{"doi":"10.1080/00952990.2020.1820018","title":"Drug overdose mortality is associated with employment status and occupation in the National Longitudinal Mortality Study","abstract":"BACKGROUND: Since 1999, over 702,000 people in the US have died of a drug overdose, and the drug overdose death rate has increased from 6.2 to 21.8 per 100,000. Employment status and occupation may be important social determinants of overdose deaths. OBJECTIVES: Estimate the risk of drug overdose death by employment status and occupation, controlling for other social and demographic factors known to be associated with overdose deaths. METHODS: Proportional hazard models were used to study US adults in the National Longitudinal Mortality Study with baseline measurements taken in the early 2000s and up to 6 years of follow-up (n = 438,739, 53% female, 47% male). Comparisons were made between adults with different employment statuses (employed, unemployed, disabled, etc.) and occupations (sales, construction, service occupations, etc.). Models were adjusted for age, sex, race/ethnicity, education, income and marital status. RESULTS: Adults who were disabled (hazard ratio (HR) = 6.96 (95% CI = 6.81-7.12)), unemployed (HR = 4.20, 95% CI = 4.09-4.32) and retired (HR = 2.94, 95% CI = 2.87-3.00) were at higher risk of overdose death relative to those who were employed. By occupation, those working in service (HR = 2.05, 95% CI = 1.97-2.13); construction and extraction (HR = 1.69, 95% CI = 1.64-1.76); management, business and financial (HR = 1.39, 95% CI = 1.33-1.44); and installation, maintenance and repair (HR = 1.32, 95% CI = 1.25-1.40) occupations displayed higher risk relative to professional occupations. CONCLUSIONS: In a large national cohort followed prospectively for up to 6 years, several employment statuses and occupations are associated with overdose deaths, independent of a range of other factors. Efforts to prevent overdose deaths may benefit from focusing on these high-risk groups.","journal":"The American Journal of Drug and Alcohol Abuse","year":2020,"id":101813,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":27,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9535,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":498560,"name":"Norman J. Johnson","orcid":null,"position":1,"is_corresponding":false},{"id":303952,"name":"Mei‐Ling Ting Lee","orcid":"0000-0001-5022-1061","position":2,"is_corresponding":false},{"id":288205,"name":"Natalie Slopen","orcid":"0000-0002-5644-6007","position":3,"is_corresponding":false},{"id":497851,"name":"Jonathan Aram","orcid":"0000-0001-5753-3121","position":0,"is_corresponding":true}],"reference_count":27,"raw_metadata":null,"created_at":"2026-07-18T22:40:22.678835Z","pmid":"32990475","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}