health_mortality_despair_county_year
Deaths of despair drill-down: drug overdose, suicide, and alcohol-induced mortality from CHR 2025 and CDC WONDER. Opioid dispensing rate (IQVIA, most recent year) added as supply-side proxy. deaths_of_despair_per_100k computed as sum of three crude rates.
overview
3,144 counties (with suppression on individual components).
current vintage — CHR 2025; CDC WONDER 2018-2024 pooled; opioid dispensing 2023
history — CHR 2010-present; WONDER 1999-present
source & licensing
fields
| name | type | definition |
|---|---|---|
| alcohol_deaths_pooled | int64 · count | Total count of alcohol-related deaths pooled across multiple years to produce stable estimates for small-population counties. Used as the numerator underlying alcohol mortality rate calculations. |
| alcohol_mortality_ci_lower | float64 · rate per 100k | Lower bound of the 95% confidence interval for the alcohol mortality rate per 100,000 population. Values closer to the point estimate indicate greater statistical precision. |
| alcohol_mortality_ci_upper | float64 · rate per 100k | Upper bound of the 95% confidence interval for the alcohol mortality rate per 100,000 population. A wide interval relative to the point estimate indicates lower statistical precision, often due to small county population. |
| alcohol_mortality_per_100k | float64 · rate per 100k | Age-adjusted mortality rate from alcohol-related causes per 100,000 population. Higher values indicate greater burden of alcohol-attributable deaths in the county. |
| country_id | string | ISO alpha-2 country code (always 'US' for domestic tables). |
| county_idkey | string | 5-character FIPS code identifying the county.Joins dim.counties on county_id. |
| deaths_of_despair_per_100k | float64 · rate per 100k | Combined age-adjusted mortality rate from drug overdose, suicide, and alcohol-related causes per 100,000 population, following the Case-Deaton deaths of despair framework. Higher values indicate greater combined burden of despair-related mortality. |
| drug_overdose_deaths_per_100k | float64 · rate per 100k | Age-adjusted mortality rate from drug overdose deaths per 100,000 population. Higher values indicate greater burden of drug overdose mortality in the county. |
| opioid_dispensing_rate | float64 · rate per 100k | Number of opioid prescriptions dispensed per 100,000 population in the county. Higher values indicate greater volume of opioid prescribing relative to the local population. |
| opioid_rate_band | string | Categorical classification of the opioid dispensing rate into ordinal bands (e.g., low, medium, high) as defined by the source methodology. Provides a standardized label for comparing counties across rate tiers. |
| opioid_year | int64 · years | The calendar year to which the opioid dispensing rate applies. May differ from the primary row year if opioid data is sourced at a different vintage than other mortality measures. |
| state_id | string | 2-character FIPS code identifying the state.Joins dim.states on state_id. |
| suicide_deaths_per_100k | float64 · rate per 100k | Age-adjusted mortality rate from suicide per 100,000 population. Higher values indicate greater burden of suicide mortality in the county. |
| yearkey | int64 | Reference year of the observation. |
joins
how to use this table
Deaths of despair = drug overdose + suicide + alcohol-induced, summed as crude rates. Drug overdose and suicide from CHR (CDC WONDER underlying, ICD-10 X40-X44 + Y10-Y14, X60-X84). Alcohol-induced from CDC WONDER pooled 2018-2024 (ICD-10 alcohol codes). Opioid dispensing rate from CDC IQVIA-derived surveillance.
Single-cause attribution claims (the despair composite is contested in literature); small-county year-on-year change (high noise + suppression); current-year tracking (1-2 year lag).
Deaths-of-despair composite includes alcohol-induced in v1.1+; v1 omitted. CHR rates are crude (not age-adjusted) for overdose and suicide.