Overdose Death Urbanicity Graphs

  • Large central metro—Counties in metropolitan statistical areas of 1 million or more population that:
    • Contain the entire population of the largest principal city
    • Have their entire population contained in the largest principal city
    • Contain at least 250,000 inhabitants of any principal city
  • Large fringe metro—Counties of 1 million or more population that did not qualify as large central metro counties.
  • Medium metro—Counties of populations of 250,000 to 999,999.
  • Small metro—Counties of populations less than 250,000.
  • Micropolitan—Counties in micropolitan statistical areas that have a population of at least 10,000 but less than 50,000.
  • Noncore—Nonmetropolitan counties that did not qualify as micropolitan.

Categories of 2013 NCHS Urban-Rural Classification Scheme for Counties (https://www.cdc.gov/nchs/data_access/urban_rural.htm)

Age-adjusted death rates for prescription opioids are plotted above by urbanization classification of residence for 2016 to 2017.  The rates remained stable for all urbanization level. The prescription opioid overdose death rate also remained stable in the United States overall from 2016 to 2017, with a total of 17,029 deaths in 2017. Deaths are classified using the International Classification of Diseases, Tenth Revision (ICD–10). Drug overdose deaths are identified using underlying cause-of-death codes X40–X44, X60–X64, X85, and Y10–Y14. Drug overdose deaths, as defined, that have prescription (natural and semi-synthetic) opioids (T40.2) or methadone (T40.3) as a contributing cause. Age-adjusted death rates were calculated using the direct method and the 2000 standard population.1

County Urbanization Level 2016 Rate 2017 Rate
United States 5.2 5.2
Large Central Metro 4.7 4.7
Large Fringe Metro 5.2 5.2
Medium Metro 6 5.9
Small Metro 5.2 5.2
Micropolitan 5.7 5.6
Noncore 5.7 5.3

  • Large central metro—Counties in metropolitan statistical areas of 1 million or more population that:
    • Contain the entire population of the largest principal city
    • Have their entire population contained in the largest principal city
    • Contain at least 250,000 inhabitants of any principal city
  • Large fringe metro—Counties of 1 million or more population that did not qualify as large central metro counties.
  • Medium metro—Counties of populations of 250,000 to 999,999.
  • Small metro—Counties of populations less than 250,000.
  • Micropolitan—Counties in micropolitan statistical areas that have a population of at least 10,000 but less than 50,000.
  • Noncore—Nonmetropolitan counties that did not qualify as micropolitan.

Categories of 2013 NCHS Urban-Rural Classification Scheme for Counties (https://www.cdc.gov/nchs/data_access/urban_rural.htm)

Age-adjusted death rates for prescription opioids are plotted above by urbanization classification of residence for 2015 to 2016. Rates increased significantly for large central metro (14.6%), large fringe metro (23.8%), and medium metro (7.1%) areas. The prescription opioid overdose death rate also increased in the United States overall—a statistically significant 10.6% increase from 2015 to 2016, with a total of 17,087 deaths in 2016. Deaths are classified using the International Classification of Diseases, Tenth Revision (ICD–10). Drug overdose deaths are identified using underlying cause-of-death codes X40–X44, X60–X64, X85, and Y10–Y14. Drug overdose deaths, as defined, that have prescription (natural and semi-synthetic) opioids (T40.2) or methadone (T40.3) as a contributing cause. Age-adjusted death rates were calculated using the direct method and the 2000 standard population.1

References

  1. Wide-ranging online data for epidemiologic research (WONDER). Atlanta, GA: CDC, National Center for Health Statistics; 2016. Available at http://wonder.cdc.gov.
CDC Guideline for Prescribing Opioids for Chronic Pain