The Central Valley opioid crisis: Deaths of despair on the rise
December 1, 2017
• New report points to growing toll of stress-related conditions
• “People are running out of hope”
The opioid epidemic has been called the worst drug crisis in American history, and while most of the reporting has focused on West Virginia and Ohio, alarming trends are now emerging in California.
So-called "deaths of despair," fueled by opioid overdoses and other related causes of death linked to stress, are skyrocketing in rural Northern California and the Central San Joaquin Valley among whites,” says the new study just released by the California Endowment, the Center on Society and Health at Virginia Commonwealth University and the Graduate School of Public Health at the University of Pittsburgh.
"Health is hope," says Tony Iton, senior vice president with the California Endowment. "Across this country, and in our state, people are running out of hope. They are struggling to find opportunities in this new economy. They are living in deep poverty and now they are turning to drugs and opioids to dull the pain. This is a national crisis that demands everyone's attention. It's not partisan. It's people."
According to the study, while death rates have generally been decreasing in the United States and other industrialized countries, death rates in California have stopped declining among young and middle-aged whites (ages 25-34 years and 40-64 years, respectively) since 2000. The impact of this trend is startling: Between 1995 and 2014, increases in death rates in these two age groups from specific causes claimed an estimated 21,350 lives.
This trend is consistent with findings from national studies, which also report rising death rates among certain groups of whites, especially those who are middle-aged, have less education, and women.
The decrease in life expectancy has been attributed to the opioid epidemic, but this study found that it reflects increased death rates from multiple causes, including drug and alcohol overdoses, suicides, and accidents. The research found that the increase in death rates among whites was concentrated among 42 counties in California, most located in largely white, rural counties in northern California or in the Central Valley.
"We did not see a rise in white mortality in metropolitan areas of California such as Los Angeles or San Francisco," says Steven Woolf, the lead author of the study. "The rise in substance abuse and suicide seems to be occurring in rural counties that have experienced stagnant wages, persistent poverty, and weak economies for many years."
Overall, the leading causes of rising death rates among whites in California include drug and alcohol overdoses, suicides, and accidents, but the rise in death rates from drug and alcohol abuse and suicides is striking. The report says:
• Death rates from drug overdoses doubled between 1995 and 2014 among young and middle-aged whites in California.
• Death rates from alcohol poisoning (e.g., binge drinking) more than quadrupled among younger whites and increased by 1163 percent -- more than a 12-fold increase — among those ages 40-64 years.
• The rate of suicides among middle-aged whites increased by 37 percent after 2000. Hanging, strangulation, or suffocation were the most common forms of non-firearm suicide, doubling in frequency after 1995.
"We are all in this together, and this cannot be solved without a comprehensive understanding of health and what we need to be healthy," says Mr. Iton. "We have to repair our fractured social compact and restore the promise of our country's potential to everyone. While access to health care alone will not solve the issue, this is certainly not the time to be cutting services. What these data show is that, in addition to health care, we need to double down on efforts to address poverty and high unemployment – creating hope and improving health."