Disparities in opioid related mortality between United States counties from 2000 to 2014

Abstract

Background: The general increase in opioid-related deaths is well documented, and disparities by geographic regions and demographic characteristics have been observed as well. However, the distribution of opioid-related deaths among U.S. counties and the trends in that distribution have not been fully explored. This study examines the inequality in opioid death rates to assess convergence or divergence in opioid-related mortality between counties.

Methods: Using mortality data from the NVSS for 2000-2014, this study examines the Gini coefficient of the county opioid mortality distribution.

Results: The distribution of opioid mortality became more equal, with the Gini coefficient falling from 0.81 in 2000 to 0.61 in 2014. Counties with lower initial opioid mortality rates experienced faster growth in mortality than counties with high initial mortality.

Conclusions: Counties have experienced a convergence in opioid mortality rates. This poses potential challenges for addressing the crisis, as measures must become much broader in scope and be implemented in areas in which the dangers of the opioid crisis are not as apparent.

Keywords: Inequality; Mortality; Opioids.