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CDC Reports Rising Rates of Drug Overdose Deaths in Rural Areas

CDC Reports Rising Rates of Drug Overdose Deaths in Rural Areas

Rates of drug overdose deaths are rising in nonmetropolitan (rural) areas, surpassing rates in metropolitan (urban) areas, according to a new report in the Morbidity and Mortality Weekly Report (MMWR) released this week by the Centers for Disease Control and Prevention (CDC).

Drug overdoses are the leading cause of injury death in the United States, resulting in approximately 52,000 deaths in 2015. This report analyzed trends in illicit drug use and disorders from 2003-2014 and drug overdose deaths from 1999-2015 in urban and rural areas. In 1999, drug overdose death rates for urban areas were higher than in rural areas (6.4 per 100,000 population versus 4.0 per 100,000). The rates converged in 2004, and in 2006 the rural rate began trending higher than the urban rate. In 2015, the most recent year in this analysis, the rural rate of 17.0 per 100,000 remains slightly higher than the urban rate of 16.2 per 100,000.

Urban and rural areas experienced significant increases in the percentage of people reporting past-month illicit drug use. However, there were also significant declines in the percentage of people with drug use disorders among those reporting illicit drug use in the past year. The new findings also show an increase in overdose deaths between 1999 and 2015 among urban and rural residents. This increase was consistent across sex, race, and intent (unintentional, suicide, homicide, or undetermined).

“The drug overdose death rate in rural areas is higher than in urban areas,” said CDC Director Brenda Fitzgerald, M.D. “We need to understand why this is happening so that our work with states and communities can help stop illicit drug use and overdose deaths in America.”

Although the percentage of people reporting illicit drug use is less common in rural areas, the effects of use appear to be greater. The percentage of people with drug use disorders among those reporting past-year illicit drug use were similar in rural and urban areas.

Additional findings from the CDC study:

  • In 1999, drug overdose death rates for urban areas were higher than in rural areas (6.4 per 100,000 population versus 4.0 per 100,000). The rates converged in 2004, and by 2006 the rural rate (11.7 per 100,000) was slightly higher than the urban rate (11.5 per 100,000).
  • The percentage of people reporting past-month use of illicit drugs declined for youth ages 12-17 over a 10-year period but increased substantially in other age groups.
  • The percentage of people reporting past-month use of illicit drugs was higher for urban areas during the study period.
  • Among people reporting illicit drug use in the past year, drug use disorders decreased during the study period.
  • In 2015, approximately six times as many drug overdose deaths occurred in urban areas than in rural areas (urban: 45,059; rural: 7,345).

Most overdose deaths occurred in homes, where rescue efforts may fall to relatives who have limited knowledge of or access to life-saving treatment and overdose follow-up care. Considering where people live and where they die from overdose could improve interventions to prevent overdose. Understanding differences in illicit drug use, illicit drug use disorders, and drug overdose deaths in urban and rural areas can help public health professionals to identify, monitor, and prioritize responses.

Visit HHS’s Opioids website for more information on their 5-point strategy to combat the opioid crisis.

Visit CDC’s Opioid Overdose website for data, tools, and resources on opioid overdose prevention.

Visit CDC’s Rural Health website for more information on rural health topics.

Posted in: Opioid

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Report: Deaths from Cancer Higher in Rural America

Report: Deaths from Cancer Higher in Rural America

Despite decreases in cancer death rates nationwide, a new report shows slower reduction in cancer death rates in rural America (a decrease of 1.0 percent per year) compared with urban America (a decrease of 1.6 percent per year), according to data released today in CDC’s Morbidity and Mortality Weekly Report. The report is part of a series of MMWR studies on rural heath.

The report is the first complete description of cancer incidence and mortality in rural and urban America. Researchers found that rates of new cases for lung cancer, colorectal cancer, and cervical cancer were higher in rural America. In contrast, rural areas were found to have lower rates of new cancers of the female breast and prostate. Rural counties had higher death rates from lung, colorectal, prostate, and cervical cancers.

“While geography alone can’t predict your risk of cancer, it can impact prevention, diagnosis and treatment opportunities – and that’s a significant public health problem in the U.S.,” said CDC Acting Director Anne Schuchat, M.D. “Many cancer cases and deaths are preventable and with targeted public health efforts and interventions, we can close the growing cancer gap between rural and urban Americans.”

In the study, researchers analyzed cancer incidence data from CDC’s National Program of Cancer Registries and the National Cancer Institute’s Surveillance, Epidemiology, and End Results program. Cancer deaths were calculated from CDC’s National Vital Statistics System. Counties were grouped by urbanization and population size.

Key findings from analysis of cancer rates

  • Death rates were higher in rural areas (180 deaths per 100,000 persons) compared with urban areas (158 deaths per 100,000 persons). Cancer deaths in rural areas decreased at a slower pace, increasing the differences between rural and urban areas.
  • While overall cancer incidence rates were somewhat lower in rural areas (442 cases per 100,000 persons) than in urban areas (457 cases per 100,000 persons), incidence rates were higher in rural areas for several cancers, including those related to tobacco use such as lung cancer and those that can be prevented by cancer screening such as colorectal and cervical cancers.
  • While rural areas have lower incidence of cancer than urban areas, they have higher cancer death rates. The differences in death rates between rural and urban areas are increasing over time.

“Cancer – its causes, its prevention, and its treatment – is complicated,” said Lisa C. Richardson, M.D., oncologist and director of CDC’s Division of Cancer Prevention and Control. “When I treat cancer patients, I don’t do it alone – other healthcare professionals and family members help the patient during and after treatment. The same is true for community-level preventive interventions. Partnerships are key to reducing cancer incidence and the associated disparities.”

The CDC researchers identify a number of proven strategies that can reduce the gaps in new cancer cases and deaths. Healthcare providers in rural areas can:

    • Promote healthy behaviors that reduce cancer risk. Prevent tobacco initiation, promote tobacco cessation, and eliminate secondhand smoke exposure. Limit excessive exposure to ultraviolet rays from the sun and tanning beds. Encourage physical activity and healthy eating to prevent and reduce obesity, which is associated with several types of cancer.
    • Increase cancer screenings and vaccinations that prevent cancer or detect it early. Recommend patients receive vaccination against cancer-related infectious diseases such as HPV and hepatitis B virus. Recommend appropriate cancer screening tests such as Pap tests and colonoscopy.
    • Participate in the state-level comprehensive control coalitions. Comprehensive cancer control programs focus on cancer prevention, education, screening, access to care, support for cancer survivors, and overall pursuit of good health.

These data from CDC provide a clear direction for the work that needs to be done to reduce cancer disparities throughout the U.S., and provide the foundation for proven strategies that could be implemented. Proven strategies to improve health-related behaviors, increased use of vaccinations that prevent infections that can cause cancer, and use of cancer screening tests – particularly among people that live in rural and underserved areas – can help reduce the rates of cancer and cancer deaths across America.

For more information on rural health: www.cdc.gov/ruralhealth.

Posted in: Health

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