Drug Poisoning Mortality: United States, 1999-2015
This storyboard presents 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 from 1999 to 2015 by selected demographic characteristics, and the third dashboard presents a series of heat maps of model-based county estimates for drug poisoning mortality from 1999 to 2015.
- The first dashboard shows national estimates. Use the year slider to select data years for the bar charts on the top. When using the drop-down menus to select age, sex, and race and ethnicity, 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 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. The line charts describe the U.S. and state trends in age-adjusted death rates for drug poisoning. Use the drop-down menu to select a state and display the state’s trend line.
- The third dashboard shows county estimates. The U.S. map shows 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 year slider to see the changes over time, or hover over a county to highlight counties within a state.
† 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 2011–2015 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. Estimates should be interpreted with caution.
§ 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 during 1999–2015. 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 are unavailable for Broomfield County, Colo., and Denali County, Alaska, before 2003 (6,7). Additionally, Bedford City, Virginia was added to Bedford County in 2015 and no longer appears in the mortality file in 2015. County boundaries are consistent with the vintage 2005-2007 bridged-race population file geographies (6).
CDC/NCHS, National Vital Statistics System, mortality data (see http://www.cdc.gov/nchs/deaths.htm); and Health Indicators Warehouse (see http://www.healthindicators.gov/Indicators/Drug-poisoning-deaths-per-100000_10016/Profile and reference 7).
- National Centers 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 1999–2015. 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.
- 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. Health Indicators Warehouse. Available from: http://www.healthindicators.gov.
Rossen LM, Bastian B, Warner M, Khan D, and Chong Y. Drug poisoning mortality: United States, 1999–2015. National Center for Health Statistics. 2017.
- Page last reviewed: April 10, 2017
- Page last updated: April 10, 2017
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