'Deaths of despair' in Pennsylvania, led by opioid fatalities, double in 10 years

Deaths from suicide, alcohol and drug use doubled over a 10-year period in Pennsylvania, driven by historically high levels of opioid overdose deaths, according to a new report by the Commonwealth Fund. In New Jersey, the rate of these deaths is also climbing rapidly, yet the number of deaths per capita still remains below the national average.

Pennsylvania ranked 24th in overall health in the 2018 Scorecard on State Health System Performance, which evaluates states based on an analysis of dozens of health indicators. The state received high marks for access to care, employer contributions to insurance plans and preventive care for children, but suicide, drug and alcohol deaths ranked 45th among all states, dragging down Pennsylvania's overall score.

Drug, alcohol, and suicide deaths, sometimes called "deaths of despair," are on the rise nationally, increasing by 50 percent between 2005 and 2016. But they've risen more rapidly in Pennsylvania — by 96 percent over the same time period — and in New Jersey, with a 68 percent increase.

"Pennsylvania performed middle of the pack overall, but this is an area where Pennsylvania absolutely is one of the worst states," said David Radley, a senior scientist with the Commonwealth Fund. "These drug death rates are really so much higher in Pennsylvania than they are other places."

New Jersey  ranked 25th overall in the study, and scored especially well in its citizens' access to health care.

Drug-related deaths drove the sharp increase in the "deaths of despair" category in Pennsylvania. While suicides and alcohol-related deaths increased by 32 percent and 22 percent respectively, drug-related deaths shot up 201 percent between 2005 and 2016, he said.

Researchers can't break out from the data whether the drug was an opioid, Radley said, "but we have a sense this is the opioid epidemic."

There were 1,217 unintentional drug overdose deaths in Philadelphia last year. Opioids were detected in 88 percent of the cases.

An analysis of Centers for Disease Control and Prevention data by Kaiser Health News found that while opioid deaths were beginning to level off in some states, they have continued to rise in others, including Pennsylvania.

Many factors could be contributing to this troubling trend, including feelings of social isolation and economic disparity, a lack of job opportunities, and prescribing practices for pain killers, said David Blumenthal, president of the Commonwealth Fund, speaking with reporters about the annual state health report.

"That is a question that people are asking and that is really critical to addressing the opioid epidemic in a definitive way," Blumenthal said.

Additionally, the report evaluates states on access and affordability, prevention and treatment, avoidable use and cost, healthy lives and disparity. The categories encompass a total of 43 indicators drawn from national health data.

Pennsylvania's most improved metrics were an increase in insured adults and adults receiving all recommended vaccines. Other highlights include a decline in infant mortality, colorectal cancer deaths, and smoking among adults. New Jersey's highlights included meeting the needs of adults with mental illness, and employee health insurance contributions as a share of median income.