Ohio’s Unequal Epidemic: Where overdose death rates are highest and lowest?

Aug 16, 2018 | 2 comments

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

Rank County 2017
1 Montgomery 98.1
2 Fayette 90.7
3 Clinton 71.6
4 Clark 71.2
5 Brown 70.8
6 Preble 70.3
7 Butler 68.9
8 Scioto 67.0
9 Trumbull 66.9
10 Gallia 60.0
11 Hamilton 54.9
12 Darke 54.1
13 Lawrence 52.6
14 Adams 50.2
15 Mahoning 48.7
16 Cuyahoga 47.9
17 Columbiana 46.3
18 Huron 46.2
19 Pike 46.2
20 Marion 46.1
21 Madison 46.1
22 Clermont 44.8
23 Summit 44.2
24 Champaign 43.9
25 Lorain 43.4
26 Shelby 43.2
27 Erie 42.6
28 Hancock 42.2
29 Jefferson 42.0
Ohio 41.8
30 Richland 40.5
31 Crawford 40.4
32 Lake 39.8
33 Miami 39.2
34 Sandusky 38.8
35 Greene 38.2
36 Ross 37.7
37 Allen 37.6
38 Warren 35.7
39 Lucas 35.4
40 Seneca 34.3
41 Franklin 34.1
42 Logan 33.2
43 Harrison 32.7
44 Morrow 31.4
45 Jackson 30.8
46 Highland 30.2
47 Pickaway 29.5
48 Hardin 28.6
49 Hocking 28.2
50 Van Wert 28.2
51 Fairfield 28.2
52 Geauga 26.6
53 Ashtabula 26.5
54 Belmont 26.2
55 Guernsey 25.6
56 Knox 24.7
57 Muskingum 24.4
58 Stark 24.4
59 Portage 24.1
60 Licking 23.8
61 Tuscarawas 23.8
62 Medina 23.7
63 Washington 23.1
64 Carroll 21.7
65 Union 18.0
66 Meigs 17.3
67 Ottawa 17.2
68 Wayne 17.2
69 Mercer 17.1
70 Perry 16.7
71 Coshocton 16.4
72 Paulding 15.9
73 Vinton 15.5
74 Delaware 14.3
75 Monroe 14.1
76 Wyandot 13.6
77 Morgan 13.5
78 Auglaize 13.1
79 Wood 13.1
80 Henry 10.9
81 Williams 10.8
82 Athens 9.1
83 Putnam 8.8
84 Defiance 7.9
85 Fulton 7.1
86 Noble 7.0
87 Ashland 5.6
88 Holmes 4.6

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

(Rates are unadjusted for age or other factors.)

2 Comments

  1. Dawn Clark
    Dawn Clark on September 12, 2018 at 2:00 pm

    Very interesting… and very sad ! I live in Gallia Co……..Raised in Summit/Stark

  2. Maryjane
    Maryjane on September 13, 2018 at 4:42 am

    Wow! I live in one of the counties with a low death rate and thought it was bad here…..Bad enough I was willing to move north….maybe better off not to. Sad

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