EMBARGOED: See study titles for embargo release dates

Contact: Arnice Cottom, [email protected], 202-777-3913 

American Journal of Public Health January issue research highlights:  

 Fentanyl-associated overdoses more prevalent in disadvantaged communities 

Drug-related deaths that involve fentanyl are more common in low-income neighborhoods, a study in the January issue of AJPH finds. 

Newswise — Researchers examined records of fatal drug overdoses at the Cook County Medical Examiner’s Office in the Chicago area from 2014 to 2018. They identified 1,433 fentanyl-involved overdoses and 1,838 overdoses that did not involve fentanyl.

When the deaths were categorized by ZIP code, low-income neighborhoods tended to have more fentanyl-involved overdoses. Such overdoses were more likely among males, blacks and Hispanics and younger people. 

Originally approved to treat severe pain, fentanyl is a synthetic opioid. As it is inexpensive, it is often mixed with heroin, enabling illicit drug dealers to make a higher profit, the researchers said. Fentanyl is also mixed with cocaine, Oxycontin, Xanax and other drugs. 

Drugs sold in low-income neighborhoods tend to be cheaply made and many times laced with fentanyl, researchers said, greatly increasing the possibility of overdose. The problem is similar to the socio-economic split between cocaine and crack in the 1980s, when the latter inexpensive drug devastated disadvantaged communities, the researchers noted. 

Neighborhood risk factors may be reduced through public health programs, such as those that improve infrastructure, community development and local health care, researchers said. 

“Future research should explore modifiable aspects of neighborhood deprivation that can be used to create actionable policy and interventions for prevention of fentanyl-involved overdoses,” the study authors said. 

[Author Contact: Elizabeth D. Nesoff, PhD, Columbia University Mailman School of Public Health, Department of Epidemiology, “The Geographic distribution of fentanyl-involved overdose deaths in Cook County, Illinois] 

 Over-the-counter dietary medicines linked to eating disorders in women 

Young women who use over-the-counter medicines to control weight are at risk for eating disorders, a study in the January issue of APHA’s AJPH finds. 

Researchers examined results of the U.S. Grow Up Today Study from 2001 to 2016, focusing on young women ages 14 to 36 who used diet-control medicines that were sold without a prescription. Over 10,000 participants were identified as using diet pills, and over 40,000 were identified as using laxatives. The researchers wanted to find out how many of the medicine users developed or had an eating disorder, such as anorexia nervosa or bulimia nervosa.

The study found that women using diet pills were at least five times more likely than other women in their age group to receive an eating disorder diagnosis within one to three years. Women using laxatives were at least six times more likely to receive a diagnosis.

Over-the-counter dietary medicines are not recommended for healthy weight control and may contribute to behavioral, physiological and psychological issues that lead to unhealthy eating habits, the researchers said.

“Public health professionals, policymakers and community advocates should pursue remedies to reduce access to and use of these products, such as a tax on these products as well as legislation to ban the sale of diet pills to minors,” the study authors said.

[Author Contact: Jordan A. Levinson, BA, the Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital, Boston, MA “Diet pill and Laxative use for weight control and subsequent incident eating disorder in US young women: 2001-2016 ]

These papers will also be available in the January issue of AJPH:

  • Prototyping a Consensus-Driven Approach as a Model for Decision-Making in Diverse Groups
  • AJPH GLOBAL NEWS January 2020
  • News from The Nation’s Health: Uninsurance rate jumps, veterinary antibiotic stewardship needed
  • Motivating girls regardless of life circumstance, to envision possibilities, rather than limitations for their lives: Chelsea Clinton’s Answer - Persist!
  • Building and maintaining an effective environmental justice presence
  • The Community Guide? A National Health Success Story
  • Ending the HIV Epidemic: Getting to Zero and Staying at Zero
  • The Photographer’s Intent: Understanding the Narratives We Amplify
  • Somali-American teenage girls and women? A hidden refugee population with barriers to health
  • Community supported agriculture: Systems Thinking in Action
  • The Time is Now to End the HIV Epidemic
  • Amy Killelea, Natalie Cramer and Michael Weir Comment
  • The Invisible U.S. Hispanic/Latino HIV Crisis: Addressing Gaps in the National Response
  • Implementing the 'Ending the HIV Epidemic' Plan in the Southern United States
  • Syringe service program utilization among people who inject drugs in Appalachian Kentucky
  • Opioid Use Fuelling HIV Transmission in an Urban Setting: An Outbreak of HIV Infection Among People Who Inject Drugs? Massachusetts, 2015-2018
  • Prevalence of injecting drug use and coverage of interventions to prevent HIV and hepatitis C virus infection among people who inject drugs in Canada
  • The Ryan White Care Program is Vital to End the HIV Epidemic
  • Designing and disseminating metrics to support jurisdictional efforts to end the public health threat posed by HIV epidemics
  • The Broader Context of? Ending the HIV Epidemic in America? Initiative?
  • Is Insurance a Barrier to HIV Pre-Exposure Prophylaxis (PrEP)? Clarifying the Issue
  • Leveraging Medicaid to Enhance Pre-exposure Prophylaxis Implementation Efforts and Ending the HIV Epidemic
  • Stigma, implicit bias, and long-lasting prevention interventions to end the domestic HIV/AIDS epidemic.
  • Preparing the Future Workforce for Safe and Healthy Employment
  • Lower Risk Cannabis Use Guidelines: Will Users Listen?
  • Reconciling suicides with accident? drug-intoxication deaths: A behaviorally-based definition of self-injury mortality (SIM)
  • Capturing racial pathology: American medical photography in the era of Jim Crow?
  • Mechanisms of deterrence: Federal immigration policies and the erosion of immigrant children’s rights
  • Surveillance of Physical Activity: Actions Needed to Support New Federal Guidelines
  • The geographic distribution of fentanyl-involved overdose deaths In Cook County, Illinois
  • Diaper Need Met Among Low-Income US Children Under Four Years of Age in 2016
  • Diet pill and laxative use for weight control and subsequent incident eating disorder in U.S. young women (2001-2016)
  • Crime Victimization, Health, and Female Genital Mutilation/Cutting among Somali Women and Teenage Girls, United States, 2017
  • Population health impact and cost-effectiveness of community-supported agriculture among low-income US adults: a microsimulation analysis
  • Regarding HIV Prevention for Black Heterosexual Men The Barbershop Talk with Brothers Cluster Randomized Trial
  • Response to Lee
  • Geographic Access to Preexposure Prophylaxis and the Case for Telemedicine
  • Siegler et al respond 

The articles above will be published online Nov. 14, 2019, at 4 p.m. EDT by AJPH under “First Look.”

“First Look” articles have undergone peer review, copyediting and approval by authors but have not yet been printed to paper or posted online by issue. AJPH is published by the American Public Health Association, and is available at www.ajph.org.

Complimentary online access to the journal is available to credentialed members of the media. Send inquiries to Arnice Cottom at APHA. A single print issue of the journal is available for $35 from the journal’s Subscriptions Department.

If you are not a member of the press, a member of APHA or a subscriber, online single-issue access is $30, and online single-article access is $22 at www.ajph.org. For direct customer service, call 202-777-2516, or email us.

To stay up-to-date on the latest in public health research, sign up for new content email alerts.


APHA champions the health of all people and all communities. We are the only organization that combines a nearly 150-year perspective, a broad-based member community and the ability to influence policy to improve the public's health.