Over 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.

在过去十年中，加拿大死于与物质相关的急性毒性的人数大幅增加。按地区特征检查死亡率可以确定受影响的人群，并为减少与物质相关的急性毒性死亡 (ATD) 的策略提供信息。本研究采用基于区域的方法，旨在调查 2016 年至 2017 年加拿大不同社区人口规模、社区偏远程度和贫困指标的物质相关急性毒性死亡率。计算了年龄标准化死亡率和比率并按性别分类。人口为 100,000 至 499,999 人的中型城市社区死亡率最高（每 100,000 人 15.9 人），其次是人口为 500,000 至 1,499,999 人的大城市（每 100,000 人 15.1 人）。死亡人数的分布也因社区偏远程度而异，交通便利的地区死亡率最高（每 10 万人 14.9 人），其次是非常偏远的地区（每 10 万人 14.7 人）。与贫困程度最低的社区相比，贫困程度最高的社区（包括居住高度不稳定、经济依赖和处境脆弱性）的 ATD 多出 1.5 至 3.2 倍。报告的男性和女性趋势相似，在所有地区特征中男性死亡率较高。这项研究提供了有关死亡背景的新证据，为加拿大减少 ATD 的应对措施提供信息，并作为可用于衡量未来进展的重要基线。