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PLoS One. 2019 Feb 27;14(2):e0212026. doi: 10.1371/journal.pone.0212026. eCollection 2019.

Individual and community characteristics associated with premature natural and drug-related deaths in 25-59 year old decedents.

Author information

1
Department of Research, The University of Texas Health Science Center at Houston, Cizik School of Nursing, Houston, Texas, United States of America.
2
Pathology Department, Harris County Institute of Forensic Sciences, Houston, Texas, United States of America.
3
Department of Management, Policy and Community Health, The University of Texas Health Science Center at Houston, School of Public Health, Houston, Texas, United States of America.
4
Recovery Department, Americares, Stamford, Connecticut, United States of America.
5
Administration, CHI Baylor St. Luke's Medical Center Houston, Texas, United States of America.
6
Systems Department, The University of Texas Health Science Center at Houston, Cizik School of Nursing, Houston, Texas, United States of America.

Abstract

The purpose of the study was to identify circumstances of death, disease states, and sociodemographic characteristics associated with premature natural and drug-related deaths among 25-59 year olds. The study also aimed to address the paucity of research on personal, community-based, and societal factors contributing to premature death. A population-based retrospective chart review of medical examiner deaths within a highly populated and ethnically diverse county [in Texas] was undertaken to identify individuals dying prematurely and circumstances surrounding cause of death [in 2013]. The sample data (n = 1282) allowed for analysis of decedent demographic variables as well as community characteristics. Descriptive statistics, multivariable logistic regression, and geospatial analyses were used to test for associations between the type of death (natural or drug-related) and demographics, circumstances of death, disease types and community characteristics. Census tract data were used to determine community characteristics. Highly clustered premature deaths were concentrated in areas with low income and under-educated population characteristics. Two-thirds of decedents whose death were due to disease had not seen a healthcare provider 30 days before death despite recent illness manifestations. Opioids were found in 187 (50.5%) of the drug-related deaths, with 92.5% of deaths by opioids occurring in combination with other substances. The study findings went beyond the cause of death to identify circumstances surrounding death, which present a more comprehensive picture of the decedent disease states and external circumstances. In turn, these findings may influence the initiation of interventions for medically underserved and impoverished communities.

Conflict of interest statement

The authors have declared that no competing interests exist.

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