Opioid Poisoning Deaths among Illinois Women of ......Data Snapshot: Opioid Poisoning Deaths among...
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Data Snapshot: Opioid Poisoning Deaths among
Illinois Women of Reproductive Age
Illinois Department of Public Health
Office of Women’s Health and Family Services March 2019
Background
• Opioid poisonings (i.e., “overdoses”) are on the rise nationally and in Illinois
• Neonatal abstinence syndrome, a collection of withdrawal symptomsexperienced by infants exposed to opioids in utero, is also increasing
• Opioid use among a woman of reproductive age therefore carries doubleweight, as it impacts her own health, and also the health of her children andany future pregnancies
• This analysis examines trends and demographic patterns in opioid poisoningdeaths among:
– Illinois women of reproductive age (ages 15-44 years old)
– Illinois women with a pregnancy during the last year (pregnancy-associateddeaths)
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Methods
• Data Source: Illinois death certificates
• Time Period: 2008 – 2017 (all years are “final” data)
• “Drug poisoning death” = underlying cause of death ICD-10 codes X40-X44, X60-X64, X85, or Y10-Y14
• Among drug poisoning deaths, opioid poisonings were identified by multiple-cause mortality codes:– T40.0 = opium– T40.1 = heroin– T40.2 = natural and semi-synthetic (“prescription”)– T40.3 = methadone– T40.4 = synthetic (including fentanyl)– T40.6 = other and unknown type
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Methods
• Among all Illinois women of reproductive age:
Mortality Rate = # 𝒐𝒑𝒊𝒐𝒊𝒅 𝒑𝒐𝒊𝒔𝒐𝒏𝒊𝒏𝒈 𝒅𝒆𝒂𝒕𝒉𝒔
# 𝒘𝒐𝒎𝒆𝒏 𝒂𝒈𝒆𝒔 𝟏𝟓−𝟒𝟒 𝒊𝒏 𝒑𝒐𝒑𝒖𝒍𝒂𝒕𝒊𝒐𝒏∗ 𝟏𝟎𝟎, 𝟎𝟎𝟎
– Population estimates derived from U.S. Census Bureau intercensal estimates (2008-2009) and postcensal estimates (2010-2017)
• Among women with a pregnancy during the last year:
Pregnancy-Associated Mortality Ratio = # 𝒐𝒑𝒊𝒐𝒊𝒅 𝒑𝒐𝒊𝒔𝒐𝒏𝒊𝒏𝒈 𝒅𝒆𝒂𝒕𝒉𝒔
# 𝒍𝒊𝒗𝒆 𝒃𝒊𝒓𝒕𝒉𝒔∗ 𝟏𝟎𝟎, 𝟎𝟎𝟎
– Live birth counts derived from Illinois birth certificates
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DEATHS TO WOMEN OF REPRODUCTIVE AGE(WOMEN AGES 15-44)
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Opioid-Related Poisoning Death Rate among Illinois Women of Reproductive Age (WRA)
• The rate of opioid-related poisoning deaths for WRA tripled from 2008 to 2017
• 347 WRA died from opioid poisoning during 2017
• Nearly 2,000 total WRA have died from opioid poisoning since 2008
6 Data Source: Illinois death certificates, 2008-2017
4.6 4.85.6 5.7
6.4 6.47.9
8.9
11.1
13.7
0
4
8
12
16
2007 2009 2011 2013 2015 2017
Rat
e p
er
10
0,0
00
WR
A
Year
Types of Opioids Involved in Opioid-Related Poisoning Deaths among Illinois Women of Reproductive Age (WRA), 2017
• Heroin was involved in nearly half of opioid poisoning deaths among Illinois WRA in 2017
• Synthetic opioids (e.g., fentanyl) were involved in 55% of opioid poisoning deaths for WRA in 2017
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Bars do not add up to 100% because more than one opioid may have been listed on the death certificate
Data Source: Illinois death certificates, 2017
48.7%
25.6%
7.5%
54.8%
5.5%
0%
20%
40%
60%
80%
100%
% o
f O
pio
id P
ois
on
ing
De
ath
s
Opioid Type
Opioid-Related Poisoning Death Rate among Illinois Women of Reproductive Age (WRA), By Opioid Type
• The rate of heroin-relateddeaths for WRA increased 11-fold in nine years
• The rate of synthetic-opioid-related deaths for WRA increased 9-fold in four years
8 Data Source: Illinois death certificates, 2008-2017
0
2
4
6
8
2007 2009 2011 2013 2015 2017
Rat
e p
er
10
0,0
00
WR
A
Year
Heroin Prescription Methadone Synthetic
Opioid-Related Poisoning Death Rate among Illinois Women of Reproductive Age (WRA), By Race/Ethnicity
• The opioid poisoning death rate is highest among non-Hispanic White WRA
• But White, Black, and Hispanic WRA all have experienced increases in opioid-related deaths over the last decade
9 Data Source: Illinois death certificates, 2008-2017
0
4
8
12
16
20
2007 2009 2011 2013 2015 2017
Rat
e p
er
10
0,0
00
WR
A
Year
White, Non-Hispanic Black, Non-Hispanic Hispanic
Opioid-Related Poisoning Death Rate among Illinois Women of Reproductive Age (WRA), By Age Group
• The rate of opioid-related deaths is highest among women 30 and older
• All groups have seen an increase in opioid-related deaths, but the relative increase was smallest among women ages 15-24
10 Data Source: Illinois death certificates, 2008-2017
0
4
8
12
16
20
2007 2009 2011 2013 2015 2017
Rat
e p
er
10
0,0
00
WR
A
Year
15-24 25-29 30-34 35-39 40-44
Opioid-Related Poisoning Death Rate among Illinois Women of Reproductive Age, By County of Residence
• The rate of opioid-related deaths is highest among WRA living in urban counties outside the Chicago area
• All areas have experienced an increase in opioid-related deaths for WRA over the last decade
11 Data Source: Illinois death certificates, 2008-2017
0
4
8
12
16
20
24
2007 2009 2011 2013 2015 2017
Rat
e p
er
10
0,0
00
WR
A
Year
Cook County Collar Counties
Other Urban Counties Rural Counties
PREGNANCY-ASSOCIATED DEATHS(DEATHS WITHIN ONE YEAR OF PREGNANCY)
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Average Annual Number of Pregnancy-Associated Deaths Due to Opioid Poisoning, Illinois Residents, 2009-2017
• The number of pregnant/ postpartum women dying from an opioid-related poisoning increased over time
• In 2017 alone, there were 18 pregnancy-associated deaths related to opioid poisoning
13 Data Source: Illinois death certificates, 2009-2017
4 8 130
2
4
6
8
10
12
14
2009-2011 2012-2014 2015-2017
Ave
rage
An
nu
al #
of
De
ath
s
3-Year Period
Pregnancy-Associated Mortality Ratio for Opioid-Related Poisoning Deaths, Illinois Residents, 2008-2017
• Pregnancy-associated deaths related to opioid poisoning increased 10-fold over a 9-year period
• The pregnancy-associated mortality ratio related to opioid poisonings nearly doubled in just one year from 2016 to 2017
14 Data Source: Illinois death certificates, 2008-2017
1.1
2.91.8
2.5
5.0
3.8
5.76.3
6.5
12.0
0
2
4
6
8
10
12
14
2007 2009 2011 2013 2015 2017
Rat
io p
er
10
0,0
00
live
bir
ths
Year
Proportion of Pregnancy-Associated Deaths that were due to Opioid Poisoning, Illinois Residents, 2008-2017
• Opioid-related poisonings have also become a leading cause of pregnancy-associated death
• In 2017, opioid poisoning was the most common causeof pregnancy-associated death
• In 2017, nearly 1 in 5 deaths of pregnant or postpartum women were due to opioid poisoning
15 Data Source: Illinois death certificates, 2008-2017
2.5%
18.8%
0%
4%
8%
12%
16%
20%
2007 2009 2011 2013 2015 2017
% o
f P
reg-
Ass
oci
ate
d D
eat
hs
Year
Pregnancy-Associated Mortality Ratio for Opioid Poisoning Deaths, Illinois 2013-2017 combined
• Pregnancy-associated deaths caused by opioid poisonings were most common among white women, women with a high school education or less, and women residing in small/medium urban counties outside the Chicago area
16 Data Source: Illinois death certificates, 2013-2017
6.8 9.92.3
4.81.7
7.9 6.5 6.4 14.5 3.0 3.5 7.2 12.8 6.80
4
8
12
16Ill
ino
is
Wh
ite
Bla
ck
His
pan
ic
Oth
er R
ace
<25
yea
rs
25
-34
yea
rs
35
+ ye
ars
<=1
2 y
ears
>12
yea
rs
Co
ok
Co
llar
Oth
er U
rban
Ru
ral
# D
eat
hs
pe
r 1
00
,00
0 li
ve b
irth
s
Race/Ethnicity Age Group Education County of Residence
For more information, contact:Amanda Bennett
This analysis was supported by the
Illinois Maternal and Child Health (Title V) Block Grant Program17