Date of Conferral

8-17-2026

Date of Award

August 2026

Degree

Ph.D.

School

Health Sciences

Advisor

Leah Miller

Abstract

Opioid overdose deaths increased significantly from 2020 to 2021, with Milwaukee County experiencing higher rates than the national and state averages. African American and Hispanic residents faced disproportionately high fatal overdose rates. The purpose of this quantitative retrospective cross-sectional study was to examine the associations among socioeconomic status, race, age, access to treatment (measured by emergency medical services [EMS] naloxone administration), and opioid overdose mortality among underserved minority populations in Milwaukee County. Guided by the social-ecological model, the study analyzed data from the Milwaukee Health Department and the Milwaukee County Medical Examiner's Office across 34 ZIP codes. Inclusion criteria for the study consisted of Milwaukee residents aged 18 years and older who were affected by the opioid crisis and had complete data available, resulting in a final sample of N = 1,455 participants. Quasi-Poisson regression showed significant disparities, with strong links between ZIP code and overdose outcomes (χ²(df) = 175.38, p < .001). Specifically, mortality differences appeared in middle-income brackets ($23,001–$54,000 (p = .001) and $54,001–$87,000 (p < .001), and race/ethnicity had a significant effect on opioid overdose outcomes (χ² = 261, p < .001). Differences in EMS naloxone use were also significant for overdose mortality (p < .001), varying notably across racial groups. These findings support the need to reevaluate policies to ensure equitable access to treatments like EMS naloxone, foster positive social change to reduce disparities, and improve health outcomes through community-specific interventions for lasting recovery.

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