Drug Overdose Deaths in Appalachia

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ECONOMIC
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STATES IN APPALACHIA
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Drug Overdose Mortality Rate
Deaths per 100k population
(Ages 15-64)
State Name Drug Overdose Mortality Rate
Appalachian Region Drug Overdose Mortality Rate
U.S. Drug Overdose Mortality Rate
Total Deaths
Population
Urban / Rural
Choose County Profile Data Time Period
2010-2014
2015-2019
Change from 2010-2014 to 2015-2019
SOCIO DEMOGRAPHIC State Name Appalachian Region United States
Race /Ethnicity
White (non-Hispanic)
African American (non-Hispanic)
Hispanic or Latino
Other (non-Hispanic)
Age
Under 15
15-64
65+
Educational Attainment
At least High School Diploma (25+)
Bachelor's Degree or more (25+)
Disability Status
% Residents with a disability (18-64)
ECONOMIC
Median Household Income
Poverty Rate
Unemployment Rate
Accident-prone Employment
Construction >
Mining
Manufacturing
Trade, Transportation, & Utilities
This data is from the Overdose Mapping Tool created by NORC at the University of Chicago and can be found at overdosemappingtool.norc.org
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THE APPALACHIAN OVERDOSE MAPPING TOOL
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The Growth of an Epidemic
The Opioid Crisis is Contributing to Lowering U.S. Life Expectancy.

Prescription and illicit opioids killed nearly 50,000 people in 2019, more than six times the number in 1999. The toll of the epidemic is so great that it contributed to the first decline in U.S. life expectancy since 1993.

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While this issue is affecting communities across the country, one of the hardest hit areas is Appalachia.
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In 2019, residents of the Appalachian Region were 41% more likely to die from a drug overdose than residents of the rest of the U.S.
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To better understand the Appalachian opioid crisis and inform effective conversations and interventions...

NORC at the University of Chicago and the Appalachian Regional Commission have created this tool to allow users to map overdose hotspots and overlay them with data that provide additional context to opioid addiction and death - including the strength and diversity of local economies, ethnicity, educational attainment, and disability status of residents.

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Methodology & Data Sources

The Appalachian Drug Overdose interactive tool was designed and developed by NORC’s Walsh Center for Rural Health Analysis, our Health Media Collaboratory, and our Visualization Laboratory in partnership with the Appalachian Regional Commission (ARC).

The interactive tool was created in JavaScript using the Leaflet library. Data was processed using SAS and converted from shapefile to TopoJSON using the Mapshaper web client. Three main data sources were accessed in the development of this tool:

  1. CDC National Center for Health Statistics (NCHS) National Vital Statistics System (NVSS) Multiple Cause of Death File
  2. U.S. Census Bureau, American Community Survey
  3. Bureau of Labor Statistics Quarterly Census of Employment and Wages

The tool presents age-adjusted mortality rates for the population aged 15 to 64. The combined population estimates for the time period (either 2010-2014 or 2015-2019) are the denominator for the mortality rates. Five-year average mortality rates were used for this tool in order to maximize the number of counties with a reliable age-adjusted mortality rate. If a county has fewer than 20 deaths over the five-year time period, the mortality rate is considered “unreliable” and we present the crude mortality rate. For counties with fewer than 10 deaths over the five-year time period, the number of deaths is suppressed, and therefore a mortality rate is not provided. However, when possible, we have calculated the maximum crude mortality rate based on the population and the assumption of less than 10 deaths.

The table below describes each of the data sources and definitions for the variables included in the tool.

Variable Data Source Definition
Drug Overdose Mortality Rate CDC NCHS NVSS – Multiple cause of death data – (2010-2014; 2015-2019) Age-adjusted mortality rate for population aged 15 to 64. Underlying cause-of-death codes: X40-X44, X60-X64, X85, and Y10-Y14.
Opioid Overdose Mortality Rate CDC NCHS NVSS – Multiple cause of death data – (2010-2014; 2015-2019) Age-adjusted mortality rate for population aged 15 to 64. Underlying cause-of-death codes: X40-X44, X60-X64, X85, and Y10-Y14. Multiple cause-of-death codes: T40.0, T40.1, T40.2, T40.3, T40.4, T40.6.
*Note: There are variations in reporting across states for the ICD-10 codes on contributing causes. Therefore, these estimates should be used with caution.
Urban/Rural ARC's simplification of the USDA Economic Research Services (ERS) 2013 Urban Influence Codes (UIC) Urban counties include large metro counties (counties that include large metropolitan centers of one million population or greater) and small metro counties (counties with metropolitan centers of less than one million population). Rural counties include non-metro counties adjacent to large metros, non-metro counties adjacent to small metros, and non-metro counties not adjacent to a metro.
Race/Ethnicity U.S. Census Bureau, ACS 5-year estimates (2010-2014; 2015-2019) Percentage of total population:
  • White (non-Hispanic)
  • African American (non-Hispanic)
  • Hispanic or Latino
  • Asian (non-Hispanic)
  • Native Hawaiian/Pacific Islander (non-Hispanic)
  • American Indian/Alaska Native (non-Hispanic)
Age U.S. Census Bureau, ACS 5-year estimates (2010-2014; 2015-2019) Percentage of total population:
  • Under 15 years old
  • Age 15 to 64
  • 65 years and above
Educational Attainment U.S. Census Bureau, ACS 5-year estimates (2010-2014; 2015-2019) Percentage of population 25 years and over in the United States:
  • Completed high school (at least high school graduate, includes equivalency)
  • Completed college (Bachelor’s degree OR graduate or professional degree)
Disability Status U.S. Census Bureau, ACS 3-year estimates and 5-year estimates (2010-2014; 2015-2019) Percentage of civilian non-institutionalized population ages 18-64 with a disability
Median Household Income U.S. Census Bureau, ACS 5-year estimates (2010-2014; 2015-2019)

Median household income in the past 12 months (in 2019 inflation-adjusted dollars)

For regional Appalachian Median household income, 2019 ACS data was used

Median household income in the past 12 months (in 2019 inflation-adjusted dollars)

Poverty Rate U.S. Census Bureau, ACS 5-year estimates (2010-2014; 2015-2019) Among the population for whom poverty status is determined, the percentage of the population that has an income in the past 12 months below the poverty level
Unemployment Rate U.S. Census Bureau, ACS 5-year estimates (2010-2014; 2015-2019) Among the population 16 years and over, the percentage of the labor force that is unemployed
Accident-prone Employment Bureau of Labor Statistics Quarterly Census of Employment and Wages(2010-2014 average employment; 2015-2019 average employment) Percent of employed population that is employed in the following:
  • Manufacturing
  • Construction
  • Mining and Natural Resources
  • Trade, Transportation, and Utilities
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More Information

More About NORC at the University of Chicago

For more than 75 years, NORC at the University of Chicago has been one of the world’s leading research organizations. NORC is also a pioneer in understanding difficult to reach audiences, integrating administrative data and social media into social science research, and making data more useful and accessible.

Among many recent projects, The Walsh Center for Rural Health Analysis has explored how “diseases of despair” have impacted the Appalachian Region, The Health Media Collaboratory has examined how tobacco companies have used Twitter and other social media channels to market e-cigarettes, especially to young people, and our Visualization Laboratory has created a calculator that helps employers compare the costs of substance abuse among employees to the cost of insurance-provided treatment.

Contact

For more information please contact:

Eric Young

NORC Senior External Affairs Manager

young-eric@norc.org

(301) 634-9536


Michael Meit

Senior Fellow and Co-Director, NORC Walsh Center for Rural Health Analysis

meit-michael@norc.org

(301) 634-9324

More About The Appalachian Regional Commission

The Appalachian Regional Commission (ARC) is a regional economic development agency that represents a partnership of federal, state, and local government. Established by an act of Congress in 1965, ARC is composed of the governors of the 13 Appalachian states and a federal co-chair, who is appointed by the president. Local participation is also provided through multicounty local development districts. ARC serves a 205,000 square-mile region of 25 million people that includes all of West Virginia and parts of twelve other states: Alabama, Georgia, Kentucky, Maryland, Mississippi, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee and Virginia.

ARC’s mission is to innovate, partner, and invest to build community capacity and strengthen economic growth in Appalachia to help the Region achieve socioeconomic parity with the nation. ARC provides funding for several hundred investments in the Appalachian Region, in areas such as business development, education and job training, telecommunications, health, infrastructure, community development, housing, and transportation.

Opioid Misuse Community Assessment Tool

In partnership with USDA, NORC at the University of Chicago developed a national version of the Appalachian Overdose Mapping Tool. The national tool can be found here.

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Embed Map

<iframe width="975" height="570" src="https://overdosemappingtool.norc.org/embed/map/map.html" frameborder="1" allowfullscreen></iframe>

Embed Table

Embed table for Menifee County, KY in 2014 - 2018

<iframe width="975" height="630" src="https://overdosemappingtool.norc.org\embed\D\T2\table21165.html" frameborder="1" allowfullscreen> </iframe>

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Using the “Drug Overdose Deaths in Appalachia” Mapping Tool

This tool allows researchers, policymakers, journalists, and the general public to create county-level maps illustrating the relationship between community and population demographics and fatal drug overdoses—including opioids—in the Appalachian Region of the United States. Insights derived from this tool can be used to target resources and interventions, and inform media coverage related to overdose deaths in Appalachia.

Base-Layer Data: Fatal Overdose Rates by County

The base layer shows the fatal overdose rate by county at two points in time. Darker-colored counties have higher overdose rates. Lighter-colored counties have lower overdose death rates. You can use the List of Counties to link directly to data on a particular county, or click on it on the map.

Overdose Type

Data specific to opioid overdoses can also be shown on the tool by selecting the “Opioid” dot; however, these mortality rates should be used with caution due to differences in reporting between states.

Timeframe

Click on the dot in the “timeframe” slider in the upper-right section of the screen to change the years represented by the overdose layer.

State/County

To view state-level data, click the "state/county" drop down in the upper-right section of the screen and select "State".

Rural vs. Urban

Use the “urban/rural” drop down to compare data from rural and urban counties.

Second-Layer Data: Community and Population Demographics by County

Choose variables from the left-hand column to layer county-level economic and demographic data on top of the baseline fatal overdose data. By showing the variables as translucent circles of varying sizes, the tool allows users to clearly see how a given measure relates to the baseline fatal overdose rate. For example, choosing “Poverty Rate” will demonstrate the relationship between an individual county’s poverty rate and its overdose mortality rate.

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