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Why drug deaths keep rising even in healthy states

Opioids and heroin play a big role, but so do variations in primary care and mental health services.

Susan Morse, Managing Editor

The drug death rate is at its highest level in 28 years, according to a report by the United Health Foundation.

America's Health Rankings Annual Report said the nation's health is challenged by increases in cardiovascular and premature deaths, as well as the growing problem of drug deaths.

[Also: Study challenges notion that emergency departments foster opioid misuse]

In the past year, the rate of drug deaths has continued an upward trend, increasing by 7 percent to its highest level since the report began 28 years ago.

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More than six out of 10 drug deaths involve an opioid, primarily prescription pain relievers such as morphine, oxycodone and hydrocodone, or heroin. Opioid-related overdose deaths increased 200 percent between 2000 and 2014, and since 1999 opioid pain reliever prescribing quadrupled, the report said.

[Also: Pennsylvania physician indicted in alleged 'pill mill' opioid operation that caused 5 deaths]

The total cost of opioid abuse throughout 2016, in fact, cost the country some $95.3 billion.

The premature death rate, meanwhile, increased for the third year in a row, this time by 3 percent from 2015. Premature death is defined as the years of potential life lost before age 75. Cardiovascular deaths also increased. For the second consecutive year, and the rate among African Americans was significantly higher than that among whites, Hispanic- and Asian-Americans, and Native Americans.

[Also: Trump declares opioid epidemic a public health emergency]

On a positive note, smoking prevalence, the rate of preventable hospitalizations and the percentage of the population without health insurance continue to fall.

But in the past five years, some of the healthiest states by overall rank have experienced large increases in drug death rates, including New Hampshire, which showed a 118 percent increase.  Massachusetts showed a 69 percent increase in drug death rates, followed by Rhode Island at a 56 percent increase.

The United Health Foundation report also raised concerns about a wide variation in the concentration of mental health and primary care providers, which the report said may contribute to differences in overall health.

The state with the highest concentration of mental health providers, Massachusetts, has six times the number than the state with the least amount, Alabama.

Massachusetts has 547 care providers per 100,000 people vs. Alabama, which has 85 care providers per 100,000 people.

There is also a significant variation in primary care physicians, with a nearly two-to-one ratio between the states with the highest and lowest concentrations.

Rhode Island, Massachusetts, New York and Connecticut have more than 200 primary care physicians per 100,000 people, compared to fewer than 100 physicians per 100,000 people in Utah and Idaho.

Massachusetts ranks as the healthiest state in 2017 for the first time, followed by Hawaii, Vermont, Utah and Connecticut.

Mississippi is ranked 50th for the second year in a row, followed by Louisiana, Arkansas, Alabama and West Virginia.

The findings illustrate the need for communities, healthcare professionals and policymakers to work together toward building healthier communities across the nation, according to Rhonda Randall, DO, senior adviser to United Health Foundation, and chief medical officer, UnitedHealthcare Retiree Solutions. 

"This is a call to action for each of us to make changes in our own lifestyles that can help improve our overall health and well-being," Randall added.

America's Health Rankings Annual Report is an assessment of the nation's health on a state-by-state basis. It analyzes 35 measures of behaviors, community and environment, policy, clinical care and outcomes data.

Twitter: @SusanJMorse
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