Residential Instability Research Articles

The spatial overlap between risk of intimate partner violence against women and suicide-related emergency calls.

Intimate partner violence against women (IPVAW) is a global problem, and suicidal behaviour is one of its most serious consequences. However, no study has investigated the spatial overlap between the two. The aim of this paper is to analyse whether there is spatial overlap between IPVAW and suicide-related calls in the same neighbourhoods, and to identify common risk factors. Geocoded data on IPVAW (N = 2060) and suicide-related calls (N = 4916) from the city of Valencia, Spain, between 2019 and 2021 were collected from the 112 emergency service and the Spanish National Police Corps. We used two analytical approaches: (i) a Bayesian spatial Poisson regression modelling analysis to identify the risk factors associated with IPVAW and suicide-related calls; (ii) Bayesian joint spatial modelling to examine the common spatial distribution of these outcomes. Relative risk maps are also displayed and analysed. The study revealed a higher incidence of IPVAW and suicide-related calls in neighbourhoods with lower income and population density, and greater residential instability and immigrant concentration. There was a 70% similarity between high- and low-risk areas for these incidents, with a moderate positive correlation of 0.43. Notably, 98% of IPVAW risk variance was explained by shared factors, while 30% applied to suicide-related calls; high IPVAW risk was also found in peripheral areas, while suicide-related calls were concentrated in the city centre. The findings highlight the need to identify areas with shared risk and neighbourhood characteristics for the development of more effective intervention strategies.

Using diversity, equity and inclusion school practices to mitigate child health inequities in Canada

Abstract Background The burden of unhealthy lifestyle behaviours and mental disorders disproportionately affects children in deprived neighbourhoods. In Canada, school practices addressing diversity, equity and inclusion (DEI) are promoted to address such inequities. We aimed to assess whether DEI school practices can help mitigate the impact of neighbourhood deprivation on children’s lifestyle behaviours and mental health. Methods In 2023 we gathered survey data from 1497 grade 4-6 children (aged 9-12) in 22 elementary schools located in deprived neighbourhoods in Alberta, Canada. Children reported their diet, screen time, physical activity, and mental health. Principals reported on the implementation of DEI practices in schools (full vs. partial). School postal codes were used to derive tertiles of the Canadian Index of Multiple Deprivation, comprised of four dimensions that capture: 1) residential instability; 2) economic dependency; 3) ethno-cultural composition and 4) situational vulnerability of neighbourhoods. Results Overall, 45% of schools had fully implemented DEI practices. These schools were located in more deprived neighbourhoods for residential instability (55%), economic dependency (71%), ethno-cultural composition (60%), and situational vulnerability (64%). Children in more deprived neighbourhoods reported more sugar consumption, more screen time, and poorer mental health, compared to children in less deprived neighbourhoods. However, in those neighbourhoods where DEI practices were fully implemented, the adverse effects of neighbourhood deprivation were alleviated, whereby children reported less sugar consumption, less screen time, and better mental health. Conclusions The implementation of DEI school practices can help mitigate the adverse effects of neighbourhood deprivation on children’s physical and mental health, particularly in deprived neighbourhoods. Key messages • School practices targeting diversity, equity, and inclusion are more commonly implemented in schools located in deprived neighbourhoods. • Diversity, equity, and inclusion school practices mitigate the adverse effects of neighbourhood deprivation on children’s lifestyle behaviours and mental health.

Childhood Exposure to Family Violence, Residential Instability, and Parental Incarceration: Compounding Household Adversities and Adolescent Delinquency

Objectives: Although childhood exposure to family violence has been linked to crime and delinquency over the life course, it rarely occurs in isolation from other household hardships. Drawing from developmental hypotheses of cumulative disadvantage and disadvantage saturation, we examine how the effect of childhood exposure to family violence (i.e., witnessing violence against one's mother) on adolescent delinquency varies when it co-occurs with two interrelated familial adversities: residential instability and parental incarceration. Methods: Using longitudinal data from the Future of Families and Child Wellbeing Study ( N = 3,191), we assess categorical combinations of childhood exposure to family violence, residential instability, and parental incarceration (years 3–9) on adolescent delinquency (year 15). Logistic regression models are specified for overall, nonviolent, and violent delinquency, controlling for a host of confounding variables. Results: Exposure to family violence has the strongest association with delinquency when combined with childhood residential instability and parental incarceration. The findings align with the cumulative disadvantage hypothesis, and these patterns are strongest for overall and nonviolent delinquency outcomes. Conclusions: Life-course research should explicitly consider the broader landscape of adversity in which childhood exposure to family violence occurs, recognizing that its long-term effects may be contingent upon or amplified by co-occurring household hardships.

Correlates of Current Methamphetamine Use and Opioid Co-Use Among Latina Women in a Low-Income Community

ABSTRACT Using data from Proyecto SALTO, a 15-year follow-up study of a cohort of Mexican American women in a low-income community in San Antonio, Texas, this study examines emerging patterns of current methamphetamine (MA) use, including opioid co-use, among this understudied population. A bivariate analysis compared individuals with and without current MA use and identified sociodemographic correlates and co-occurring mental health and substance use. A secondary analysis compared those with current MA use, opioid use, and concurrent MA and opioid use. Nineteen percent of the sample had current MA use. MA use was associated with having a lower income (OR = 7.04–1.93, SE = 1.59–5.46), residential instability (OR = 5.19, SE = 1.99), and suicidal ideation (OR = 2.62, SE = 0.93). Participants with MA use had more than four times the odds of using opioids than those without MA use. Women with concurrent MA and opioid use differed in sociodemographics and behavioral risks compared to those with only MA or only opioid use. These findings explore the social, mental health, and structural inequities that exacerbate risks and harms associated with high-risk substance use among marginalized Latino populations. Prevention and intervention strategies should adopt a holistic approach that considers and addresses polysubstance use, mental health, and the sociocultural contexts in which individuals live.

Residential Instability and Children’s Mental Health: Emotional and Behavioral Consequences of Frequent Relocation

Residential instability, characterized by frequent relocations, poses significant risks to children’s mental health, impacting their emotional and behavioral development. This study explores the emotional and behavioral consequences of frequent relocations on children aged 5 to 15, using a mixed-methods approach that combines longitudinal quantitative data and qualitative interviews. The findings reveal that children who experience three or more relocations within five years exhibit significantly higher levels of anxiety, depression, and attachment issues, alongside increased externalizing behaviors such as aggression and defiance and internalizing behaviors such as social withdrawal and anxiety. Academic performance also suffers, with lower average scores in core subjects like mathematics and reading observed among frequently relocated children. These outcomes are moderated by factors such as parental support, community integration, and economic stability, highlighting the complex interplay between individual, familial, and contextual variables. The study underscores the need for targeted interventions and supportive policies to mitigate the negative impacts of residential instability and promote children’s mental health and well-being. Future research should focus on the long-term effects, specific vulnerable populations, and protective factors to better understand and address the challenges faced by children in unstable housing situations.

Characteristics of family physicians with additional training or focused practices in caring for older adults: Population-based retrospective cohort study.

To identify FPs with additional training and focused practice activities relevant to the needs of older patients within health administrative data and to describe their medical practices and service provision in community-based primary care settings. Retrospective cohort study. Ontario. Family physicians with Certificates of Added Competence in care of the elderly from the College of Family Physicians of Canada or focused practice billing designations in care of the elderly. Evidence of additional training or certification in care of the elderly or practice activities relevant to the care of older adults. Of 14,123 FPs, 242 had evidence of additional scope to better support older adults. These FPs mainly practised in team-based care models, tended to provide comprehensive care, and billed for core primary care services. In an unadjusted analysis, factors statistically significantly associated with greater likelihood of having additional training or focused practices relevant to the care of older patients included physician demographic characteristics (eg, female sex, having completed medical school in Canada, residential instability at the community level), primary care practice model (ie, focused practice type), primary care activities (eg, more likely to provide consultations, practise in long-term care, refer patients to psychiatry and geriatrics, bill for complex house call assessments, bill for home care applications, and bill for long-term care health report forms), and patient characteristics (ie, older average age of patients). The FP workforce with additional training or focused practices in caring for older patients represents a small but specialized group of providers who contribute a portion of the total primary care activities for older adults. Health human resource planning should consider the contributions of all FPs who care for older adults, and enhancing geriatric competence across the family medicine workforce should be emphasized.

Perceived School Belonging Among Youth with Chronic Physical Illness.

In a sample of youth aged 10-16years with chronic physical illness, this study examined psychometric properties of a modified Psychological Sense of School Membership (m-PSSM) scale; described longitudinal trends in perceptions over 24months; and, identified factors associated with school belonging. Youth were recruited from a pediatric hospital in Canada. A total of 105 youth attended school in the past year and provided self-reports. The four-item m-PSSM had a unidimensional structure which was measurement invariant between youth in elementary (10-13years) versus secondary school (14-16years). Internal consistency was (ω > .80). There was no evidence that m-PSSM scores changed significantly over time (η2 = 0.05). Predictors of lower perceived school belonging were being in secondary school, having psychopathology, reporting lower quality of life in the domains of social support and school environment, experiencing peer victimization, and living in a community with higher residential instability and lower material deprivation.

Home injuries in British Columbia: patterns across the deprivation spectrum

The significant burden of home injuries has become a growing concern that affect thousands of people every year across Canada. This study examined the relationship between neighbourhood deprivation and unintentional injuries occurring at home leading to hospitalizations in British Columbia (BC) between 2015 and 2019. This study used de-identified hospitalization data on unintentional home-related injuries from the Discharge Database (DAD) and population data for each dissemination area from Statistics Canada’s 2016 Census Profiles. Hospitalization rates were computed for unintentional home-related injuries across four dimensions specified in the Canadian Index of Multiple Deprivation (CIMD) for BC. For three CIMD dimensions (situational vulnerability, economic dependency, and residential instability), unintentional home injury rates were higher in areas with higher deprivation, while the inverse was observed for ethno-cultural diversity. Understanding socio-economic disparities within neighbourhoods enables injury prevention partners to identify vulnerable populations and prioritize the development and implementation of evidence-based injury prevention interventions.

Impact of Neighborhood Social Deprivation on Delays to Access for Transcatheter Aortic Valve Replacement: Wait-Times and Clinical Consequences.

Transcatheter aortic valve replacement (TAVR) has become the standard of care for severe aortic stenosis treatment. Exponential growth in demand has led to prolonged wait times and adverse patient outcomes. Social marginalization may contribute to adverse outcomes. Our objective was to examine the association between different measures of neighborhood-level marginalization and patient outcomes while on the TAVR waiting list. A secondary objective was to understand if sex modifies this relationship. We conducted a population-based retrospective cohort study of 11 077 patients in Ontario, Canada, referred to TAVR from April 1, 2018, to March 31, 2022. Primary outcomes were death or hospitalization while on the TAVR wait-list. Using cause-specific Cox proportional hazards models, we evaluated the relationship between neighborhood-level measures of dependency, residential instability, material deprivation, and ethnic and racial concentration with primary outcomes as well as the interaction with sex. After multivariable adjustment, we found a significant relationship between individuals living in the most ethnically and racially concentrated areas (quintile 4 and 5) and mortality (hazard ratio [HR], 0.64 [95% CI, 0.47-0.88] and HR, 0.73 [95% CI, 0.53-1.00], respectively). There was no significant association between material deprivation, dependency, or residential instability with mortality. Women in the highest ethnic or racial concentration quintiles (4 and 5) had significantly lower risks for mortality (HR values of 0.52 and 0.56, respectively) compared with quintile 1. Higher neighborhood ethnic or racial concentration was associated with decreased risk for mortality, particular for women on the TAVR waiting list. Further research is needed to understand the drivers of this relationship.

Housing and mental health inequalities during COVID-19: the role of income and housing support measures

The COVID-19 pandemic negatively impacted people’s mental health and wellbeing. Using a national dataset of >11,000 Australians collected before and during the first two years of the pandemic, this study examines housing and mental health effects of COVID-19, and the extent to which access to government income support (social security measures, crisis payments and wage subsidy), early superannuation withdrawal, mortgage and rent relief, and tenant eviction moratoriums offered protection. Results show that the mental health gap between private rental and more secure housing tenures and between good- and poor-quality housing widened during the pandemic. Government income support provided a social safety net and was important in buffering housing instability especially when strong eviction moratoriums were lacking. Mortgage relief measures were associated significantly lower risks of housing affordability stress. Strong eviction moratoriums were effective in reducing risks of residential instability and forced moves. The pandemic exposed health vulnerabilities generated from people’s housing circumstances, reinforcing the need for public policies to address these social inequities to improve health and wellbeing. Findings emphasise the importance of tenure security, housing quality and enforcement of rental market interventions during disasters and identify the benefits of policies providing income support and strong eviction protection.

Contextual determinants of multiple sexual partnerships amongst young people in South Africa: a multilevel analysis

BackgroundRisky sexual behaviour (RSB), particularly multiple sexual partnerships (MSP) continues to be a major public health concern and has been linked to the increasing STIs, including HIV/AIDS in many parts of sub-Saharan Africa (SSA), suggesting that there is an association between contextual factors and multiple sexual partnering. However, in South Africa, this association is not well established in recent literature. Hence, this study examined the contextual factors contributing to multiple sexual partnerships among young people in South Africa.Materials and methodsData was extracted from the 2016 South Africa Demographics and Health Survey (2016 SADHS). A cross-sectional study of 3889 never-married young people. Descriptive and inferential statistics as well as multilevel logistic regression were used to analyse the data on never-married young people aged 15 to 24 years.ResultsThe results indicated that at the individual level, young males (61.7%) were significantly more likely than their female counterparts (56.1%) to engage in multiple sexual partners, although, the difference was not as significant as expected. At the community level clustering, the likelihood of exposure to multiple sexual partnerships significantly increased among females (OR = 1.47; 95% CI: 1.25–1.73) but decreased among their male counterparts (OR = 0.73; 95% CI: 0.58–0.92), in particular, family disruption, residential instability, and ethnic diversity led young people to engage in multiple sexual partnerships.ConclusionsThere is a need to intensify programmes aimed at considering appropriate policy options to reduce the prevalence of multiple sexual partnerships. Adopting the implications of these findings is essential for a developmental strategy towards achieving the sustainable development goal of ending STIs among young people in South Africa.

Examining the Etiology of Asian American Suicide in the United States.

Research highlights racial and ethnic disparities in suicide, but Asian American suicide receives very little attention in the literature. This is the first comprehensive, large-scale, nationally representative study of completed suicide among Asian Americans in the United States. Descriptive and multilevel regression techniques compared the risk factors for completed suicide across 227,786 Asian American, White, African American, Hispanic, and American Indian suicide decedents from 2003 to 2019. Results indicated that Asian American suicide decedents were significantly less likely than their counterparts to have several risk factors for suicide. Asian Americans were less likely to be male, uneducated, and unmarried. Asian Americans were less likely to use alcohol and drugs, to have mental health problems, and to die by firearm, relative to other suicide methods. Asian Americans were less likely to have a history of prior suicide attempts, to have intimate partner problems, and to have criminal legal problems. Conversely, Asian Americans were more likely to reside in places with higher levels of concentrated disadvantage, residential instability, racial and ethnic heterogeneity, and population density. The results underscore the need for race-specific suicide prevention strategies that, for Asian Americans in particular, take into account cultural values and barriers to help-seeking behavior.

Barriers to mental health service utilization among African immigrants in the United Kingdom: A systematic review

AbstractBackgroundAfrican immigrants in the United Kingdom (UK) face unique challenges in accessing mental health services (MHSs), in contrast to their peers born in the UK, contributing to their worsening mental and physical health outcomes. This study aims to uncover barriers to MHS utilization and proffer evidence‐based recommendations toward addressing the mental health needs of African immigrants residing in the UK.MethodsA systematic literature search was conducted across six databases: Medline, PsycINFO, Web of Science, CIHNAL, Scopus, and Embase published up to September 2022. To assess methodological quality of the included studies, the Critical Appraisal Skills Program qualitative checklist and the Mixed Methods Appraisal Tool Version 2018 were used. Consecutively, a deductive thematic analysis was employed to group related barriers within overarching themes.ResultsThe study selection process yielded eight studies conducted in the UK, encompassing African populations identifying as African/Afro‐Caribbean origin, Somali refugees, and ethnic minorities of Black/British descent. The findings highlight the complex interplay of key barriers such as stigma, residential instability, cultural influences, discrimination, and accessibility issues, among others, that continue to hinder African populations from accessing and utilizing MHSs. These barriers were categorized into predisposing,enabling and need factors (themes), aligning with Anderson's model of health service utilization, reflecting a comprehensive range of challenges affecting this population.ConclusionThis systematic review illuminates the myriad barriers faced by African immigrants in utilizing MHSs in the UK, underlining the urgent need for targeted interventions. The findings advocate for the development of culturally sensitive, affordable, and accessible MHSs and policies that address the personal, sociocultural, and structural barriers identified. Collaboration across key stakeholders is highly recommended for advancing equitable and inclusive MHSs for all.

Residential Move During COVID-19 Pandemic and Psychological Health Among College Students: The Role of Perceived Social Support

Research has widely documented the high stress levels posed to college students by the Coronavirus Disease 2019 (COVID-19). However, the role of social support in mitigating the mental health impacts of stressors like residential instability among college students is less well-researched. Using data from a multi-campus online survey of college students’ experiences during the COVID-19 pandemic (n = 2,486), this study examines the role of social support in the association between residential move during COVID-19 pandemic and college students’ reports of depressive symptoms and anxiety. We tested whether perceived social support was more significantly related to depressive symptoms among students who moved in response to COVID-19. The results show significantly higher levels of depressive symptoms and higher prevalence rates of severe anxiety among college students with COVID-19-related move relative to those who did not move during the pandemic. Irrespective of their residential status, college students who received less support than needed during the pandemic had significantly higher levels of depressive symptoms and higher odds of severe anxiety. The findings add to the existing studies showing how the COVID-19 pandemic compounds the problems of depression and anxiety among college students, particularly those experiencing residential instability and with limited social support.

Disparities in clinical trial enrollment at a Canadian comprehensive cancer center: A 15-year retrospective study.

Disparities in clinical trials (CTs) enrollment perpetuate inequities in treatment access and outcomes, but there is a paucity of Canadian data. The objective of this study was to examine disparities in cancer CT enrollment at a large Canadian comprehensive cancer center. Retrospective study of CT enrollment among new patient consultations from 2006 to 2019, with follow-up to 2021 (N=154,880), with the primary outcome of enrollment as a binary variable. Factors associated with CT enrollment were evaluated using multivariable Bayesian hierarchical logistic regression with random effects for most responsible physician (MRP) and geography, adjusted for patient characteristics (sex, age, language, geography, and primary care provider [PCP]), area-level marginalization (residential instability, material deprivation, dependency, and ethnic concentration), disease (cancer site and stage), and MRP (department, sex, language, and training). A sensitivity analysis of the cumulative incidence of enrollment was conducted to account for differences in disease type and follow-up length. CT enrollment was 11.2% overall, with a 15-year cumulative incidence of 18%. Lower odds of enrollment were observed in patients who were female (adjusted odds ratio [AOR], 0.82; 95% confidence interval [CI], 0.78-0.86), ≥65 years (AOR vs.<40, 0.61; 95% CI, 0.56-0.66), non-English speakers (0.72; 95% CI, 0.67-0.77), living ≥250 km away (AOR vs.<15 km, 0.71; 95% CI, 0.62-0.80), and without a PCP. Disease characteristics accounted for the largest proportion of observed variation (20.8%), with significantly greater odds of enrollment in patients with genitourinary cancers and late-stage disease. Significant sociodemographic disparities were observed, suggesting the need for targeted strategies to increase diversity in access to cancer CTs in Canada.

The Achieving Success Everyday Group Counseling Model: Providing Social Support for Homeless Students* in School Settings

ABSTRACT The Achieving Success Everyday (ASE) group counseling model is discussed to support homeless students’ unique and complex needs. The phenomenology of student homelessness is reviewed, as well as how residential and environmental instability negatively impacts students’ academic and psychosocial functioning. Social support for homeless students is also discussed. Next, the ASE group model is described in detail and existing research on its application in school settings is reviewed. Implications for research and practice are provided as they may influence future efforts to support homeless students. Session examples are used to help school personnel apply the ASE model in their respective schools and communities.

Environmental Injustice in Peel Region: A Cross-Sectional Analysis of Air Pollution and Social Vulnerability

Background: Nitrogen dioxide (NO2), a traffic-related air pollutant, is co-emitted with greenhouse gasses that contribute to climate change and negatively affect health. This research examines the relationship between air pollution exposure and social vulnerability to determine whether communities at a social disadvantage experience environmental injustice. Methods: The 2016 census measures for Peel Region were assessed. Peel Region has 1,381,739 people across Mississauga, Brampton, and Caledon; the spatial unit of analysis was the dissemination area (DA) with an average size of 837 people in Peel. Average ambient NO2 concentrations for 2016 came from the Canadian Urban Environmental Health Research Consortium and resampled to DAs. Social disadvantage was defined by the Ontario Marginalization Index (ON-Marg). Measures within index components came from the Canadian census. Environmental injustice was identified through correlation analysis between ON-Marg and NO2 exposure and an analysis of index components with exposure. Results: The 2016 annual NO2 concentrations were positively correlated with the overall ON-Marg quintiles (Spearman: 0.34, p &lt; .001, 95% CI 0.29 to 0.37). The components and their correlations with NO2 were residential instability (Spearman: 0.37, p &lt; .001, 95% CI 0.33 to 0.42), material deprivation (Spearman: 0.15, p &lt; .001, 95% CI 0.10 to 0.19), dependency (Spearman: 0.31, p &lt; .001, 95% CI 0.26 to 0.35), and ethnic concentration (Spearman: −0.06, p = .02, 95% CI −0.11 to −0.01). Conclusions: In Peel Region, a correlation exists between social vulnerability and air pollution, indicating inequitable exposure to NO2. Marginalized communities may not be able to choose their living environment. Environmental justice research in the context of NO2 will support policy aiming to reduce inequitable exposure.

Exploring Gender Moderation: The Impact of Neighborhood Factors on Adolescent Internalizing and Externalizing Symptoms.

Limited previous studies investigated the influences of various types of neighborhood factors on adolescent behavior problems. Meanwhile, although previous theoretical frameworks suggested that gender played a significant role in terms of neighborhood impacts on adolescent behavioral problems, few studies investigated the gender differences in such neighborhood influences. Using the year 9 and year 15 data of the national dataset Future of Families and Child Wellbeing Study (FFCWS, overly sampled participants from low-income families), this study examined how the neighborhood structural and process factors can affect adolescent behavioral problems (internalizing and externalizing symptoms) and whether gender worked as a significant moderator for such relationships in the U.S. Structural equation models and multigroup SEM were estimated (N = 3411). Findings suggested that residential instability was associated with increased levels of internalizing symptoms among adolescents at age 15, whereas neighborhood social cohesion was linked to reduced levels of externalizing symptoms throughout adolescence. Furthermore, the moderating effects of gender were found for the association between residential instability and internalizing symptoms. Implications of such findings are further discussed.

Contact with Foster Care and the Juvenile Delinquency Court: A Prospective Examination from Birth through Age 18

Abstract Purpose Research has demonstrated a link between out-of-home foster care and subsequent juvenile justice involvement. Understanding factors that may contribute to dual system involvement for young people who entered foster care is essential for disrupting this relationship. Method We used population-based linked administrative records to examine the prevalence of juvenile delinquency court petitions among individuals placed in out-of-home foster care in Los Angeles County from birth to age 18. By integrating records from child welfare and probation, this analysis of individuals born between 1998 and 2001 and who lived in the county’s out-of-home foster care system (N = 29,434) showed that 2,554 (8.7%) had encountered a juvenile delinquency court petition prior to turning 18. Results Regression results showed an increased rate of dual system involvement among young people in foster care who experienced unstable living conditions, periods of absence from care, commercial sexual exploitation, or group homes. Instability in living situations (staying in care for more than a year, with three or more homes or placements; RR = 1.31; CI = 1.16, 1.48) and history of group home care (RR = 1.43; CI = 1.25, 1.64) were significantly associated with a heightened rate of dual system involvement. As shown in the gender-stratified models, the magnitude of associations between dual system involvement and foster care experiences differed by gender. Discussion The current study aligns with prior studies showing a relationship between residential instability and group homes to subsequent delinquency court involvement. Findings set a baseline so future work can explore if policies aiming to reduce reliance on group care are associated with changes in the likelihood of dual system involvement.

Substance-Related Acute Toxicity Deaths by Area-Based Characteristics: A Descriptive Analysis of a National Chart Review Study of Coroner and Medical Examiner Data

AbstractOver the last decade, Canada has experienced a substantial increase in people dying from substance-related acute toxicity. Examining mortality rates by area-level characteristics can identify disproportionately affected populations and inform strategies to reduce substance-related acute toxicity deaths (ATDs). Using area-based methods, this study sought to examine substance-related acute toxicity mortality rates for varying community population sizes, levels of community remoteness, and indicators of deprivation in Canada from 2016 to 2017. Age-standardized mortality rates and rate ratios were calculated and disaggregated by sex. Mortality rates were highest in mid-sized urban communities with populations of 100,000 to 499,999 residents (15.9 per 100,000 population), followed by larger cities of 500,000 to 1,499,999 (15.1 per 100,000 population). The distribution of people who died also varied by community remoteness, with the highest mortality rates observed in accessible areas (14.9 per 100,000 population), followed by very remote areas (14.7 per 100,000 population). Neighbourhoods with the highest levels of deprivation, including high residential instability, economic dependency, and situational vulnerability, experienced 1.5 to 3.2 times more ATDs compared to neighbourhoods with the lowest levels of deprivation. Reported trends were similar among males and females, with higher mortality rates for males across all area-level characteristics. This study provides novel evidence on the context surrounding deaths to inform responses to reduce ATDs in Canada and serves as an important baseline that can be used to measure future progress.