Income Inequality and Opioid Prescribing Rates: Exploring Rural/Urban Differences in Pathways via Residential Stability and Social Isolation

While opioid prescribing rates have drawn researchers' attention, little is known about the mechanisms through which income inequality affects opioid prescribing rates and even less focuses on whether there is a rural/urban difference in mediating pathways. Applying mediation analysis techniques to a unique ZIP code level dataset from several sources maintained by the Centers for Medicare and Medicaid Services, we explicitly examine two mechanisms through residential stability and social isolation by rural/urban status and find that (1) income inequality is not directly related to opioid prescribing rates, but it exerts its influence on opioid prescribing via poor residential stability and elevated social isolation; (2) social isolation accounts for two‐thirds of the mediating effect of income inequality on opioid prescribing rates among urban ZIP codes, but the proportion halves among rural ZIP codes; (3) residential stability plays a larger role in understanding how income inequality matters in rural than in urban ZIP codes; and (4) beneficiary characteristics only matter in urban ZIP codes. These findings offer nuanced insight into how income inequality affects opioid prescribing rates and suggests that the determinants of opioid prescribing rates vary by rural/urban status. Future research may benefit from identifying place‐specific factors for opioid prescribing rates.     

Spatial Non-stationarity in Opioid Prescribing Rates: Evidence from Older Medicare Part D Beneficiaries

Population Research and Policy Review - Previous research that examined spatial patterns of opioid prescribing rates and factors associated with them has mainly relied on a global modeling...     

Influence of Perceptions of Current and Future Community on Residential Aspirations of Rural Youth

Outmigration of youth has concerned rural communities and researchers for several decades. Yet not all communities experience extensive youth outmigration and some youth want to stay in their rural communities as adults. This article examines youth satisfaction with their current community and the importance of characteristics of the community in which they would like to live as an adult for youth preferences to leave or stay in their rural community. The data are for rural ninth‐grade youth in Pennsylvania from the Rural Youth Education Project. The results suggest that perceptions of available jobs and educational opportunities in both current and future community, parental and friend influences, and the quality of the natural environment and outdoor recreation are important in determining residential aspirations. In particular, identifying a clean natural environment and outdoor recreation as important in the adult community increases the likelihood that rural youth have residential aspirations to stay in their rural community. This research adds to our knowledge about factors important in determining youth residential aspirations by identifying attributes of community beyond jobs and educational opportunities that youth find attractive as they consider places to live as adults.