Metro/Nonmetro Migration as a Risk Factor for Opioid Use Disorder Among Older Medicare Beneficiaries: A Longitudinal Analysis of 2013

Abstract

Opioid use disorder (OUD) among older adults (65+) has drawn researchers’ attention. Nonetheless, whether migration between a metropolitan (metro) and nonmetropolitan (nonmetro) county shapes the risk of OUD remains underexplored. The drift hypothesis argues that individuals susceptible to a certain health condition tend to move, increasing the prevalence of the health condition in the destinations. By contrast, the environmental breeder hypothesis claims that migration alters the exposures to residential environment factors, which are associated with the occurrence of health conditions. Applying fixed-effects modeling to longitudinal data of older Medicare beneficiaries moving at least once between 2013 and 2018 (N = 6,227, person-year = 28,874), this study finds that older beneficiaries moving between metro and nonmetro counties demonstrated a higher risk of OUD than those who did not move. The positive association between migration and OUD risk is particularly strong for those moving from metro to nonmetro counties and the drift hypothesis receives stronger support.

Keywords

opioid use disorder medicare older adults metro-nonmetro difference

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References

Allison

P. D.

(2005). Fixed effects regression methods for longitudinal data using SAS. Sas Institute.

Allison

P. D.

(2009) Fixed effects regression models (Vol. 160). Sage publications.

Bernard

Bell

Charles‐Edwards

(2014). Life‐course transitions and the age profile of internal migration. Population and Development Review, 40(2), 213–239. https://doi.org/10.1111/j.17284457201400671x

Blazer

George

L. K.

Landerman

Pennybacker

Melville

M. L.

Woodbury

Manton

K. G.

Jordan

Locke

(1985). Psychiatric disorders: A rural/urban comparison. Archives of General Psychiatry, 42(7), 651–656. https://doi.org/10.1001/archpsyc.1985.01790300013002

Brimblecombe

Dorling

Shaw

(2000). Migration and geographical inequalities in health in Britain. Social science & medicine, 50(6), 861–878. https://doi.org/10.1016/s02779536(99)003718

Busse

J. W.

Wang

Kamaleldin

Craigie

Riva

J. J.

Montoya

Mulla

S. M.

Lopes

L. C.

Vogel

Chen

Kirmayr

De Oliveira

Olivieri

Kaushal

Chaparro

L. E.

Oyberman

Agarwal

Couban

Tsoi

Guyatt

G. H.

(2018). Opioids for chronic noncancer pain: A systematic review and meta-analysis. JAMA, 320(23), 2448–2460. https://doi.org/10.1001/jama.201818472

Butler

M. M.

Ancona

R. M.

Beauchamp

G. A.

Yamin

C. K.

Winstanley

E. L.

, (2016). Emergency department prescription opioids as an initial exposure preceding addiction. Annals of Emergency Medicine, 68(2), 202–208. https://doi.org/10.1016/j.annemergmed.2015.11.033

Cacioppo

J. T.

Hughes

M. E.

Waite

L. J.

Hawkley

L. C.

Thisted

R. A.

(2006). Loneliness as a specific risk factor for depressive symptoms: Cross-sectional and longitudinal analyses. Psychology and Aging, 21(1), 140–151. https://doi.org/10.1037/08827974.21.1.140

Carter

M. W.

Yang

B. K.

Davenport

Kabel

(2019). Increasing rates of opioid misuse among older adults visiting emergency departments. Innovation in aging, 3(1), igz002. https://doi.org/10.1093/geroni/igz002

10.

Franz

Cronin

C. E.

Lindenfeld

Pagan

J. A.

Lai

A. Y.

Krawczyk

Rivera

B. D.

Chang

J. E.

(2024). Rural-urban disparities in the availability of hospital-based screening, medications for opioid use disorder, and addiction consult services. Journal of Substance Use and Addiction Treatment, 160, 209280. https://doi.org/10.1016/j.josat.2023.209280

11.

Ginsburg

Collinson

M. A.

Gómez-Olivé

F. X.

Gross

Harawa

Lurie

M. N.

Mukondwa

Pheiffer

C. F.

Tollman

Wang

White

M. J.

(2021). Internal migration and health in South Africa: Determinants of healthcare utilisation in a young adult cohort. BMC Public Health, 21, 554. https://doi.org/10.1186/s12889-021-10590-6

12.

Green

M. A.

Arcaya

Subramanian

(2017). Using internal migration to estimate the causal effect of neighborhood socioeconomic context on health: A longitudinal analysis, england, 1995–2008. Annals of the American Association of Geographers, 107(6), 1266–1278. https://doi.org/10.1080/24694452.2017

13.

Green

M. A.

Subramanian

Vickers

Dorling

(2015). Internal migration, area effects and health: Does where you move to impact upon your health? Social Science & Medicine, 136–137, 27–34. https://doi.org/10.1016/j.socscimed

14.

Halliday

T. J.

Kimmitt

M. C.

(2008). Selective migration and health in the USA, 1984–93. Population studies, 62(3), 321–334. https://doi.org/10.1080/00324720802339806

15.

Jeffery

M. M.

Wolfson

Meier

S. K.

Dowd

B. E.

Abraham

J. M.

Kane

R. L.

(2018). Health care service use among elderly seasonal migrators. Population Health Management, 21(5), 415–421. https://doi.org/10.1089/pop.20170155

16.

Johnson

K. M.

Winkler

R. L.

(2015). Migration signatures across the decades: Net migration by age in US counties, 1950-2010. Demographic Research, 32, 1065–1080. https://doi.org/10.4054/DemRes20153238

17.

Langford

Hunter

(2021). Interventions to reduce opioid use for pain management in the older adult population: A systematic review. Journal of Applied Gerontology, 40(11), 1637–1648. https://doi.org/10.1177/0733464820975550

18.

Le Roux

Tang

Drexler

(2016). Alcohol and opioid use disorder in older adults: Neglected and treatable illnesses. Current Psychiatry Reports, 18(9), 87. https://doi.org/10.1007/s11920-016-0718-x

19.

Lin

L. A.

Knudsen

H. K.

(2019). Comparing buprenorphine-prescribing physicians across nonmetropolitan and metropolitan areas in the United States. The Annals of Family Medicine, 17(3), 212–220. https://doi.org/10.1370/afm.2384

20.

Matthews

K. A.

Croft

J. B.

Liu

Kanny

Wheaton

A. G.

Cunningham

T. J.

Khan

L. K.

Caraballo

R. S.

Holt

J. B.

Eke

P. I.

Giles

W. H.

(2017). Health-related behaviors by urban-rural county classification — United States, 2013. Morbidity and Mortality Weekly Report (MMWR), 66(5), 1–8. https://doi.org/10.15585/mmwr.ss6605a1

21.

Meit

Knudson

Gilbert

A. T.-C.

Tanenbaum

Ormson

TenBroeck

Bayne

Popat

(2014). The 2014 update of the rural-urban chartbook. Rural Health Reform Policy Research Center.

22.

National Research Council . (2007). Using the American community survey: Benefits and challenges. National Academies Press.

23.

Nguyen

Andraka-Christou

Simon

Bradford

W. D.

(2019). Comparison of rural vs urban direct-to-physician commercial promotion of medications for treating opioid use disorder. JAMA Network Open, 2(12), e1916520. https://doi.org/10.1001/jamanetworkopen

24.

T.-S.

Huber

Macy

J. T.

Bray

B. C.

Lin

H.-C.

(2023). Stressful life events and patterns of polysubstance use among U.S. Late middle-aged and older adults: A latent class analysis. Journal of Applied Gerontology, 42(8), 67–76. https://doi.org/10.1177/07334648231165256

25.

Park

Lavin

(2010). Risk factors associated with opioid medication misuse in community-dwelling older adults with chronic pain. The Clinical Journal of Pain, 26(8), 647–655. https://doi.org/10.1097/AJP.0b013e3181e94240

26.

Paulozzi

L. J.

Mack

K. A.

Hockenberry

J. M.

Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, CDC . (2014). Vital signs: Variation among states in prescribing of opioid pain relievers and benzodiazepines—United States, 2012. MMWR. Morbidity and Mortality Weekly Report, 63(26), 563–568.

27.

Popham

Boyle

P. J.

O'Reilly

Leyland

A. H.

(2011). Selective internal migration. Does it explain Glasgow’s worsening mortality record? Health & Place, 17(6), 1212–1217. https://doi.org/10.1016/j.healthplace

28.

Prusaczyk

Tilmon

Landman

Seibert

Colston

D. C.

Westergaard

, et al. (2024). (Forthcoming). Barriers to healthcare and social service utilization among rural older adults who use drugs. Journal of Applied Gerontology, 7334648241258018. https://doi.org/10.1177/07334648241258018

29.

Riva

Curtis

Norman

(2011). Residential mobility within England and urban–rural inequalities in mortality. Social science & medicine, 73(12), 1698–1706. https://doi.org/10.1016/j.socscimed

30.

Roberts

A. W.

Eiffert

Wulff-Burchfield

E. M.

Dusetzina

S. B.

Check

D. K.

(2021). Opioid use disorder and overdose in older adults with breast, colorectal, or prostate cancer. JNCI: Journal of the National Cancer Institute, 113(4), 425–433. https://doi.org/10.1093/jnci/djaa122

31.

Shoff

Yang

T.-C.

Shaw

B. A.

(2021). Trends in opioid use disorder among older adults: Analyzing Medicare data, 2013–2018. American Journal of Preventive Medicine, 60(6), 850–855. https://doi.org/10.1016/j.amepre202101010

32.

Sullivan

M. D.

Edlund

M. J.

Zhang

Unützer

Wells

K. B.

(2006). Association between mental health disorders, problem drug use, and regular prescription opioid use. Archives of Internal Medicine, 166(19), 2087–2093. https://doi.org/10.1001/archinte166192087

33.

Sun

Yang

(2021). Impacts of internal migration experience on health among middle-aged and older adults—evidence from China. Social Science & Medicine, 284, 114236. https://doi.org/10.1016/j.socscimed.2021.114236

34.

Taylor

M. H.

Grossberg

G. T.

(2012). The growing problem of illicit substance abuse in the elderly: A review. The primary care companion for CNS disorders, 14(4). https://doi.org/10.4088/PCC11r01320

35.

Tunstall

Pickett

Johnsen

(2010). Residential mobility in the UK during pregnancy and infancy: Are pregnant women, new mothers and infants unhealthy migrants. Social science & medicine, 71(4), 786–798. https://doi.org/10.1016/j.socscimed

36.

United Health Foundation . (2018). America’s health rankings senior report 2018. Available at: https://assets.americashealthrankings.org/app/uploads/ahrsenior18-finalv1.pdf.

37.

Verheij

R. A.

(1996). Explaining urban-rural variations in health: A review of interactions between individual and environment. Social Science & Medicine, 42(6), 923–935. https://doi.org/10.1016/0277-9536(95)00190-5

38.

Wang

Y.-P.

Andrade

L. H.

(2013). Epidemiology of alcohol and drug use in the elderly. Current Opinion in Psychiatry, 26(4), 343–348. https://doi.org/10.1097/YCO.0b013e328360eafd

39.

(2014). Spatial and longitudinal patterns in county age-specific net migration in the United States 1950–2010. The Professional Geographer, 66(4), 641–652. https://doi.org/10.1080/00330124

40.

Yang

T.-C.

Shoff

Kim

(2022a). Social isolation, residential stability, and opioid use disorder among older Medicare beneficiaries: Metropolitan and non-metropolitan county comparison. Social Science & Medicine, 292, 114605. https://doi.org/10.1016/j.socscimed.2021

41.

Yang

T.-C.

Shoff

Kim

Shaw

B. A.

(2022b). County social isolation and opioid use disorder among older adults: A longitudinal analysis of Medicare data, 2013–2018. Social Science & Medicine, 301, 114971. https://doi.org/10.1016/j.socscimed.2022

42.

Zhang

Liu

Zhang

(2015). Internal migration and the health of the returned population: A nationally representative study of China. BMC Public Health, 15, 719. https://doi.org/10.1186/s128890152074x

43.

Zolopa

Høj

S. B.

Minoyan

Bruneau

Makarenko

Larney

(2022). Ageing and older people who use illicit opioids, cocaine or methamphetamine: A scoping review and literature map. Addiction, 117(8), 68–88. https://doi.org/10.1111/add.15813

Metro/Nonmetro Migration as a Risk Factor for Opioid Use Disorder Among Older Medicare Beneficiaries: A Longitudinal Analysis of 2013–2018 Data

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