In this brief, author Shannon Monnat examines county-level mortality data from the U.S. Centers for Disease Control and Prevention, pooled for 2006–2015, to gain insight into the U.S. drug overdose problem. She reports that, unlike the news media’s regular portrayal of the drug overdose epidemic being a national crisis, some places have much higher drug mortality rates than others. On average, rates are higher in counties with higher levels of economic distress and family dissolution, and they are lower in counties with a larger per capita presence of religious establishments. These findings hold even when controlling for demographic differences, urban or rural status, and health care supply. She urges policy makers to consider the substantial geographic variation in drug-related mortality rates to ensure targeting the hardest-hit areas. Social and economic environments are important targets for prevention because they affect stress, optimism and hope, health care investment, residents’ knowledge about and access to services, self-efficacy, social support, and opportunities for social interaction. Religious and other civic organizations may play an important role in marshaling social capital to fight the drug epidemic.

Publication Date

Spring 3-27-2018


National Issue Brief No. 134


Durham, N.H. : Carsey School of Public Policy, University of New Hampshire

Document Type



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