Substance Use
The Impact of Gentrification on Fatal Opioid Overdoses in Chicago Gabrielle Zuckerman* Gabrielle Zuckerman Kechna Cadet Elizabeth Nesoff
Background: Neighborhood contextual factors (e.g., socioeconomic disadvantage, structural racism) significantly influence fatal opioid overdose (OOD) disparities. Few studies have examined the association between fatal OOD and gentrification, where socioeconomic forces transform urban neighborhoods, often displacing earlier, usually poorer residents. This study assessed whether gentrification impacted neighborhood-level fatal OOD rates at two time points, enabling a cross-sectional analysis of neighborhood socioeconomic stressors.
Methods: Cook County Medical Examiner records of fatal OODs from 2019 (n=793) and 2022 (n=1264) were aggregated to Chicago Census tracts. Census tracts were classified as non-gentrifiable, gentrifiable, or gentrifying using the Freeman method with American Community Survey 5-year estimates (2014, 2017). We used negative binomial regression to estimate tract-level associations between gentrification status and neighborhood fatal OOD rate, adjusting for segregation and population density via complete case analysis.
Results: The neighborhood fatal OOD rate for gentrifying tracts was 37% higher than for non-gentrifiable tracts in 2019 and 24% higher in 2022 (2019: IRR=1.37, 95% CI=1.06-1.77; 2022: IRR=1.24, 95% CI=1.00-1.55). Neighborhoods with larger proportions of non-Hispanic Black residents experienced higher fatal OOD rates in both years (2019: IRR=0.48, 95% CI=0.41-0.55; 2022: IRR=0.37, 95% CI=0.32-0.42). Fatal OOD rate was not significantly associated with being gentrifiable in either year.
Conclusions: Gentrifying neighborhoods and neighborhoods with higher proportions of non-Hispanic Black residents experienced higher fatal OOD rates, emphasizing the role of structural inequities. Addressing neighborhood contextual factors and socioeconomic stressors, including gentrification and segregation, is critical for mitigating fatal OOD disparities.