Opioid-related mortality in rural America: Geographic heterogeneity and intervention strategies

Trends in Non‐Hispanic White Mortality in the United States by Metropolitan‐Nonmetropolitan Status and Region, 1990–2016

“…). However, these “deaths of despair” cannot fully explain the slowdown in mortality declines, since the adverse trends persist even after eliminating mortality from these causes (Squires and Blumenthal ; Monnat ; Rigg, Monnat, and Chavez ). Other causes of death are also hypothesized to be important contributors to stagnating mortality declines.…”

“…Elevated mortality from these causes of death is especially concentrated among individuals with low levels of education (see also Ho 2017;Kochanek et al 2016b). However, these "deaths of despair" cannot fully explain the slowdown in mortality declines, since the adverse trends persist even after eliminating mortality from these causes (Squires and Blumenthal 2016;Monnat 2018;Rigg, Monnat, and Chavez 2018). Other causes of death are also hypothesized to be important contributors to stagnating mortality declines.…”

The Contributions of Socioeconomic and Opioid Supply Factors to Geographic Variation in U.S. Drug Mortality Rates

“…However, simplified binary urban/rural comparisons can mask important differences across degrees of rurality and opportunity structures (James, 2014;Roberts et al, 2016). For example, although rates of opioid-related inpatient hospitalizations, emergency department visits, and mortality are high in some predominantly rural states (e.g., Maine, Kentucky, and West Virginia), they are comparatively low in other very rural states (e.g., Iowa, Nebraska, Idaho, and the Dakotas) (Keyes et al, 2014;Rigg et al, 2018), reflecting that the magnitude of the contemporary drug crisis varies substantially across the rural U.S.…”

“…A common media and public health narrative around the contemporary U.S. drug crisis is that is has become disproportionately rural (Noonan, 2017;Runyon, 2017;van Vlaanderen, 2018), including the extreme claim that rural America is the new 'inner city' (Adamy and Overberg, 2017). This coverage, while bringing much needed attention to rural areas in distress, misrepresents the geography of drug overdose and ignores the tremendous heterogeneity in the severity of the drug crisis in rural areas (Rigg and Monnat 2018;Monnat, forth).…”

The Opioid Crisis in Rural and Small Town America

“…Specific causes of opioid-related death are detailed in the peerreviewed article. 13 All rates are ageadjusted and represent the number of deaths per 100,000 population.…”