274375 Poisoning mortality in Appalachia compared to the US, 1999 - 2009

Sunday, October 28, 2012

Kelly K. Gurka, MPH, PhD , Department of Epidemiology/Injury Control Research Center, West Virginia University, Morgantown, WV
Margaret Warner, PhD , Division of Vital Statistics, Mortality Statistics Branch, National Center for Health Statistics (CDC), Hyattsville, MD
Miheret Yitayew, MD , School of Public Health / Injury Control Research Center, West Virginia University, Morgantown, WV
Hope Tiesman, PhD , Division of Safety Research, CDC/NIOSH, Morgantown, WV
Jeffrey H. Coben, MD , Injury Control Research Center, West Virginia University, Morgantown, WV
Background. Mortality from poisoning has been increasing in the US. Indeed, poisoning is the leading cause of injury-related death in the US. Appalachia is characterized by myriad health disparities. This study quantifies poisoning mortality in Appalachia compared to the non-Appalachian US. Methods. Data from the US National Vital Statistics System multiple cause mortality files and bridged-race estimates of the resident population were used to estimate age-adjusted death rates (AADR) for poisoning in Appalachia and the non-Appalachian US, 1999 - 2009. Poisoning deaths were defined by ICD-10 UCD codes X40X49 (X40X44 due to drugs), X60-X69 (X60-X64 due to drugs), X85X90 (X85 due to drugs), Y10Y19 (Y10Y14 due to drugs), and Y35.2. Results. In 1999, the AADR for poisoning overall (5.9 per 100,000) and drug poisoning (4.9 per 100,000) for Appalachia was significantly lower than for the non-Appalachian US (7.2 and 6.1 per 100,000, respectively). In 2001, this relationship reversed, and the AADRs have been significantly higher in Appalachia through 2009, with the difference in the rates generally increasing over time. By 2009, rates were a third higher in Appalachia (17.1 and 15.6 per 100,000) than in the non-Appalachian US (13.1 and 11.7 per 100,000). Unintentional drug overdoses are responsible for the vast majority of poisoning deaths and largely drive the increase in poisoning deaths overall. Conclusions. Appalachia experiences a disproportionately high number of deaths due to poisoning. New and existing programs need to be developed and translated into culturally-appropriate programs for evaluation and dissemination in Appalachia.

Learning Areas:

Learning Objectives:
1. Describe mortality due to poisoning overall and drug poisoning, specifically, in the Appalachian region of the US. 2. Compare mortality due to poisoning overall and drug poisoning, specifically, in Appalachia to that of the rest of the US.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been well-trained in epidemiologic methods and have experience conducting analyses of descriptive, observational studies. I am particularly interested in the epidemic of drug-related poisoning deaths in my state (WV) and region (Appalachia).
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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