Nav: Home

American death rate from drugs, alcohol, and mental disorders nearly triples since 1980

December 13, 2016

SEATTLE - More than 2,000 US counties witnessed increases of 200% or more in deaths related to substance abuse and mental disorders since 1980, including clusters of counties in Kentucky, West Virginia, and Ohio with alarming surges over 1,000%, according to a new scientific study.

The study examines deaths in 21 cause groups, ranging from chronic illnesses like diabetes and other endocrine diseases, to infectious diseases, such as HIV/AIDS and tuberculosis, to accidents, including traffic fatalities. It explores mortality rates and how they have changed in every US county between 1980 and 2014, creating the most comprehensive view to date of how Americans die.

The study was conducted by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington in Seattle, and was published today in JAMA.

Cardiovascular disease was the leading cause of death overall in the United States in 2014, but cancers were responsible for more years of life lost to early death than any other cause. Still, the rate at which Americans die from cancer and other diseases or injuries differs significantly among communities, highlighting stark health disparities across the nation. For instance, the counties with the highest and the lowest mortality rates from cirrhosis and other liver diseases were both in South Dakota, with 193 deaths per 100,000 people in Oglala Lakota County, to seven deaths per 100,000 people in Lincoln County.

"While the leading causes of death are similar across counties, we found massive disparities in the rates at which people are dying among causes and communities," explained lead author Laura Dwyer-Lindgren. "For causes of death with effective treatments, inequalities in mortality rates spotlight areas where access to essential health services and quality of care needs to be improved."

Other causes vary by changes in mortality rates since 1980. For example, about half of US counties saw increases in suicide and violence, while the other half of counties experienced decreases. Kusilvak Census Area in Alaska topped the list with a 131% mortality rate increase, while the rate in New York County, New York, dropped by 72% - the most dramatic decrease in the country.

Mortality rates from substance abuse - including alcohol and drug use - and mental health disorders are highly variable as well, showing the greatest increases in Clermont County, Ohio (2,206%), and Boone County, West Virginia (2,030%), and the largest drops in Aleutians East Borough, Aleutians West Census Area, Alaska, and Miami-Dade County, Florida, declining by 51% and 45%, respectively.

"The mortality trends in mental and substance use disorders, as well as with other causes of death covered in the study, point to the need for a well-considered response from local and state governments, as well as care providers, to help reduce the disparities we are seeing across the country," said Dr. Christopher Murray, Director of IHME.

Other county-level trends in the study include:
  • Chronic respiratory diseases, a group that includes COPD and asthma, saw the most dramatic increases in a band of counties spanning northern Texas to the Carolinas. Concurrently, a small number of counties along the Mexico border, in northwestern New Mexico, and in central Colorado, experienced decreases.

  • The national mortality rate from traffic accidents decreased by 45% between 1980 and 2014. Generally, lower death rates were found in urban areas, and higher rates were seen in rural counties.

  • While select counties in Montana, Florida, and North and South Dakota have the highest mortality rates from cirrhosis and liver disease, sharp increases were seen in southwestern Oregon and northwestern Texas since 1980.

    Deaths from neurological disorders, such as Alzheimer's disease and other forms of dementia, increased in the majority of counties over the 35-year span of the study, with especially large increases in counties stretching from eastern Texas and Oklahoma to Alabama.


"We know that unequal medical access and quality of care create health disparities in the US for many causes of death, while other causes are linked to risk factors or policies," said Dr. Ali Mokdad, Professor of Global Health at IHME and study co-author. "Indeed, this study will inform the debate on how to improve the health of our nation."

While nearly all deaths in the United States are reported in death certificates, the causes of death recorded may be vague or even implausible. For example, a physician may report that someone died of heart disease, when the underlying cause was, in fact, hypertensive heart disease. To correct for this, the study authors reassigned deaths with nonspecific causes to their likely underlying causes, improving the accuracy of the estimates.

Below are the 10 counties with the largest increases in mortality rates from cancer, 1980-2014:

>1. Owsley County, Kentucky (+46%)
2. Lee County, Kentucky (+40%)
3. Estill County, Kentucky (+38%)
4. Breathitt County, Kentucky (+38%)
5. Madison County, Mississippi (+36%)
6. Anderson County, Texas (+35%)
7. Union County, Florida (+33%)
8. Marlboro County, South Carolina (+32%)
9. Powell County, Kentucky (+30%)
10. Johnson County, Kentucky (+29%)

Below are the 10 counties with the largest decreases in mortality rates from cancer, 1980-2014:

1. Aleutians East Borough, Aleutians West Census Area, Alaska (-58%)
2. Alexandria City, Virginia (-46%)
3. Loudoun County, Virginia (-46%)
4. Summit County, Colorado (-46%)
5. Howard County, Maryland (-46%)
6. Eagle County, Colorado (-45%)
7. Pitkin County, Colorado (-44%)
8. Presidio County, Texas (-44%)
9. Rockland County, New York (-43%)
10. Falls Church City, Virginia (-43%)
-end-
NOTE: To view mortality trends at the county level between 1980 and 2014, IHME has created an interactive map, 3,142 county profiles, and downloadable spreadsheets revealing the top and bottom 10 counties for each cause group and mortality data for each state.

Link to the study in JAMA: http://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2016.13645

US Health Map data visualization tool: http://vizhub.healthdata.org/us-health-map/

County profiles: http://www.healthdata.org/us-county-profiles

US Data for Download: http://ghdx.healthdata.org/us-data

Institute for Health Metrics and Evaluation

Related Cancer Articles:

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.
Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.
Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.
Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.
More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.
New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.
American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.
Oncotarget: Cancer pioneer employs physics to approach cancer in last research article
In the cover article of Tuesday's issue of Oncotarget, James Frost, MD, PhD, Kenneth Pienta, MD, and the late Donald Coffey, Ph.D., use a theory of physical and biophysical symmetry to derive a new conceptualization of cancer.
Health indicators for newborns of breast cancer survivors may vary by cancer type
In a study published in the International Journal of Cancer, researchers from the UNC Lineberger Comprehensive Cancer Center analyzed health indicators for children born to young breast cancer survivors in North Carolina.
Few women with history of breast cancer and ovarian cancer take a recommended genetic test
More than 80 percent of women living with a history of breast or ovarian cancer at high-risk of having a gene mutation have never taken the test that can detect it.
More Cancer News and Cancer Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Clint Smith
The killing of George Floyd by a police officer has sparked massive protests nationwide. This hour, writer and scholar Clint Smith reflects on this moment, through conversation, letters, and poetry.
Now Playing: Science for the People

#562 Superbug to Bedside
By now we're all good and scared about antibiotic resistance, one of the many things coming to get us all. But there's good news, sort of. News antibiotics are coming out! How do they get tested? What does that kind of a trial look like and how does it happen? Host Bethany Brookeshire talks with Matt McCarthy, author of "Superbugs: The Race to Stop an Epidemic", about the ins and outs of testing a new antibiotic in the hospital.
Now Playing: Radiolab

Dispatch 6: Strange Times
Covid has disrupted the most basic routines of our days and nights. But in the middle of a conversation about how to fight the virus, we find a place impervious to the stalled plans and frenetic demands of the outside world. It's a very different kind of front line, where urgent work means moving slow, and time is marked out in tiny pre-planned steps. Then, on a walk through the woods, we consider how the tempo of our lives affects our minds and discover how the beats of biology shape our bodies. This episode was produced with help from Molly Webster and Tracie Hunte. Support Radiolab today at Radiolab.org/donate.