Publication Date




Embargo Period


Degree Type


Degree Name

Doctor of Philosophy (PHD)


Public Health Sciences (Medicine)

Date of Defense


First Committee Member

David J. Lee

Second Committee Member

Alberto J. Caban-Martinez

Third Committee Member

Seth J. Schwartz

Fourth Committee Member

Jeffrey N. Bernstein


Poisoning is the leading cause of injury death in the United States, with most fatal poisonings resulting from drug overdoses in adults. Much remains unknown about epidemiologic factors at the county level that might affect population risk for poison-related outcomes. Hispanic individuals consistently have lower death and hospitalizations rates from poisoning, so it was hypothesized that having a larger proportion of Hispanic residents, might, in effect, “protect” a county from high rates of poisoning. This ecological, longitudinal study examined Hispanic concentration at the county-level in Florida and the incidence of poison death, nonfatal hospitalizations from poisoning, and calls to poison control centers while adjusting for potential confounders including poverty, age, and urban/rural status. This dissertation’s findings were surprising in that counties with greater-than-average Hispanic concentration had higher death and hospitalization rates from poisoning, after adjusting for other covariates. These “high Hispanic” counties were not found to underutilize poison control centers, so other causes must be identified for the disparity. The findings of this research may be useful to policymakers and public health authorities seeking to implement primary and secondary poison prevention measures around Florida. Florida’s poison control centers can also apply these findings immediately to better tailor outreach activities in high-risk counties and to ensure poison center services are available to all.


poisoning; Hispanic; Florida; mortality; poison control; hospitalizations

Available for download on Friday, December 04, 2020