Animation lays bare how American deaths from drugs, alcohol and mental disorders have TRIPLED since 1980

  • More than 2,000 US counties saw 200% rise in substance-use deaths
  • Some counties in Kentucky, West Virginia and Ohio saw 1000% spike since 1980

Deaths from alcohol, drugs and mental disorders have almost tripled in the United States since 1980, a new federal study reveals. 

More than 2,000 US counties witnessed increases of 200 percent or more in deaths related to substance abuse and mental disorders since 1980.

The worst affected were counties in Kentucky, West Virginia, and Ohio, which saw alarming surges of more than 1,000 percent.

The findings by the University of Washington in Seattle represent the most comprehensive study to date of why and how Americans die. 

The research team examined 21 causes of death - from chronic illnesses such as diabetes to infectious diseases including HIV/AIDS, accidents, and drug use.

Cardiovascular disease was the leading cause of death overall in the United States in 2014, though cancers were responsible for the most early deaths. 

And drug use has rocketed - particularly in the last decade. 

There were marked disparities across the nation. 

About half of US counties saw increases in suicide and violence, while the other half of counties experienced decreases. Drug overdoses are far more prevalent in rural areas, the data showed. 

The researchers said this points to a need for more tailored healthcare and support programs that take into account each area's leading causes of death. 

'While the leading causes of death are similar across counties, we found massive disparities in the rates at which people are dying among causes and communities,' explained lead author Laura Dwyer-Lindgren. 

'For causes of death with effective treatments, inequalities in mortality rates spotlight areas where access to essential health services and quality of care needs to be improved.' 

While nearly all deaths in the United States are reported in death certificates, the causes of death recorded may be vague or even implausible. 

For example, a physician may report that someone died of heart disease, when the underlying cause was, in fact, hypertensive heart disease. 

This is important because hypertensive heart disease specifically refers to a build up of blood pressure, and health care providers could target their work in that area. 

To correct for this, the study authors reassigned deaths with nonspecific causes to their likely underlying causes, improving the accuracy of the estimates.


The highest increase in mortality rates was seen in Kusilvak Census Area in Alaska, with a 131 percent mortality rate increase.

The biggest drop in deaths was seen in New York County, New York, were mortality rates dropped by 72 percent.


The rate at which Americans die from cancer and other diseases or injuries differs significantly among communities, highlighting stark health disparities across the nation.

The counties with the highest and the lowest mortality rates from cirrhosis and other liver diseases were both in South Dakota, with 193 deaths per 100,000 people in Oglala Lakota County, to seven deaths per 100,000 people in Lincoln County. 


The greatest increases in substance-related deaths were in Clermont County, Ohio (2,206 percent), and Boone County, West Virginia (2,030 percent).

The largest drops in this category were seen in Aleutians East Borough, Aleutians West Census Area, Alaska, and Miami-Dade County, Florida, declining by 51 percent and 45 percent, respectively.

'The mortality trends in mental and substance use disorders, as well as with other causes of death covered in the study, point to the need for a well-considered response from local and state governments, as well as care providers, to help reduce the disparities we are seeing across the country,' said Dr Christopher Murray, Director of IHME.


  • Chronic respiratory diseases, a group that includes COPD and asthma, saw the most dramatic increases in a band of counties spanning northern Texas to the Carolinas. Concurrently, a small number of counties along the Mexico border, in northwestern New Mexico, and in central Colorado, experienced decreases.
  • The national mortality rate from traffic accidents decreased by 45 percent between 1980 and 2014. Generally, lower death rates were found in urban areas, and higher rates were seen in rural counties.
  • While select counties in Montana, Florida, and North and South Dakota have the highest mortality rates from cirrhosis and liver disease, sharp increases were seen in southwestern Oregon and northwestern Texas since 1980.
  • Deaths from neurological disorders, such as Alzheimer's disease and other forms of dementia, increased in the majority of counties over the 35-year span of the study, with especially large increases in counties stretching from eastern Texas and Oklahoma to Alabama.

'We know that unequal medical access and quality of care create health disparities in the US for many causes of death, while other causes are linked to risk factors or policies,' said Dr. Ali Mokdad, Professor of Global Health at IHME and study co-author. 

'Indeed, this study will inform the debate on how to improve the health of our nation.'  


  1. Owsley County, Kentucky (+46%)
  2. Lee County, Kentucky (+40%) 
  3. Estill County, Kentucky (+38%) 
  4. Breathitt County, Kentucky (+38%) 
  5. Madison County, Mississippi (+36%) 
  6. Anderson County, Texas (+35%) 
  7. Union County, Florida (+33%) 
  8. Marlboro County, S Carolina (+32%) 
  9. Powell County, Kentucky (+30%) 
  10. Johnson County, Kentucky (+29%) 


  1. Aleutians West Census, Alaska (-58%)
  2. Alexandria City, Virginia (-46%) 
  3. Loudoun County, Virginia (-46%) 
  4. Summit County, Colorado (-46%) 
  5. Howard County, Maryland (-46%) 
  6. Eagle County, Colorado (-45%) 
  7. Pitkin County, Colorado (-44%) 
  8. Presidio County, Texas (-44%) 
  9. Rockland County, New York (-43%) 
  10. Falls Church City, Virginia (-43%) 


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