The CDC based its data on the National Vital Statistics System’s multiple-cause-of-death mortality files, accessible through the public health database CDC WONDER. The data indicate the drug overdose death rate rose from 6.4 per 100,000 in 1999 to 22 in 2017 for urban counties. The rates increased from 4 to 20 per 100,000 in rural counties during the same period.
The data also revealed that males have higher overdose death rates in urban than in rural counties (a rate of 29.9 per 100,000 vs. 24.3, respectively). In contrast, females died at higher rates in rural than in urban counties (15.5 and 14.2).
Rural and urban counties also differed in terms of the type of drugs causing the overdoses. Rates were higher in urban than in rural counties for deaths involving heroin, synthetic opioids other than methadone, and cocaine. Rural areas had higher death rates for overdoses of natural and semisynthetic opioids and psychostimulants with abuse potential.
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