New research shows that deaths due to the mix of substance abuse and suicides known as “diseases of despair” declined slightly in 2018. But the mortality rates throughout the Ohio Valley and Appalachian region are still higher than the national average.
A report from the Appalachian Regional Commission found that overall mortality rates from diseases of despair, which include suicide, liver disease, and overdoses, decreased between 2017 and 2018 — the first decline since 2012.
But the research, done by the Walsh Center for Rural Health Analysis and Center for Rural Health Research at East Tennessee State University, shows those mortality rates are still disproportionately higher for Appalachia compared to the rest of the United States.
“What’s interesting about this is how you define the decline,” Michael Meit explained.
Meit is the director of research and programs at the Center for Rural Health Research at ETSU and an author of the report.
He said that the region’s diseases of despair mortality rate only decreased by one percentage point.
“In 2015, diseases of despair as a group was 37% higher in the Appalachian region compared to the rest of the nation and now 2018 data shows it’s 36% higher.”
By using the Centers for Disease Control and Prevention mortality rates, researchers are able to keep track of what’s happening in the region; 2018 is the most recent data on record.
What Meit found most interesting is the profile shift of the types of deaths within the region.
“Where things changed is that the disparity in overdose went down considerably from 65 % higher to 48% higher,” Meit explained. “But that was then balanced out by suicide which went from 20% higher to 30% higher and alcohol liver disease which went from 8% higher to 13% higher.”
He said the decline in diseases of despair mortality could be driven by a shift from opioid use to methamphetamines and the decline of overdose deaths.
“It’s easy to overdose on opioids, particularly when fentanyl came around. That led to the spike in overdose mortality. Methamphetamine does not typically lead to fatal overdose unless it is spiked with fentanyl or something else,” Meit said.
As a whole, there are still major challenges in diseases of despair within the region.
The diseases of despair mortality rate among 25 to 54-year-olds in Appalachia was 43% higher than the rest of the nation and disparities among women were larger in 2018 compared to the rest of the country.
ARC Federal Co-Chairman Tim Thomas said in a press release that the Appalachian region still needs support.
“This report highlights why ARC’s economic development efforts are so critical when it comes to addressing issues like substance abuse,” Thomas said.
Researchers are anticipating the impacts of the coronavirus pandemic may have on disease of despair mortality rates in the future.
The reports notes that “the impact of COVID-19 will likely lead to an increase in mortality from disease of despair, particularly as the Appalachian region and the rest of the United States experience economic challenges as a result of the pandemic, isolation, and limitations on access to in-person treatment and recovery support.”
Meit said anecdotal evidence suggests that there could be an increase in overdose deaths in 2020. That data won’t be available until late 2021 or 2022.