Drug Poisoning Mortality in the United States, 1999-2016
These figures present drug poisoning deaths at the national, state, and county levels. The first two dashboards depict U.S. and state trends in age-adjusted death rates for drug poisoning beginning in 1999 by selected demographic characteristics, and the third and fourth dashboards present a series of heat maps and grids of model-based county estimates for drug-poisoning mortality. Select a dashboard from the drop-down menu, then click on “Update Dashboard” to navigate through different graphics.
- The first dashboard shows national estimates. Use the year slider to select data years for the bar charts on the top. When using the radio buttons to select age, sex, and race and Hispanic origin, the bar charts display deaths for drug poisoning by sex or age groups, and the line chart shows national trends in death rates for selected demographic groupings.
- The second dashboard shows state estimates. The line charts describe the U.S. and state trends in age-adjusted death rates for drug poisoning. The U.S. map presents age-adjusted death rates for drug poisoning per 100,000 population by state and year, with the magnitude of the state death rates indicated by the color gradient. Click on a state in the map to display that state’s trend line in the graph.
- The third dashboard is a heat map of county estimates, showing model-based age-adjusted death rates for drug poisoning per 100,000 population by county and year. The color scale indicates the magnitude of the estimated county-level death rates in ranges. Use the arrows or the slider to select a year. Click on any state to zoom into it on the map. Click outside the state to zoom back out to the map of the U.S. Users may click on the gray “home” icon in the upper right-hand corner of the map to reset the view, if necessary.
- The fourth dashboard features a county grid showing the change in estimated drug poisoning death rates rate by year using the same color scale as the county heat map. Click on a state in the map to display the counties for that state in the grid.
Download datasets in CSV format by clicking on the link for the desired dataset under “CSV Format” link. Additional file formats are available for download for each dataset at Data.CDC.Gov.
† Deaths are classified using the International Classification of Diseases, Tenth Revision (ICD–10). Drug-poisoning deaths are defined as having ICD–10 underlying cause-of-death codes X40–X44 (unintentional), X60–X64 (suicide), X85 (homicide), or Y10–Y14 (undetermined intent).
‡ Estimates are based on the National Vital Statistics System multiple cause-of-death mortality files (1). Age-adjusted death rates (deaths per 100,000 U.S. standard population for 2000) are calculated using the direct method. Populations used for computing death rates for 2011–2016 are postcensal estimates based on the 2010 U.S. census. Rates for census years are based on populations enumerated in the corresponding censuses. Rates for noncensus years before 2010 are revised using updated intercensal population estimates and may differ from rates previously published.
* Estimate does not meet standards of reliability or precision. Death rates are flagged as “Unreliable” in the chart when the rate is calculated with a numerator of 20 or less.
** Death rates for some states and years may be low due to a high number of unresolved pending cases or misclassification of ICD–10 codes for unintentional poisoning as R99, “Other ill-defined and unspecified causes of mortality” (2). For example, this issue is known to affect New Jersey in 2009 and West Virginia in 2005 and 2009 but also may affect other years and other states. Drug poisoning death rates may be underestimated in those instances.
§ Smoothed county age-adjusted death rates (deaths per 100,000 population) were obtained according to methods described elsewhere (3–5). Briefly, two-stage hierarchical models were used to generate empirical Bayes estimates of county age-adjusted death rates due to drug poisoning for each year. These annual county-level estimates “borrow strength” across counties to generate stable estimates of death rates where data are sparse due to small population size (3,5). Estimates for 1999-2015 have been updated, and may differ slightly from previously published estimates. Differences are expected to be minimal, and may result from different county boundaries used in this release (see below) and from the inclusion of an additional year of data. Previously published estimates can be found here for comparison.(6) Estimates are unavailable for Broomfield County, Colorado, and Denali County, Alaska, before 2003 (7,8). Additionally, Clifton Forge County, Virginia only appears on the mortality files prior to 2003, while Bedford City, Virginia was added to Bedford County in 2015 and no longer appears in the mortality file in 2015. These counties were therefore merged with adjacent counties where necessary to create a consistent set of geographic units across the time period. County boundaries are largely consistent with the vintage 2005-2007 bridged-race population file geographies, with the modifications noted previously (7,8).
CDC/NCHS, National Vital Statistics System, mortality data (see http://www.cdc.gov/nchs/deaths.htm).
- National Center for Health Statistics. National Vital Statistics System: Mortality data. Available from: http://www.cdc.gov/nchs/deaths.htm.
- CDC. CDC Wonder: Underlying cause of death 1999–2016. Available from: http://wonder.cdc.gov/wonder/help/ucd.html.
- Rossen LM, Khan D, Warner M. Trends and geographic patterns in drug-poisoning death rates in the U.S., 1999–2009. Am J Prev Med 45(6):e19–25. 2013.
- Rossen LM, Khan D, Warner M. Hot spots in mortality from drug poisoning in the United States, 2007–2009. Health Place 26:14–20. 2014.
- Rossen LM, Khan D, Hamilton B, Warner M. Spatiotemporal variation in selected health outcomes from the National Vital Statistics System. Presented at: 2015 National Conference on Health Statistics, August 25, 2015, Bethesda, MD. Available from: http://www.cdc.gov/nchs/ppt/nchs2015/Rossen_Tuesday_WhiteOak_BB3.pdf.
- Rossen LM, Bastian B, Warner M, and Khan D. NCHS – Drug Poisoning Mortality by County: United States, 1999-2015. Available from: https://data.cdc.gov/NCHS/NCHS-Drug-Poisoning-Mortality-by-County-United-Sta/pbkm-d27e.
- National Center for Health Statistics. County geography changes: 1990–2012. Available from: http://www.cdc.gov/nchs/data/nvss/bridged_race/County_Geography_Changes.pdf.
- National Center for Health Statistics. County geography changes: 1990–2015. Available from: https://www.cdc.gov/nchs/nvss/bridged_race/county_geography-_changes2015.pdf.
Rossen LM, Bastian B, Warner M, Khan D, Chong Y. Drug poisoning mortality: United States, 1999–2016. National Center for Health Statistics. 2017.
Designed by B Bastian, L Rossen, JM Keralis, and Y Chong: CDC/National Center for Health Statistics.
- Page last reviewed: January 11, 2018
- Page last updated: January 11, 2018
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