = {{Critical Public Health}},
  title        = {{Intersectional inequalities and the U.S. opioid crisis: challenging dominant narratives and revealing heterogeneities}},
  url          = {{http://dx.doi.org/10.1080/09581596.2019.1626002}},
  doi          = {{10.1080/09581596.2019.1626002}},
  volume       = {{30}},
  year         = {{2020}},
}