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These Maps Show Where "Deaths Of Despair” Are Most Likely, Including Murder, Suicide, And Drugs

Drug use and violence are a problem in the US — but they are killing more Americans in some parts of the country than others.

Posted on March 22, 2018, at 6:20 p.m. ET

New maps reveal where Americans are dying at alarming rates from drugs, alcohol, suicide, and homicide. These so-called deaths of despair do not affect all places equally.

More than 2.8 million people died in the US between 1980 and 2014 due to homicide, suicide, and substance abuse. In a new study, researchers at the University of Washington analyzed these deaths looking for trends across the US.They found that mortality rates from these four causes of death — alcohol, drugs, suicide, and homicide — varied widely among different counties. There were striking increases in deaths due to drug use, according to the findings published in JAMA. While deaths due to alcohol, suicide, and homicide decreased at a national level, they increased in certain counties.These “deaths of despair," as they are called in a groundbreaking 2015 study on mortality in the US, are a growing problem in the US, especially among young people. And for the first time since the 1960s, life expectancy in the US has declined for two years in a row. Experts point to the opioid epidemic and other substance use disorders for reversing the progress in life expectancy rates the US has seen in the last 50 years.
University of Washington / Via jamanetwork.com

More than 2.8 million people died in the US between 1980 and 2014 due to homicide, suicide, and substance abuse. In a new study, researchers at the University of Washington analyzed these deaths looking for trends across the US.

They found that mortality rates from these four causes of death — alcohol, drugs, suicide, and homicide — varied widely among different counties. There were striking increases in deaths due to drug use, according to the findings published in JAMA. While deaths due to alcohol, suicide, and homicide decreased at a national level, they increased in certain counties.

These “deaths of despair," as they are called in a groundbreaking 2015 study on mortality in the US, are a growing problem in the US, especially among young people. And for the first time since the 1960s, life expectancy in the US has declined for two years in a row. Experts point to the opioid epidemic and other substance use disorders for reversing the progress in life expectancy rates the US has seen in the last 50 years.

Drug-related deaths have increased by 618.3% since 1980, and Appalachian states have been hit the hardest. The opioid epidemic is likely to blame.

The study found that deaths due to drug use increased in all counties in the US. However, there were major differences among counties and mortality rates were alarmingly high in parts of Kentucky, West Virginia, Ohio, Indiana, and Oklahoma. "The magnitude of some of the differences was still pretty shocking ... In the hardest hit counties, there were increases of more than 5000%," Laura Dwyer-Lindgren, assistant professor of global health at the University of Washington, told BuzzFeed News. As the map shows, Appalachia has become the epicenter of the US opioid epidemic. Past studies have shown that the majority of deaths due to drug use in the US are from opioids, Dwyer-Lindgren said, so the increases in drug-related mortality is likely a reflection of the increase in deaths due to opioids. "Drug use disorders are a big and growing problem everywhere in the US. That said, there are certain regions that have been hit especially hard, and they need particular help and support," the authors wrote.
University of Washington / Via jamanetwork.com

The study found that deaths due to drug use increased in all counties in the US. However, there were major differences among counties and mortality rates were alarmingly high in parts of Kentucky, West Virginia, Ohio, Indiana, and Oklahoma.

"The magnitude of some of the differences was still pretty shocking ... In the hardest hit counties, there were increases of more than 5000%," Laura Dwyer-Lindgren, assistant professor of global health at the University of Washington, told BuzzFeed News. As the map shows, Appalachia has become the epicenter of the US opioid epidemic.

Past studies have shown that the majority of deaths due to drug use in the US are from opioids, Dwyer-Lindgren said, so the increases in drug-related mortality is likely a reflection of the increase in deaths due to opioids.

"Drug use disorders are a big and growing problem everywhere in the US. That said, there are certain regions that have been hit especially hard, and they need particular help and support," the authors wrote.

Deaths due to homicide decreased by 44.9% overall across the country, but rates spiked in parts of the South and Mississippi Delta.

Nationally, the age-standardized mortality rate due to interpersonal violence actually decreased by 44.9% between 1980 and 2014. So the overall number of people dying from homicide in the US has decreased, but it has spiked in certain pockets of the country. States with high mortality rates include Alabama, Alaska, North Dakota, South Dakota, Kansas, Michigan, Virginia, and North Carolina.
University of Washington / Via jamanetwork.com

Nationally, the age-standardized mortality rate due to interpersonal violence actually decreased by 44.9% between 1980 and 2014. So the overall number of people dying from homicide in the US has decreased, but it has spiked in certain pockets of the country. States with high mortality rates include Alabama, Alaska, North Dakota, South Dakota, Kansas, Michigan, Virginia, and North Carolina.

Deaths from suicide decreased between 1980 and 2000, then increased between 2000 and 2014. Alaska and Western states were hit the hardest.

While the national mortality rate due to suicide was decreasing in the last part of the 20th century, it has shown a steady increase in certain parts of the country in the past 15 years. "Even though mortality rates from suicides declined for the US as a whole from 1980 to 2014, a majority of counties experienced an increase over this period," Dywer-Lindgren said. According to the study, deaths from self-harm were particularly high in "regions of the Western United States with high rates of firearm availability and relatively low population density." The researchers say that better access to mental health care might help reduce the suicide rate in those areas.
University of Washington / Via jamanetwork.com

While the national mortality rate due to suicide was decreasing in the last part of the 20th century, it has shown a steady increase in certain parts of the country in the past 15 years. "Even though mortality rates from suicides declined for the US as a whole from 1980 to 2014, a majority of counties experienced an increase over this period," Dywer-Lindgren said.

According to the study, deaths from self-harm were particularly high in "regions of the Western United States with high rates of firearm availability and relatively low population density." The researchers say that better access to mental health care might help reduce the suicide rate in those areas.

The number of alcohol-related deaths increased in Alaska and in some Southwestern states.

On a national level, the age-standardized mortality rate from alcohol use decreased by 8.1%. However, there were very high mortality rates in Alaska and the area of the Southwest where Utah, Colorado, Arizona, and New Mexico meet.
University of Washington / Via jamanetwork.com

On a national level, the age-standardized mortality rate from alcohol use decreased by 8.1%. However, there were very high mortality rates in Alaska and the area of the Southwest where Utah, Colorado, Arizona, and New Mexico meet.

"This is a good reminder that what we see at the national level often doesn’t reflect what’s going on in many parts of the country."

"Broadly speaking, mortality from alcohol use disorders, suicides, and homicides has gone down since 1980, but this hides individual counties where the opposite is true. Progress overall doesn’t mean progress for everyone, and we hope that this research can be used to identify communities that are struggling," Dwyer-Lindgren said.

The researchers hope the findings help people develop policies and public health strategies that reduce these deaths of despair.

"Deaths from substance use disorders and intentional injuries are particularly interesting from this perspective because they are preventable, and because they tend to affect younger individuals than most major causes of death," Dwyer-Lindgren said.

"The better we all understand why some places do well and why others do poorly, the better equipped we are to improve the situation for everyone," she said.

If you are dealing with thoughts of suicide, you can speak to someone immediately at IMAlive or by calling the National Suicide Prevention Lifeline at 1-800-273-8255.

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