The geography of risk: understanding disparities in nonmedical opioid mortality and the role of socio-built environments in New Jersey

Disparities in NMO mortality are shaped by SBEs that vary across urban, suburban, and rural municipalities. Housing instability, economic distress, and spatial access gaps in opioid health programs consistently contributed to elevated mortality, while stronger local economies and more stable housing were protective. These findings underscore that the risk of overdose mortality emerges through place-based conditions and call for strategies responsive to local SBEs, expanding affordable housing, strengthening community economies, and improving spatial access to harm reduction and treatment services across diverse geographic settings, as demonstrated in New Jersey.