Drugs, Alcohol, and Suicide Represent Growing Share of U.S. Mortality

In this brief, author Shannon Monnat identifies trends in mortality rates from drugs, alcohol, and suicide by race and sex for adults aged 25 to 54, from the years 2000 to 2014. She reports that—nationwide--the mortality rate from deaths involving drugs, alcohol, and suicide rose 52 percent from 2000 to 2014. Drug, alcohol, and suicide mortality rates are highest among middle-aged non-Hispanic white males and are growing fastest among non-Hispanic white females. Nearly half of all young white male deaths are caused by drugs, alcohol, or suicide. A little over a quarter of young Hispanic male deaths and 13 percent of young black male deaths are due to these causes. Drugs, alcohol, and suicide are the leading cause of death for young white adults. Monnat concludes that although there are political and economic constraints to implementing comprehensive policies that address the underlying causes of high rates of drug, alcohol, and suicide mortality, such policies are likely to provide the best chance for reducing these deaths

Drug Overdose Rates Are Highest in Places With the Most Economic and Family Distress

In this brief, author Shannon Monnat examines county-level mortality data from the U.S. Centers for Disease Control and Prevention, pooled for 2006–2015, to gain insight into the U.S. drug overdose problem. She reports that, unlike the news media’s regular portrayal of the drug overdose epidemic being a national crisis, some places have much higher drug mortality rates than others. On average, rates are higher in counties with higher levels of economic distress and family dissolution, and they are lower in counties with a larger per capita presence of religious establishments. These findings hold even when controlling for demographic differences, urban or rural status, and health care supply. She urges policy makers to consider the substantial geographic variation in drug-related mortality rates to ensure targeting the hardest-hit areas. Social and economic environments are important targets for prevention because they affect stress, optimism and hope, health care investment, residents’ knowledge about and access to services, self-efficacy, social support, and opportunities for social interaction. Religious and other civic organizations may play an important role in marshaling social capital to fight the drug epidemic

Disease Prevalence and Behavioral Risk in Nevada

Throughout the last several years, people living in the United States have engaged in intense debates about health care reform, costs, and mandates. What is often missing from these debates is arguably the key issue in American health: What is making us sick in the first place

The Opioid Crisis in Rural and Small Town America

In this brief, authors Shannon Monnat and Khary Rigg examine rural versus urban differences in opioid mortality and identify challenges for dealing with the opioid crisis in rural areas. They report that, in 2016, opioid mortality rates were higher in urban than in rural counties, particularly in the Midwest, but rates have increased more in rural than in urban counties over the past two decades. Since 2010, the share of drug overdose deaths involving prescription opioids has declined, but the share of deaths involving heroin and synthetic opioids has spiked in both rural and urban areas. The most dramatic increases in opioid deaths were in the rural Midwest, where they were 16 times higher in 2016 than in 1999, and in the rural Northeast, where they were 11.4 times higher. Prescription opioids are involved in a larger share of rural than urban drug overdose deaths, whereas heroin and synthetic opioids (such as fentanyl) account for a larger share of urban deaths. Over half of drug overdose deaths involve multiple drugs. Policy initiatives to date have been largely ineffective at addressing the opioid crisis in many of the hardest-hit rural communities, and the recent surge in fentanyl overdoes in large urban areas may be a precursor of what to expect in at-risk rural communities in the coming years. Existing interventions are unlikely to be effective without addressing the underlying social and economic factors that are plaguing the hardest-hit areas

There are Multiple and Geographically Distinct Opioid Crises in the U.S.

Rates of fatal drug overdose increased 250% in the U.S. between 1999 and 2017, due in large part to a massive surge in overdoses involving opioids. However, there is substantial geographic variation in fatal opioid overdoses, and prescription opioids, heroin, and fentanyl are differentially responsible for high overdose rates across different parts of the U.S. This research brief summarizes the findings from a study just published in the American Journal of Public Health. The study shows that there are at least four geographically distinct opioid overdose crises in the U.S

The U.S. Rural Mortality Penalty is Wide and Growing

In the U.S., rural mortality rates are much higher than those in urban areas, and the gap has widened in recent years. Several causes of death are to blame

Why Coronavirus Could Hit Rural Areas Harder

As rates of coronavirus (COVID-19) infection and death continue to rise, it is important to consider how rural areas may be differentially affected. Rural economies may also be affected in different ways than their urban counterparts, which has implications for long-term rural population health outcomes

Identifying and Describing the Network of Health, Education, and Social Service Non-Profit Organizations in Southern Nevada

Many of the economic, social, and demographic issues facing southern Nevada are dynamic and interrelated, requiring a coordinated approach on the part of southern Nevada’s non‐profit community. The coordination of services, skills, and talents enables community needs to be addressed in ways that exceed the scope and capacity of any single organization. With the increasing desire of funding organizations to support collaborative efforts, maintaining sustainable connections between southern Nevada’s non‐profit organizations is needed now more than ever before. This is the first comprehensive study of southern Nevada’s health, education, and social service non‐profit network. Via a web‐based survey of nearly 300 executive directors and other leaders of health, education, and social service related non‐profit organizations, we were able to conduct a social network analysis to identify the structure of the non‐profit network as well as the positions of individual organizations within that network. We found that southern Nevada’s non‐profit network is not very dense, but that this is partly because of the vast size of the network (460 organizations were identified). The largest organizations are well connected, but there are opportunities for developing more connections across organizations of all sizes and sectors. Our findings show that the average organization is connected with 10 other non‐profit organizations in southern Nevada, but there are also a number of isolates (i.e., completely disconnected organizations). In terms of overall participation and activity, influence, access to information and resources, and ability to mobilize the non‐profit community, University of Nevada, Las Vegas (UNLV), United Way of Southern Nevada (UWSN), HELP of Southern Nevada, Catholic Charities, Three Square, the Clark County School District, Goodwill of Southern Nevada, and Opportunity Village consistently ranked highly. However, there were also a number of smaller organizations that we found to be important brokers and connectors, and these organizations can be used as models for helping to build the capacity of lower‐budget and lesser‐resourced organizations in the community. When asked about barriers to collaboration, survey respondents indicated lack of funding and resources, perceptions of territoriality and competition, the need for training, concern about lack of data availability and usage, the desire for more networking opportunities, and critiques of leadership. However, respondents’ comments also reflected hope and promise for the future of the non‐profit community in southern Nevada. Based upon our findings, we have provided some suggestions for building sustainable inter‐organizational collaborations at the end of this report

New York State’s Rural Counties Have Higher COVID-19 Mortality Risk

As New York’s regions move through their various phases of reopening businesses and recreations activities, policymakers and residents should be mindful of the underlying health vulnerabilities and the higher COVID-19 mortality risk in several of NY’s rural counties. Is your county at high risk

Adolescent and Young Adult Mental Health is Better in States that Mandate More School Mental Health Policies

Mental health problems and suicide rates have increased among adolescents and young adults over the past several years. This research brief shows that adolescent and young adult mental health is better in states that mandate more school mental health policies, including school-based mental health centers, professional development in suicide prevention, and social-emotional curricula