The Evolving Landscape of Substance Use Disorder Mortality in the United States: A Spatiotemporal Analysis of Emerging Hotspots and Vulnerable Populations (2005-2020)

The escalating Substance Use Disorder (SUD) crisis in the U.S., marked by a significant rise in mortality since 1999, underscores the urgent need for a comprehensive analysis of its spatiotemporal dynamics. This study aims to elucidate the heterogeneous geospatial distribution of SUD mortality, identifying specific locations where vulnerable communities face heightened risk. By examining SUD mortality data from the CDC for the period 2005-2020, we applied scan statistics to delineate temporal and geospatial clusters of elevated SUD-related deaths, further dissecting these patterns across racial subpopulations and regions. Our findings reveal 27 distinct clusters nation-wide, predominantly emerging post-2013 and persisting until 2020, indicating a shifting epicenter of the epidemic. Notably, the white subpopulation was associated with 26 clusters, closely mirroring the broader national trends, yet with a pronounced concentration in the eastern U.S. Conversely, the black subpopulation demonstrated a different pattern, with 17 clusters arising between 2013 and 2020, primarily post-2015, suggesting a temporal and spatial divergence in the impact of the epidemic across racial subpopulations. This analysis not only highlights the critical need for targeted public health interventions and policies but also calls for continued surveillance to monitor and mitigate the evolving SUD crisis. By understanding the complex spatiotemporal and racial variations in SUD mortality, we can better allocate resources, develop effective prevention strategies, and support the communities most in need.