# The Impact of Community Infrastructure Reinvestment Programs on Opioid Misuse and Opioid Overdose

> **NIH NIH R01** · UNIVERSITY OF PENNSYLVANIA · 2024 · $755,931

## Abstract

PROJECT SUMMARY/ABSTRACT
Discriminatory housing and zoning policies that cause residential racial segregation, concentrated poverty, and
lack of economic opportunity often result in neighborhood disinvestment and increased neighborhood disorder.
Neighborhood disorder—deterioration of the urban landscape, also known as blight—significantly impacts opioid
misuse, including opioid initiation, injection drug use, opioid use disorder development and duration, and risk of
opioid-involved overdose. Interventions to improve disorder have shown significant positive impacts on
neighborhood crime, gun violence, and mental health. No studies have yet investigated the degree to which
neighborhood disorder interventions influence opioid misuse or associated overdose risk. The broad objective
of this study is to investigate the impact of community infrastructure reinvestment programs on opioid misuse
and opioid overdose. In Philadelphia, government, community, and academic partnerships have resulted in
structural interventions (PHS Philadelphia LandCare and Basic Systems Repair Program) to remediate vacant
lots, abandoned buildings, and dilapidated homes. These programs are designed to improve neighborhood
disorder in resource-deprived, minority-majority neighborhoods with little to no green space and may have distal
effects on opioid misuse and associated overdose risk. Previous Philadelphia studies have shown significant
reductions in crime and improved stress and depression for residents on blocks with blight remediation. This
study will use spatial analysis methods and systematic social observation to address HEAL's RFA DA-23-051
Preventing Opioid Misuse and Co-Occurring Conditions by Intervening on Social Determinants. Specific aims
are: (1) Investigate whether street block-level indicators of opioid misuse differ on blocks with blight remediation
activities using systematic social observation methods for primary data collection of litter from opioid misuse
(e.g., syringes, tourniquets) and harm reduction paraphernalia (e.g., wound care, naloxone); (2) Examine if fatal
and nonfatal opioid overdose rates improved with remediation activities using a longitudinal spatial panel
approach with fatal overdose data from Philadelphia's medical examiner and nonfatal overdose data from
hospital emergency care visits; (3) Explore mechanisms by which remediation activities improve neighborhood
indicators of opioid misuse and fatal and nonfatal overdose rates, including improved community mental health
(measured by BRFSS data) and improved community social capital and social cohesion (measured by primary
data collection of neighborhood structures related to these concepts), using systematic social observation and
spatial analysis methods. This study will examine the impact of highly innovative place-based public health
interventions on opioid misuse and fatal and nonfatal opioid overdose. Findings will provide support for
expanding neighborhood disorder remediation proj...

## Key facts

- **NIH application ID:** 10932970
- **Project number:** 5R01DA059371-02
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Elizabeth Nesoff
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $755,931
- **Award type:** 5
- **Project period:** 2023-09-30 → 2028-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10932970

## Citation

> US National Institutes of Health, RePORTER application 10932970, The Impact of Community Infrastructure Reinvestment Programs on Opioid Misuse and Opioid Overdose (5R01DA059371-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10932970. Licensed CC0.

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