When Congress passed an omnibus budget bill in March, it provided $100 million to fight the opioid epidemic in rural counties. The bill includes a list of 220 counties slated to be the focus of the funding. Many counties with high rates of drug deaths weren’t on the list, like Rio Arriba County here in New Mexico. That’s because the CDC study the list came from emphasized places with high populations of white people as one of six criteria that researchers looked at. Rio Arriba County is 71 percent Hispanic and 20 percent Native American.
We did extensive analysis of rural county drug death data and demographics to understand which counties were included on the list, which were left off, and why.
Since we began reporting on this story, the Health Resources and Services Administration (HRSA) changed its announcement about the funding and deleted mention of the list. HRSA’s spokesperson said in an email this week that the list of 220 counties will not be used for funding decisions after all.
We pulled drug death data from the CDC from 2014-2016, via countyhealthrankings.org, to evaluate how race impacted the list of 220 counties. While this data misses some counties where the population or number of deaths is too small, there are over 700 rural counties with high drug death rates and 152 of those were on the list of counties that were to be the focus of the rural opioid funding. But many other counties with high drug death rates were not targeted for funding.
When you look at the chart below, you can see that the counties on the list (purple) have a wide range of drug death rates including 18 counties with drug death rates that are below the national average.
What unites the 220 counties on the list is that, on average, only 7 percent of the people in those counties are people of color, while 33 percent of the people in rural counties overall are people of color.
You can also see that many counties in New Mexico, Colorado and Oklahoma with high rates of drug deaths and high populations of color are not included in the list (orange). If the list of counties targeted for funding were race-neutral we would expect to see purple dots spread evenly across the chart.
We used drug death data and drug death estimates* to make the map of rural counties below.
The orange counties were not targeted for funding but they do have high drug death rates, 30 deaths per 100,000 people or higher, according to CDC data and modeling estimates.
Dark purple counties have high drug death rates as well, and were targeted for rural opioid funding. Light purple counties were targeted for funding but have lower drug death rates.
*Because many counties have small populations, and mortality data from drug deaths isn’t available, the CDC created a model that estimates drug death rates for every county in the U.S. We used that model estimate when there weren’t actual drug death data for a given county on the map.