Focusing on a large neighborhood in Philadelphia, Pennsylvania, known for its open-air drug markets, this study examined whether deaths from accidental drug overdose were clustered around street corners controlled by drug trafficking gangs.
Research has found that drug markets tend to cluster in space, potentially because of the profit that can be made when customers are drawn to areas with multiple suppliers; however, few studies have examined how these clusters of drug markets—which have been termed “agglomeration economies”—may be related to accidental overdose deaths, particularly the spatial distribution of mortality from overdose. The current study incorporated theoretically informed social and physical environmental characteristics of street corner units into the models predicting overdose deaths. Given some environmental changes relevant to drug use locations was occurring in the focal neighborhood during the analysis period, the authors first employed a novel concentration metric—the Rare Event Concentration Coefficient—to assess clustering of overdose deaths annually between 2015 and 2019. The results of these models revealed that overdose deaths became less clustered over time and that the density was considerably lower after 2017. Hence, the predictive models in this study focused on the 2-year period between 2018 and 2019. Results from spatial econometric regression models found strong support for the association between corner drug markets and accidental overdose deaths. In addition, some socio-structural factors, such as concentrated disadvantage, and physical environmental factors, particularly blighted housing, were associated with a higher rate of overdose deaths. Implications from this study highlight the need for efforts that strategically coordinate law enforcement, social service provision, and reductions in housing blight targeted to particular geographies. (publisher abstract modified)