Age-Adjusted Drug Overdose Death Rate Higher in Urban Counties

In 2017, the age-adjusted rate of drug overdose deaths was higher in urban than rural counties, according to an August data brief published by the U.S. Centers for Disease Control and Prevention National Center for Health Statistics.

Holly Hedegaard, M.D., from the National Center for Health Statistics in Hyattsville, Maryland, and colleagues examined urban-rural differences in drug overdose death rates using the most recent data from the National Vital Statistics System.

The researchers found that compared with rural counties, urban counties had a higher age-adjusted rate of drug overdose deaths in 2017 (22.0 versus 20.0 per 100,000, respectively). The rates were higher in urban than rural counties for men (29.9 versus 24.3) and in rural versus urban counties for women (15.5 versus 14.2). Higher rates were seen in urban versus rural counties for drug overdose deaths involving heroin (5.2 versus 2.9), synthetic opioids other than methadone (9.3 versus 7.0), and cocaine (4.6 versus 2.4). In contrast, rural counties had higher rates for drug overdose deaths involving natural and semisynthetic opioids (4.9 versus 4.3) and psychostimulants with abuse potential (4.0 versus 3.1).

"The pattern in drug overdose mortality rates by urban and rural counties has varied over time," the authors write. "From 1999 through 2003, rates were higher in urban than in rural counties. Rates were similar from 2004 through 2006, then higher in rural counties from 2007 through 2015."

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