TABLE 2. Number and age-adjusted rate per 100,000 persons for self-reported drug overdose deaths, by sex, race/ethnicity, intent of death, and age-group, for metropolitan and nonmetropolitan counties of residence — National Vital Statistics System, United States, 1999–2015*.
| Characteristic | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Urbanicity |
No. of deaths (age-adjusted rate) |
||||||||||||||||||
| 1999 | 2000 | 2001 | 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2012 | 2013 | 2014 | 2015 | % change 1999/2015 | ||
| Metro | 15,120 (6.4) | 15,408 (6.5) | 16,937 (7.0) | 20,512 (8.4) | 22,263 (9.0) | 23,394 (9.4) | 25,520 (10.1) | 29,321 (11.5) | 30,604 (11.8) | 30,862 (11.8) | 31,266 (11.8) | 32,323 (12.1) | 34,853 (12.9) | 35,264 (13.0) | 37,547 (13.7) | 40,272 (14.6) | 45,059 (16.2) | 198 | |
| Nonmetro |
1,729 (4.0) |
2,007 (4.6) |
2,457 (5.7) |
3,006 (6.9) |
3,522 (8.2) |
4,030 (9.4) |
4,293 (9.9) |
5,104 (11.7) |
5,406 (12.3) |
5,588 (12.7) |
5,738 (12.9) |
6,006 (13.6) |
6,487 (14.7) |
6,238 (14.2) |
6,435 (14.6) |
6,783 (15.6) |
7,345 (17.0) |
325 |
|
| All deaths | 16,849 (6.1) | 17,415 (6.2) | 19,394 (6.8) | 23,518 (8.2) | 25,785 (8.9) | 27,424 (9.4) | 29,813 (10.1) | 34,425 (11.5) | 36,010 (11.9) | 36,450 (11.9) | 37,004 (11.9) | 38,329 (12.3) | 41,340 (13.2) | 41,502 (13.1) | 43,982 (13.8) | 47,055 (14.7) | 52,404 (16.3) | 211 | |
| Sex | |||||||||||||||||||
| Metro females | 4,895 (4.1) | 5,058 (4.2) | 5,778 (4.7) | 7,322 (5.9) | 8,018 (6.4) | 8,705 (6.8) | 9,363 (7.3) | 10,520 (8.1) | 11,486 (8.7) | 11,643 (8.7) | 11,926 (8.8) | 12,795 (9.4) | 13,572 (9.9) | 13,672 (9.8) | 14,403 (10.3) | 15,290 (10.8) | 16,321 (11.5) | 233 | |
| Nonmetro females |
696 (3.1) |
794 (3.6) |
958 (4.3) |
1,168 (5.4) |
1,368 (6.3) |
1,599 (7.3) |
1,726 (7.9) |
2,012 (9.1) |
2,226 (10.0) |
2,339 (10.5) |
2,485 (11.1) |
2,528 (11.5) |
2,780 (12.5) |
2,718 (12.4) |
2,780 (12.6) |
2,953 (13.4) |
3,126 (14.3) |
349 |
|
| Metro males | 10,225 (8.8) | 10,350 (8.8) | 11,159 (9.4) | 13,190 (11.0) | 14,245 (11.7) | 14,689 (12.0) | 16,157 (13.0) | 18,801 (14.9) | 19,118 (15.0) | 19,219 (14.9) | 19,340 (14.9) | 19,528 (14.9) | 21,281 (16.1) | 21,592 (16.2) | 23,144 (17.2) | 24,982 (18.4) | 28,738 (21.0) | 181 | |
| Nonmetro males | 1,033 (4.8) | 1,213 (5.6) | 1,499 (6.9) | 1,838 (8.5) | 2,154 (9.9) | 2,431 (11.3) | 2,567 (11.8) | 3,092 (14.1) | 3,180 (14.5) | 3,249 (14.7) | 3,253 (14.6) | 3,478 (15.6) | 3,707 (16.7) | 3,520 (16.0) | 3,655 (16.6) | 3,830 (17.6) | 4,219 (19.5) | 308 | |
| Race/Ethnicity† | |||||||||||||||||||
| Metro AI/AN | 100 (7.1) | 79 (5.5) | 106 (7.4) | 134 (9.1) | 172 (11.9) | 200 (13.6) | 185 (12.7) | 211 (14.1) | 217 (14.4) | 236 (15.2) | 264 (17.3) | 255 (16.5) | 276 (18.0) | 301 (18.9) | 304 (18.8) | 343 (21.4) | 361 (22.1) | 261 | |
| Nonmetro AI/AN |
31 (3.9) |
47 (5.5) |
51 (6.1) |
66 (7.5) |
77 (8.9) |
94 (10.6) |
125 (13.9) |
126 (14.0) |
128 (14.1) |
157 (17.0) |
169 (18.2) |
165 (17.3) |
177 (18.5) |
181 (18.8) |
173 (18.5) |
191 (20.2) |
192 (19.8) |
519 |
|
| Metro black | 2,321 (8.0) | 2,305 (7.9) | 2,422 (8.1) | 2,688 (8.8) | 2,723 (8.8) | 2,762 (8.8) | 3,147 (9.8) | 3,715 (11.4) | 3,407 (10.3) | 2,993 (8.9) | 2,983 (8.6) | 2,950 (8.4) | 3,195 (9.0) | 3,329 (9.2) | 3,723 (10.1) | 4,124 (11.1) | 4,802 (12.7) | 107 | |
| Nonmetro black |
108 (3.1) |
86 (2.5) |
97 (2.7) |
96 (2.6) |
99 (2.8) |
133 (3.6) |
175 (4.8) |
197 (5.4) |
167 (4.5) |
154 (4.2) |
177 (4.7) |
172 (4.5) |
190 (5.0) |
159 (4.2) |
205 (5.3) |
199 (5.3) |
268 (7.1) |
148 |
|
| Metro Hispanic§ | 1,581 (5.5) | 1,356 (4.6) | 1,401 (4.5) | 1,719 (5.4) | 1,888 (5.7) | 1,786 (5.2) | 2,079 (5.8) | 2,352 (6.3) | 2,325 (5.9) | 2,342 (5.8) | 2,418 (5.8) | 2,375 (5.6) | 2,715 (6.1) | 2,832 (6.2) | 3,110 (6.6) | 3,246 (6.7) | 3,852 (7.7) | 144 | |
| Nonmetro Hispanic |
88 (4.5) |
87 (4.3) |
82 (3.7) |
112 (4.9) |
121 (5.0) |
126 (5.2) |
141 (5.4) |
167 (6.3) |
162 (5.6) |
194 (6.8) |
183 (6.1) |
208 (6.8) |
226 (7.2) |
223 (7.3) |
235 (7.4) |
258 (7.7) |
265 (7.5) |
201 |
|
| Metro A/PI | 118 (1.1) | 114 (1.0) | 140 (1.2) | 168 (1.4) | 181 (1.4) | 191 (1.5) | 214 (1.6) | 261 (1.9) | 263 (1.8) | 246 (1.6) | 297 (1.9) | 309 (1.9) | 387 (2.3) | 389 (2.2) | 407 (2.3) | 449 (2.4) | 530 (2.7) | 349 | |
| Nonmetro A/PI |
11 (U) |
11 (U) |
—¶ |
— |
10 (U) |
— |
20 (4.6) |
— |
14 (U) |
22 (4.5) |
12 (U) |
13 (U) |
15 (U) |
14 (U) |
17 (U) |
16 (U) |
18 (U) |
64 |
|
| Metro white | 10,844 (6.6) | 11,402 (6.9) | 12,727 (7.7) | 15,688 (9.5) | 17,172 (10.5) | 18,369 (11.2) | 19,780 (12.0) | 22,678 (13.7) | 24,293 (14.7) | 24,913 (15.0) | 25,120 (15.1) | 26,280 (15.8) | 28,098 (17.0) | 28,178 (17.0) | 29,788 (17.9) | 31,853 (19.3) | 35,148 (21.4) | 224 | |
| Nonmetro white | 1,484 (4.0) | 1,769 (4.8) | 2,222 (6.2) | 2,718 (7.6) | 3,203 (9.0) | 3,655 (10.4) | 3,824 (10.8) | 4,596 (13.0) | 4,924 (13.9) | 5,053 (14.2) | 5,183 (14.5) | 5,431 (15.3) | 5,863 (16.6) | 5,645 (16.1) | 5,793 (16.5) | 6,092 (17.6) | 6,572 (19.2) | 343 | |
| Intent of death | |||||||||||||||||||
| Metro unintentional | 10,058 (4.3) | 10,429 (4.4) | 11,364 (4.7) | 14,308 (5.9) | 15,678 (6.4) | 16,868 (6.8) | 19,213 (7.6) | 22,533 (8.9) | 23,491 (9.1) | 23,844 (9.1) | 24,248 (9.2) | 25,256 (9.5) | 27,845 (10.4) | 28,147 (10.4) | 30,534 (11.2) | 33,155 (12.1) | 38,039 (13.8) | 278 | |
| Nonmetro unintentional |
1,097 (2.5) |
1,283 (2.9) |
1,660 (3.8) |
2,086 (4.8) |
2,616 (6.1) |
2,970 (6.9) |
3,235 (7.5) |
3,867 (8.9) |
4,167 (9.6) |
4,327 (9.9) |
4,506 (10.2) |
4,750 (10.9) |
5,226 (11.9) |
5,028 (11.6) |
5,129 (11.8) |
5,563 (12.9) |
6,087 (14.2) |
455 |
|
| Metro suicide | 2,767 (1.2) | 2,751 (1.2) | 3,042 (1.3) | 3,291 (1.4) | 3,338 (1.3) | 3,526 (1.4) | 3,613 (1.4) | 3,854 (1.5) | 4,076 (1.5) | 4,310 (1.6) | 4,336 (1.6) | 4,535 (1.7) | 4,552 (1.6) | 4,719 (1.7) | 4,650 (1.7) | 4,663 (1.6) | 4,445 (1.5) | 61 | |
| Nonmetro suicide |
414 (0.9) |
492 (1.1) |
517 (1.2) |
593 (1.3) |
552 (1.3) |
682 (1.5) |
627 (1.4) |
717 (1.6) |
696 (1.5) |
717 (1.6) |
705 (1.5) |
763 (1.6) |
746 (1.6) |
746 (1.6) |
782 (1.7) |
770 (1.6) |
761 (1.6) |
84 |
|
| Metro undetermined | 2,264 (1.0) | 2,199 (0.9) | 2,494 (1.0) | 2,876 (1.2) | 3,205 (1.3) | 2,941 (1.2) | 2,647 (1.1) | 2,874 (1.1) | 2,989 (1.2) | 2,654 (1.0) | 2,625 (1.0) | 2,484 (0.9) | 2,399 (0.9) | 2,333 (0.8) | 2,306 (0.8) | 2,397 (0.9) | 2,509 (0.9) | 11 | |
| Nonmetro undetermined |
209 (0.5) |
230 (0.5) |
275 (0.6) |
321 (0.7) |
348 (0.8) |
365 (0.8) |
421 (1.0) |
505 (1.2) |
530 (1.2) |
530 (1.2) |
514 (1.1) |
479 (1.1) |
492 (1.1) |
449 (1.0) |
495 (1.1) |
426 (1.0) |
470 (1.1) |
125 |
|
| Metro homicide | 31 (0.0) | 29 (0.0) | 37 (0.0) | 37 (0.0) | 42 (0.0) | 59 (0.0) | 47 (0.0) | 60 (0.0) | 48 (0.0) | 54 (0.0) | 57 (0.0) | 48 (0.0) | 57 (0.0) | 65 (0.0) | 57 (0.0) | 57 (0.0) | 66 (0.0) | 113 | |
| Nonmetro homicide | — | — | — | — | — | 13 (U) | 10 (U) | 15 (U) | 13 (U) | 14 (U) | 13 (U) | 14 (U) | 23 (0.1) | 15 (U) | 29 (0.1) | 24 (0.0) | 27 (0.1) | 200 | |
| Age group (yrs)** | |||||||||||||||||||
| Metro 0–11 | 43 (0.1) | 36 (0.1) | 48 (0.1) | 57 (0.1) | 60 (0.1) | 63 (0.2) | 67 (0.2) | 80 (0.2) | 72 (0.2) | 79 (0.2) | 68 (0.2) | 68 (0.2) | 68 (0.2) | 75 (0.2) | 64 (0.2) | 63 (0.2) | 84 (0.2) | 95 | |
| Nonmetro 0–11 |
14 (U) |
10 (U) |
15 (U) |
13 (U) |
12 (U) |
10 (U) |
14 (U) |
18 (U) |
27 (0.4) |
13 (U) |
18 (U) |
17 (U) |
11 (U) |
10 (U) |
18 (U) |
17 (U) |
22 (0.3) |
57 |
|
| Metro 12–17 | 113 (0.6) | 134 (0.7) | 167 (0.8) | 166 (0.8) | 193 (0.9) | 235 (1.1) | 221 (1.0) | 248 (1.1) | 282 (1.3) | 244 (1.1) | 232 (1.1) | 238 (1.1) | 232 (1.1) | 161 (0.8) | 165 (0.8) | 175 (0.8) | 192 (0.9) | 70 | |
| Nonmetro 12–17 |
15 (U) |
27 (0.7) |
39 (1.0) |
41 (1.0) |
43 (1.1) |
52 (1.3) |
50 (1.2) |
63 (1.6) |
57 (1.5) |
63 (1.6) |
46 (1.2) |
53 (1.4) |
34 (0.9) |
49 (1.4) |
41 (1.1) |
30 (0.8) |
40 (1.1) |
167 |
|
| Metro 18–25 | 1,210 (4.7) | 1,370 (5.2) | 1,526 (5.7) | 1,910 (7.0) | 2,258 (8.1) | 2,482 (8.7) | 2,646 (9.2) | 3,194 (11.0) | 3,284 (11.2) | 3,297 (11.1) | 3,168 (10.6) | 3,424 (11.4) | 3,708 (12.2) | 3,521 (11.5) | 3,753 (12.1) | 3,977 (12.8) | 4,533 (14.6) | 275 | |
| Nonmetro 18–25 |
114 (2.5) |
156 (3.4) |
232 (4.9) |
306 (6.4) |
395 (8.1) |
473 (9.6) |
519 (10.5) |
636 (13.0) |
636 (13.1) |
544 (11.2) |
552 (11.4) |
557 (11.6) |
564 (11.6) |
508 (10.4) |
516 (10.5) |
513 (10.4) |
583 (11.9) |
411 |
|
| Metro 26–34 | 2,749 (8.7) | 2,625 (8.4) | 2,787 (9.0) | 3,314 (10.7) | 3,477 (11.3) | 3,556 (11.6) | 4,117 (13.5) | 4,778 (15.6) | 5,025 (16.3) | 5,083 (16.2) | 5,383 (16.9) | 5,777 (18.0) | 6,507 (19.9) | 6,657 (20.0) | 7,045 (20.9) | 7,927 (23.2) | 9,377 (27.1) | 241 | |
| Nonmetro 26–34 |
292 (5.9) |
320 (6.5) |
387 (8.1) |
510 (10.8) |
641 (13.7) |
677 (14.6) |
736 (16.0) |
926 (20.2) |
981 (21.2) |
1,034 (22.1) |
1,037 (21.9) |
1,138 (23.9) |
1,195 (24.8) |
1,159 (24.1) |
1,114 (23.1) |
1,260 (26.2) |
1,428 (29.7) |
389 |
|
| Metro ≥35 | 10,990 (9.4) | 11,231 (9.5) | 12,394 (10.3) | 15,056 (12.3) | 16,265 (13.1) | 17,049 (13.5) | 18,464 (14.4) | 21,009 (16.1) | 21,938 (16.6) | 22,156 (16.6) | 22,409 (16.5) | 22,812 (16.7) | 24,332 (17.5) | 24,848 (17.7) | 26,515 (18.7) | 28,124 (19.5) | 30,868 (21.1) | 181 | |
| Nonmetro ≥35 | 1,293 (5.5) | 1,494 (6.2) | 1,784 (7.4) | 2,135 (8.8) | 2,431 (9.9) | 2,817 (11.4) | 2,974 (11.9) | 3,461 (13.7) | 3,704 (14.5) | 3,934 (15.3) | 4,084 (15.8) | 4,241 (16.3) | 4,683 (18.0) | 4,512 (17.3) | 4,745 (18.2) | 4,963 (19.0) | 5,272 (20.1) | 308 | |
Abbreviations: AI/AN = American Indian/Alaska Native; A/PI = Asian/Pacific Islander; U = unreliable (i.e., death count <20).
* Rates per 100,000 persons are adjusted to the 2000 U.S. standard population by the direct method. The NCHS six classification levels for counties are 1) large central metropolitan: part of a metropolitan statistical area with ≥1 million population and covers a principal city; 2) large fringe metropolitan: part of a metropolitan statistical area with ≥1 million population but does not cover a principal city; 3) medium metropolitan: part of a metropolitan statistical area with ≥250,000 but <1 million population; 4) small metropolitan: part of a metropolitan statistical area with <250,000 population; 5) micropolitan (nonmetropolitan): part of a micropolitan statistical area (has an urban cluster of ≥10,000 but <50,000 population); and 6) noncore (nonmetropolitan): not part of a metropolitan or micropolitan statistical area. For a dichotomous measure, metropolitan combines categories 1–4 and nonmetropolitan combines 5 and 6.
† Race not determined in 3,041 deaths.
§ Hispanic origin can be of any race; other race categories exclude Hispanic origin.
¶ Subnational data representing <10 (0–9) persons are suppressed.
** Age not determined in 133 deaths.