One-fourth of state suffers most

Amish country escapes devastation

Ohio is a big, complicated state. It’s sometimes hard to get a sense of where the drug overdose epidemic has hit hardest.

Robert B. Hood, a talented student getting a PhD in epidemiology at the Ohio State University, kindly mapped overdose death rates by Ohio counties in 2017. The results are informative.

Montgomery County (Dayton) and Fayette County (Washington Court House) — shown in bright red — had our state’s worst overdose death rates. They were the only two Ohio counties that suffered overdose deaths rates greater than a ratio of 80 deaths per 100,000 residents. In fact, both those counties had a death rate above 90 deaths per 100,000 residents and rates that were more than double the Ohio average of 41.8 overdose deaths per 100,000 residents.

The counties in the lighter shade of red suffered greatly, too. Ohio’s pattern of overdose death can be seen more clearly when the counties are ranked — from 1 to 88 — by their overdose deaths rates.

The ten highest overdose death rates are shown in bright red. Counties ranked 11th to 20th in overdose death rates are in crimson red. Counties ranking 21 to 30 are in pale red.

What’s clear is that southern one-fourth of Ohio has been hit hardest, from rural Gallia county in the east to Butler and Preble counties on the western border with Indiana. Trumbull County (populaton: 210,000, county seat: Warren) is the only county in the top ten that is not in the southern/western quarter of Ohio.

Cuyahoga County (Cleveland) recorded the most overdose deaths (598) in 2017 but ranked just 16th in overdose death when population is taken into account. Franklin County (Columbus) ranked 41st and had an overdose death rate significantly below the state average: 34.1 for Franklin County vs. 41.8 for Ohio.

Holmes County, in Amish country, had the lowest overdose death rate — a ratio of 4.6 deaths per 100,000, or barely one-tenth of the state average.

In Ohio, the overdose epidemic is wide. For the first time, in 2017, every county suffered at least one overdose death.

But overdose death doesn’t run deep  in certain parts of the state — in rural northwest Ohio, for example. But, oddly, the rural vs. urban divide, usually a signature difference in trends, is not an overwhelming factor in the overdose epidemic. Rural counties and small towns in Ohio’s southern quarter have been devastated by fentanyl- and carfentanil-laced drugs, first heroin and now mostly cocaine and meth.

In this epidemic, geography (and social class) has been destiny. So far.

Ohio Overdose Death Rates, by county, 2017

Source: Harm Reduction Analysis of Ohio Department of Health mortality date.

(Rates are unadjusted for age or other factors.)