NCHS - Drug Poisoning Mortality by County: United States

This dataset describes drug poisoning deaths at the county level by selected demographic characteristics and includes age-adjusted death rates for drug poisoning from 1999 to 2015. Deaths are classified using the International Classification of Diseases, Tenth Revision (ICD–10). Drug-poisoning deaths are defined as having ICD–10 underlying cause-of-death codes X40–X44 (unintentional), X60–X64 (suicide), X85 (homicide), or Y10–Y14 (undetermined intent). Estimates are based on the National Vital Statistics System multiple cause-of-death mortality files (1). Age-adjusted death rates (deaths per 100,000 U.S. standard population for 2000) are calculated using the direct method. Populations used for computing death rates for 2011–2015 are postcensal estimates based on the 2010 U.S. census. Rates for census years are based on populations enumerated in the corresponding censuses. Rates for noncensus years before 2010 are revised using updated intercensal population estimates and may differ from rates previously published. Estimate does not meet standards of reliability or precision. Death rates are flagged as “Unreliable” in the chart when the rate is calculated with a numerator of 20 or less. Death rates for some states and years may be low due to a high number of unresolved pending cases or misclassification of ICD–10 codes for unintentional poisoning as R99, “Other ill-defined and unspecified causes of mortality” (2). For example, this issue is known to affect New Jersey in 2009 and West Virginia in 2005 and 2009 but also may affect other years and other states. Estimates should be interpreted with caution. Smoothed county age-adjusted death rates (deaths per 100,000 population) were obtained according to methods described elsewhere (3–5). Briefly, two-stage hierarchical models were used to generate empirical Bayes estimates of county age-adjusted death rates due to drug poisoning for each year during 1999–2015. These annual county-level estimates “borrow strength” across counties to generate stable estimates of death rates where data are sparse due to small population size (3,5). Estimates are unavailable for Broomfield County, Colo., and Denali County, Alaska, before 2003 (6,7). Additionally, Bedford City, Virginia was added to Bedford County in 2015 and no longer appears in the mortality file in 2015. County boundaries are consistent with the vintage 2005-2007 bridged-race population file geographies (6).

本数据集以县级行政单元为统计维度，收录了基于选定人口统计学特征的药物中毒死亡相关数据，涵盖1999年至2015年的药物中毒年龄调整死亡率。所有死亡案例均采用《国际疾病分类第十次修订版》（International Classification of Diseases, Tenth Revision, ICD-10）进行分类判定。药物中毒死亡被定义为对应以下ICD-10根本死因编码的案例：X40–X44（意外中毒）、X60–X64（自杀）、X85（他杀）以及Y10–Y14（意图未明确）。本数据集的估算值基于美国国家生命统计系统（National Vital Statistics System）的多死因死亡档案（参考文献1）。年龄调整死亡率（以2000年美国标准人口为基准，单位为每10万人死亡数）采用直接法计算得到。其中，2011-2015年死亡率计算所用的人口数据为基于2010年美国人口普查的后普查估算值；普查年份的死亡率依托对应普查中统计的人口数计算；2010年之前非普查年份的死亡率已通过更新的普查间人口估算值完成修订，可能与此前发布的同口径死亡率存在差异。当死亡率的分子（死亡例数）≤20时，图表中会将该死亡率标记为“不可靠”，此类估算未达到可靠性或精度标准。部分州份和年份的死亡率可能偏低，原因包括未决案件占比过高，或是将意外中毒的ICD-10编码错误归类为R99（“其他不明原因及未明确的死亡原因”，参考文献2）。已知新泽西州2009年、西弗吉尼亚州2005年及2009年存在此类数据异常问题，该问题也可能波及其他年份与州份，因此对本数据集估算结果的解读需格外谨慎。本数据集同时提供了经过平滑处理的县级年龄调整死亡率（单位为每10万人死亡数），其计算方法详见已有研究文献（参考文献3-5）。简言之，研究采用两阶段分层模型，针对1999-2015年各年份的县级药物中毒死亡年龄调整死亡率生成经验贝叶斯（Empirical Bayes）估算值。此类年度县级估算值通过跨县域借用信息的方式，为因人口规模较小导致数据稀疏的县域生成稳定的死亡率估计结果（参考文献3、5）。2003年之前，科罗拉多州布鲁姆菲尔德县（Broomfield County, Colo.）与阿拉斯加州德纳利县（Denali County, Alaska）无可用估算值（参考文献6、7）。此外，弗吉尼亚州贝德福德市于2015年并入贝德福德县，2015年的死亡档案中不再单独收录贝德福德市的相关数据。本数据集的县域边界与2005-2007年桥接种族人口档案（bridged-race population file）的地理划分标准保持一致（参考文献6）。