Scott County, Indiana, was hammered in spring 2015 with an outbreak of HIV spread by intravenous drug users sharing needles. It was a wake-up call for the county about its opioid problem, an epidemic playing out in similar places all over the United States.
Since then, Scott County officials have tried to stem the outbreak by opening a needle exchange for drug users, by getting people signed up for Medicaid and into treatment for HIV and for addiction.
But premature deaths remain high in Scott County, according to data in the County Health Rankings released this week. It had the highest rate of premature deaths (defined by the study as death before age 75) of any Indiana county in 2015. A significant number of these, 133 from 2011-2015, were deaths by injury, which includes overdose deaths.
The same pattern holds true around the country. The County Health Rankings, published Wednesday by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, shows premature deaths are up in 2015 and that drug overdose was “by far the single leading cause of premature death” in the United States that year. More than 1.2 million people died premature deaths, an increase of 40,000 from 2014.
The report ranks Indiana’s counties – and counties across each state of the United States – by overall health outcomes. Scott County ranks last, while Hamilton County ranked first, based on measures such as how long people live and how healthy they feel. Hamilton County, a suburban county near Indianapolis, has the highest median household income in the state – $91,844 – compared to $43,104 in Scott County.
Scott County suffers from many public health issues – obesity, physical inactivity and teen birth rates are all higher there than the statewide averages, which are themselves higher than the national averages. It also suffers from a lack of available medical care: There is one primary care doctor for every 2,630 people living there, compared to the statewide average of one for every 1,490 Hoosiers. And the unemployment rate, at 5.4 percent, is more than 2 percentage points higher than the national average.
But the opioid epidemic remains a pressing concern. Officials last year estimated 500 people in Austin, the county’s 2nd largest city, abused drugs. Efforts to help people curb their addiction in the county have been slow to stop the epidemic, like at an inpatient rehab program run by a community mental health center.
The County Health Rankings report suggests that tracking prescription drugs; increasing access to naloxone, which can reverse the effects of a drug overdose; and offering non-violent offenders treatment instead of jail time could lower the rate of drug overdose nationwide.
“The Rankings allow local leaders to clearly see and prioritize the challenges they face – whether it's rising premature death rates or the growing drug overdose epidemic – so they can bring community leaders and residents together to find solutions,” said Dr. Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation, in a release.
This story was produced by Side Effects Public Media, a news collaborative covering public health.