Date of Conferral

2022

Degree

Ph.D.

School

Public Health

Advisor

Aaron B. Mendelsohn

Abstract

Opioid misuse is a rapidly evolving health epidemic in the United States, leading to opioid use disorders, overdose deaths, and disparities in treatment. The rural population may be more susceptible given socioeconomic status, less educational attainment, and lower income. The impact on specific populations is not well understood. The purpose of this study was to identify the association of nonmedical prescription opioid use (NPOU), prescription opioid misuse (POM), and treatment-seeking with race, age, sex, education, and insurance status among rural Americans. The social-ecological model (SEM) served as the theoretical framework. The SEM described the interplay between individual, relationship, community, and societal elements. A quantitative approach was used to analyze data from the 2019 National Survey on Drug Use and Health. Multiple logistic regression models were used to examine associations between the potential risk factors and the opioid-related outcome variables noted above among rural Americans. Results revealed that Black race, age, education, and health insurance coverage were important predictors of NPOU. Black race and younger age were predictors of POM. Finally, younger age, male sex, and persons with lower levels of education were predictors of treatment-seeking. Social change could result from implementing policies based on this study to ensure equitable practices for this vulnerable population, preventing opioid misuse and increasing access to treatment.

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