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Drug Overdose Deaths Generally Higher in Urban Counties

THURSDAY, March 18, 2021 -- From 1999 to 2019, the age-adjusted rate of drug overdose deaths increased in urban and rural counties, with rates generally higher in urban counties, according to a March data brief published by the U.S. Centers for Disease Control and Prevention National Center for Health Statistics.

Holly Hedegaard, M.D., and Merianne Rose Spencer, M.P.H., from the National Center for Health Statistics in Hyattsville, Maryland, used the most recent mortality data from the National Vital Statistics System to examine urban-rural differences in drug overdose death rates for all drugs.

The researchers found that the rate of drug overdose deaths increased from 6.4 to 22.0 per 100,000 in urban counties and from 4.0 to 19.6 in rural counties from 1999 through 2019. In California, Connecticut, North Carolina, Vermont, and Virginia, rates in rural counties were higher than in urban counties in 2019. From 2004 through 2017, rates of drug overdose deaths involving natural and semisynthetic opioids were higher in rural than urban counties, but were similar in 2018 and 2019. The rate of drug overdose deaths involving psychostimulants with abuse potential was 1.4 times higher in rural than urban counties (6.7 versus 4.8 per 100,000) in 2019.

"Rates for drug overdose deaths involving heroin or cocaine were consistently higher in urban than in rural counties over the entire period," the authors write.

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