Chandler McClellan

Using social media to monitor mental health discussions − evidence from Twitter

Objectives Given the public health importance of communicating about mental illness and the growing use of social media to convey information, our goal was to develop an empirical model to identify periods of heightened interest in mental health topics on Twitter. Materials and Methods We collected data on 176 million tweets from 2011 to 2014 with content related to depression or suicide. Using an autoregressive integrated moving average (ARIMA) data analysis, we identified deviations from predicted trends in communication about depression and suicide. Results Two types of heightened Twitter activity regarding depression or suicide were identified in 2014: expected increases in response to planned behavioral health events, and unexpected increases in response to unanticipated events. Tweet volume following expected increases went back to the predicted level more rapidly than the volume following unexpected events. Discussion Although ARIMA models have been used extensively in other fields, they have not been used widely in public health. Our findings indicate that our ARIMA model is valid for identifying periods of heightened activity on Twitter related to behavioral health. The model offers an objective and empirically based measure to identify periods of greater interest for timing the dissemination of credible information related to mental health. Conclusion Spikes in tweet volume following a behavioral health event often last for less than 2 days. Individuals and organizations that want to disseminate behavioral health messages on Twitter in response to heightened periods of interest need to take this limited time frame into account.

Economic conditions, illicit drug use, and substance use disorders in the United States

We provide the first analysis of the relationship between economic conditions and the use of illicit drugs other than marijuana. Drawing on US data from 2002 to 2015, we find mixed evidence on the cyclicality of illicit drug use. However, we find robust evidence that economic downturns lead to increases in the intensity of prescription pain reliever use as well as increases in clinically relevant substance use disorders involving opioids. These effects are concentrated among working-age white males with low educational attainment. We conclude that policymakers should consider devoting more, not fewer, resources to treating substance use disorders during economic downturns.

LESS CASH, LESS CRIME: EVIDENCE FROM THE ELECTRONIC BENEFIT TRANSFER PROGRAM

It has been long recognized that cash plays a critical role in fueling street crime because of its liquidity and transactional anonymity. In this paper, we investigate whether the reduction in the circulation of cash on the streets associated with electronic benefit transfer (EBT) program implementation had an effect on crime. To address this question, we exploit the variation in the timing of EBT implementation across Missouri counties and counties in the states bordering Missouri. According to our results, the EBT program had a negative and significant effect on the overall crime rate and specifically for burglary, assault, and larceny. The point estimates indicate that the overall crime rate decreased by 9.2 percent in response to the EBT program. Interestingly, the significant drop in crime in the United States over several decades coincided with a period of steady decline in the proportion of financial transactions involving cash.

Opioid-overdose laws association with opioid use and overdose mortality

INTRODUCTION Since the 1990s, governmental and non-governmental organizations have adopted several measures to increase access to the opioid overdose reversal medication naloxone. These include the implementation of laws that increase layperson naloxone access and overdose-specific Good Samaritan laws that protect those reporting overdoses from criminal sanction. The association of these legal changes with overdose mortality and non-medical opioid use is unknown. We assess the relationship of (1) naloxone access laws and (2) overdose Good Samaritan laws with opioid-overdose mortality and non-medical opioid use in the United States. METHODS We used 2000-2014 National Vital Statistics System data, 2002-2014 National Survey on Drug Use and Health data, and primary datasets of the location and timing of naloxone access laws and overdose Good Samaritan laws. RESULTS By 2014, 30 states had a naloxone access and/or Good Samaritan law. States with naloxone access laws or Good Samaritan laws had a 14% (p = 0.033) and 15% (p = 0.050) lower incidence of opioid-overdose mortality, respectively. Both law types exhibit differential association with opioid-overdose mortality by race and age. No significant relationships were observed between any of the examined laws and non-medical opioid use. CONCLUSIONS Laws designed to increase layperson engagement in opioid-overdose reversal were associated with reduced opioid-overdose mortality. We found no evidence that these measures were associated with increased non-medical opioid use.

Poverty and Mortality in Hemodialysis Patients

A vexing observation among individuals with ESRD is the decreased mortality associated with attributes that, in healthy populations, confer increased risk of death. Examples include the apparent protective benefit of obesity, higher levels of LDL cholesterol, elevated systolic and diastolic BP, and