Abstract
The opioid crisis has severely impacted Ohio, with overdose death rates surpassing national averages and disproportionately affecting rural and Appalachian regions. Accurately predicting county-level opioid overdose (OD) deaths is critical for timely intervention but remains challenging due to the wide differences in opioid OD deaths between large and small counties. We propose a Spatial-Temporal Graph Neural Network (ST-GNN) framework that integrates graph neural networks (GNNs) to capture spatial relationships between counties and Long Short-Term Memory (LSTM) networks to model temporal dynamics. Using quarterly OD death data from Q1 2017 to Q2 2023 for 88 Ohio counties, we incorporate a nine-dimensional dynamic feature set, including naloxone administration events and high-risk opioid prescribing, along with a static Social Determinants of Health (SDoH) index. Compared to traditional statistical models and temporal deep learning baselines, our ST-GNN demonstrates superior performance, particularly in larger counties, while a classification-based strategy improves predictions for small counties, leading to more stable and reliable results. Our findings emphasize the need for spatial-temporal modeling and customized training to enhance public health decision-making in addressing the opioid crisis.