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A Comparative Study of Mortality Among Puerto Rican Injection Drug Users in East Harlem, New York, and Bayamon, Puerto Rico

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Abstract

Drug users have been found to be at high risk of mortality but the mortality experience of Hispanic drug users remains understudied. This study assessed mortality among Puerto Rican injection drug users (IDUs) in New York City (NY), and in Puerto Rico (PR). Study subjects were 637 IDUs from NY and 319 IDUs from PR. Mortality was ascertained using data from the National Death Index. Annual mortality rate of the NY cohort was 1.3 per 100 person years compared to the PR cohort with a rate of 4.8. Compared to the Hispanic population of New York City, the standardized mortality ratio (SMR) of the NY cohort was 4.4. Compared to the population of Puerto Rico, the SMR of the PR cohort was 16.2. The four principal causes of death were: NY—HIV/AIDS (50.0%), drug overdoses (13.3%), cardiovascular conditions (13.3%), and pulmonary conditions (10.0%); PR—HIV/AIDS (37.0%), drug overdoses (24.1%), sepsis (13.0%), and homicide (11.1%). Modeling time to death using Cox proportional hazards regression, the relative risk of mortality of the PR cohort as compared to the NY cohort was 9.2. The other covariates found to be significantly associated with time to death were age, gender, education, social isolation, intoxication with alcohol, and HIV seropositivity. The large disparity in mortality rates found in this study suggests that health disparities research should be expanded to identify intra-group disparities. Furthermore, these results point to an urgent need to reduce excess mortality among IDUs in Puerto Rico.

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AcknowledgEments

This study was funded by the National Institute On Drug Abuse, Grant DA10425. The authors also wish to express their appreciation to the Demographic Registry of the Puerto Rico Department of Health, the National Death Index of the National Center for Health Statistics, and the Office of Vital Statistics, New York City Department of Health, for their collaboration in obtaining the mortality data.

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Authors and Affiliations

  1. Center for Addiction Studies, School of Medicine, Universidad Central del Caribe, Box 60327, Bayamon, 00960-6032, Puerto Rico

    Hector Manuel Colon, Rafaela Rivera Robles, Myrna Cabassa & Hardeo Sahai

  2. Center for Drug Use and HIV Research, National Development and Research Institutes, Inc., New York City, New York, USA

    Sherry Deren & Sung -Yeon Kang

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  1. Hector Manuel Colon
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  2. Sherry Deren
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Correspondence to Hector Manuel Colon.

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Colon, H.M., Deren, S., Robles, R.R. et al. A Comparative Study of Mortality Among Puerto Rican Injection Drug Users in East Harlem, New York, and Bayamon, Puerto Rico. J Urban Health 83, 1114–1126 (2006). https://doi.org/10.1007/s11524-006-9088-8

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  • DOI: https://doi.org/10.1007/s11524-006-9088-8

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