Humboldt’s ‘Deaths of Despair’ Are Three Times California’s
On the 31st of May, Southern Humboldt Unified School District’s Family Resource Center (FRC) hosted a Mental Health Town Hall at their place behind the Redway Elementary School.
The keynote speaker, Ron Largusa of the Humboldt County Health Department, gave an overview of what he calls the “Deaths of Despair” that occur in Humboldt County. Largusa is an epidemiologist for the Health Department and as such, Largusa said he looks at every Death Certificate recorded in the County of Humboldt. The ‘Deaths of Despair’ Largusa described include drug and alcohol-related deaths as well as suicides. Largusa’s statistics sketch a very troubling picture in Humboldt County relative to the rest of California and the nation. He says Humboldt County’s Deaths of Despair rates “have been triple that of the State of California for well over a decade.”
The County’s suicide rate ranks among the top ten in the state and has for most of a decade. Suicide numbers dropped significantly in 2017 but only for middle-aged adults, and Largusa said Humboldt County’s suicide rate has already rebounded in 2018. Largusa finds that 90% of all suicides in Humboldt County are accomplished through gunshot, hanging, and overdose. And because men tend to choose firearms most frequently, men tend to account for about 75% of suicide deaths per year, according to Largusa.
Largusa said that it isn’t possible to predict who will commit suicide in a community, but that the science shows that “access to lethal means and that mostly means firearms, during a short-term mental crisis” is a significant factor in suicide deaths.
In drug overdose deaths, Humboldt County’s rates are in the deepest red division nationwide. The death rate for overdose in the United States as a whole is 16.3, in California it is 11.8 and in Humboldt County, it is 24.7.
According to California Public Health Department data, Humboldt County had the second highest rate of overdose deaths in California’s 58 counties for the period 2014 to 2016.
Largusa’s statistics looked at drug-related deaths from a number of perspectives. One slide showed that between 2012 and 2016, 180 people in Humboldt County died from a drug or alcohol overdose. Of those deaths, 54% involved opiates in some form while 27% involved methamphetamine. (41% of the 180 deaths involved multiple drugs, so there’s some overlap in those numbers)
Furthermore, in Humboldt County, Methamphetamine deaths have been skyrocketing. In 2012, 22 people died from deaths involving methamphetamine, climbing steadily to 39 in 2016; although 2014 did see a drop to 18. Nonetheless, Humboldt County experienced a 77% increase in methamphetamine-related deaths over the four years.
SMALL TOWNS MAKE IMPACTS BIGGER
Statistics are represented in deaths per hundred thousand residents which can be problematic in terms of comparison to other places because Humboldt County’s population is only about 135,000 residents. This means every three deaths moves the statistic two points. For example, 2,200 people died from an overdose in Los Angeles County in 2016, but with a population of over ten million, the rate was around 7 per hundred thousand. Whereas in Humboldt county, 132 people died from an overdose in 2016, the overdose rate was 33 per hundred thousand.
While comparing regions of high to low population by deaths per hundred thousand is challenging, comparing deaths by cause illustrates the extreme morbidity of Humboldt County’s overdose rate more clearly. Between 2012 and 2016, according to Largusa, a total of 372 people died in Humboldt County. Nearly half (47%) of them died of an overdose while 17% died of heart disease. By comparison, data available online for Los Angeles County in 2012 shows the leading cause of death was heart disease at a rate of 115 per hundred thousand and drug overdose was not even among the top ten causes of death.
Largusa points out there are big differences by zip code around the county in the death rates. Eureka’s 95501 zip code, Hoopa and Myers Flat all have a drug-related death rate of over 65 per hundred thousand, where Arcata, McKinleyville, and Fortuna are below 40 per hundred thousand.
The group of 16 people gathered at the Mental Health Town Hall meeting spent some time pondering why the “Deaths of Despair” in Humboldt County might be so high. Largusa asked rhetorically, “Is this merely a high tax for the opportunity to live here?”
Largusa spoke about the impacts of “cumulative disadvantages.” For example, in addition to lower income and fewer educational opportunities in the rural county, pregnant women in Humboldt County are four times more likely than the state average to have a substance abuse issue. And 50% more women in Humboldt County experience domestic violence.
Furthermore, one in three adults in Humboldt County had four or more “adverse childhood experiences” which correlates statistically to adults with higher rates of injury, suicide drug addiction, but also to higher rates of chronic disease such as diabetes and heart disease. Examples of Adverse Childhood Experiences include the death or incarceration of a parent, homelessness, witnessing or being a victim of violence.
When searching for solutions, Largusa said that the scale of Humboldt County’s problem is large and that we must seek solutions that match the scale of the problem. “This problem that we face in the County is so huge, the solutions that it will take to fix it have to be equally as large.”
Largusa advocates for, and says Humboldt County is on track, to convene a suicide and drug mortality review panel. The panel will review every death and look deeper into the lives of people who die in these categories to discern patterns that may lead to meaningful solutions to prevent future Deaths of Despair.
Largusa hopes Humboldt County will soon have medically assisted drug treatment services to help reduce the drug overdose rate. A company called Aegis is seeking a site to have such a clinic. Regarding the occasional community outcry against needle exchange programs, Largusa compared blaming addiction on needle exchange programs to blaming alcoholism on whiskey bottles. He said that syringes have become “stigmatized containers,” and reassured the public that there has never been a documented case of Hepatitis or HIV being contracted via syringe litter.
Largusa said that the county is like a large ocean-going vessel and will take time to change direction.