County-by-County Analysis Reveals Huge Disparities in Deaths Due to Drug & Alcohol Abuse

Mar 26, 2018

Age-standardized mortality rate for both sexes combined in 2014. Trends and Patterns of Geographic Variation in Mortality From Substance Use Disorders and Intentional Injuries Among US Counties, 1980-2014

We know we have an opioid epidemic. Opioid overdoses have become the leading cause of accidental deaths for Americans under the age of 50. But the problem is far worse in some places than in others. A new county-by-county analysis of deaths due to drug and alcohol abuse highlights just how enormous the disparities can be.

Case in point, drug-related deaths increased nationwide - and in every single county. But, in some counties the increase was a modest eight percent, while in others it was more than 8,000 percent. Some of the hardest-hit counties are in southern West Virginia, Ohio, and eastern Kentucky – areas that already had some of the highest drug abuse death rates.

 “By giving a number for a state or for the nation, for example, you are really giving an average,” said Ali Mokdad, a public health researcher at University of Washington and co-author of the new study. “By pointing out the problem at the local level this is when you energize the community and the local authorities to act.”  In the case of alcohol abuse, the difference between national and local statistics was especially striking. Overall, at the national level, alcohol-related deaths decreased between 1980 and 2014. But sixty five percent of counties saw increases. Mokdad says the key in reconciling those two facts is the population sizes in those counties; a small number of counties with large populations can skew the national average and hide widespread problems.  Southeastern Massachusetts falls in the middle of the range for per capita deaths due to both drug and alcohol abuse, but the region has seen some of the largest increases. It’s a worrisome trend, but Mokdad also notes that their analysis stops at 2014 so may not account for recent policy changes.  While this kind of localized information is critical information for policymakers, many places do not have the resources to do the research themselves. So, the Institute for Health Metrics and Evaluation at the University of Washington, where Mokdad is a professor of global health, has committed to working with towns and counties to provide the analyses they need.  “We strongly, here, believe in the power of data,” Mokdad said. “Unless you are counting, you aren’t going to do anything about it. And unless you are able to measure a problem or a public health issue, you’re not going to act on it.”