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Spat Spatiotemporal Epidemiol. 2017 Aug;22:15-25. doi: 10.1016/j.sste.2017.05.002. Epub 2017 Jun 9.

Modeling spatio-temporal variations of substance abuse mortality in Iran using a log-Gaussian Cox point process.

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Department of Health Management, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran; Deputy for Treatment, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Social Determinants of Health Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
Department of Statistics, Razi University, Kermanshah, Iran. Electronic address:
Research Department, Iranian Forensic Medicine Organization, Tehran, Iran.


Substance use disorder is one of the main mental health problems in Iran. In this paper, the six-monthly counts of deaths due to substance abuse in Iran at provincial level between March 21, 2005, and March 20, 2014, were modeled using a log-Gaussian Cox point process model. By assuming population density as the exposure variable, the considered model incorporated known and unknown influential factors in order to describe spatio-temporal variations in the relative risk of substance abuse mortality. We found evidence of spatial heterogeneity and inequality by gender in deaths related to substance abuse across Iran. This study provides the first evidence in Iran on the spatio-temporal heterogeneity in mortality caused by substance use disorders.


Integrated nested Laplace approximation; Intensity function; Matérn correlation function; Point processes; Relative risk; Substance-related deaths

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