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Visualizing The US Drug Epidemic


The drug problem in the United States has reach epidemic proportions in recent years, led by the ease of access and low cost of heroin and other opioids. In 2014 alone, over 47,000 people died from drug-related causes. In 2013, it was the ninth ranked cause of death (http://www.drugwarfacts.org/cms/Causes_of_Death#sthash.CzcT5d1w.dpbs).

CDC Data
Each year, the Centers for Disease Control and Prevention (CDC) compiles—and makes public—data on the number of drug poisoning deaths in the United States, breaking that information down by state and county. These data sets include the crude death rate and a calculated age-adjusted death rate (both measured as the number of deaths per 100,000 people in the U.S population). The CDC’s 2014 National Vital Statistics Report (http://www.cdc.gov/nchs/data/nvsr/nvsr65/nvsr65_04.pdf) explains these measures:

Age-adjusted death rates are constructs that show what the level of mortality would be if no changes occurred in the age composition of the population from year to year….Thus, age-adjusted death rates are better indicators than unadjusted (crude) death rates for examining changes in the risk of death over a period of time when the age distribution of the population is changing. Age-adjusted death rates also are better indicators of relative risk when comparing mortality across geographic areas or between sex or race subgroups of the population that have different age distributions.

The CDC provides three data sets which includes data from 1999 to 2014:
  1. County – Age-adjusted rates for each county.
  2. State – Crude rates, age-adjusted rates, and numerous other metrics for each State.
  3. Country – Crude rates, age-adjusted rates, and numerous other metrics for the United States, broken down by gender, race, and age.

 I obtained copies of all three data sets and did some analysis. The results are staggering.
  • In 1999, only 3 of the 3,139 counties, from which data was collected, had an age-adjusted death rate of more than 20 (Rio Arriba County, NM, McDowell County, WV, and Wyoming County, WV). By 2014, that number had increased to 630.
  • In 1999, no state had an overall age-adjusted rate over 20 (the top was New Mexico, with 15.0, followed by Nevada, with 11.5). By 2014, ten states— Oklahoma, Delaware, Pennsylvania, Utah, Rhode Island, Ohio, Kentucky, New Hampshire, New Mexico, and West Virginia—were able to make that claim. And sixteen other states had a rate over 15.
  • In 1999, the United States’ overall age-adjusted rate was 6.4 (16,849 deaths). By 2014, that rate had increased to 14.7 (47,055 deaths). The rate has increased every year except 2008 and 2009 (no change from the previous year) and 2012 (a 0.1 decrease from 2011).

Visualization
But, I think that this data is all the more striking when visualized. I mapped the county data in Tableau Public. The visualization allows you to scroll through each year from 1999 to 2014 and watch as the number of overdoses increase year over year.



I used the visualization to create the following video which animates the change over the past 15 years.



I also created a similar simulation of the overall state data. Below is the data from 1999, followed by the data from 2014.






 Once again, the change from 1999 to 2014 is striking. A few statistics:
  • The states with the highest age-adjusted rates in 1999 were New Mexico, Nevada, and Maryland, with respective rates of 15.0, 11.5, and 11.4.
  • In 2014, the states with the highest rates were West Virginia, New Mexico, and New Hampshire, with respective rates of 35.5, 27.3, and 26.2.
  • The rate in West Virginia went from 4.1 (ranked 37th) to 35.5 (ranked 1st) in this fifteen-year period.
  • North Dakota, while ranked 51st in both 1999 and 2014, still saw its rate increase from 1.8 to 6.3.

I also did some analysis based on age, race, and gender.



A few observations:
  • While the rate of both men and women have increased significantly, men still have a much higher rate than women (in 2014, 374.0 and 209.4, respectively).
  • Interestingly, the age most impacted by drug-related deaths is 45-54, followed closely by 35-44 and 55-64. We often think of drugs as a problem for our youth, but the 15-24 age group is ranked 3rd lowest in 2014.
  • Non-Hispanic Whites, are affected in much larger numbers than Non-Hispanic Blacks and Hispanics, with a rate that is more than the other two combined.
  • The rate of increase for Non-Hispanic Whites is also much more significant than Non-Hispanic Blacks and Hispanics.

Wrap-Up
I am not entirely sure what is at the root of this problem and I certainly do not know how to fix it. But I’m hopeful that this post, if nothing else, will help to bring greater visibility to the magnitude of this crisis. If you would like get involved, donate, or know someone who is suffering from addiction, there are numerous non-profit organizations and charities you can contact, including To Write on Her Arms with Love (www.twloha.com ), Amy Winehouse Foundation (www.amywinehousefoundation.org), and Shatterproof (www.shatterproof.org) just to name a few.

Also, if you are interested in exploring the CDC data further, you can find the data sets here:

And, if you’d like to interact with the dashboard I created, you can check it out on Tableau Public here

Note: This article was original posted on 9/11/2016, but was updated on 1/8/2017 with updated visualizations.

Ken Flerlage, September 6, 2016
Tableau Public: https://public.tableau.com/profile/ken.flerlage#!/


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