1. The Opioid Crisis: Lack of Data among Nashville Area Tribal Nations
Christy Duke, Senior Epidemiologist

2. What we know: Deaths Population Crude Rate Per 100,000
Age Adjusted Rate Per 100,000
American Indian or Alaska Native
2015
511
1,072,200
47.7
58.9
2016
565
1,084,017
52.1
61.5
2017
592
1,100,069
53.8
62.2
Total
1,668
3,256,286
51.2
60.9
Asian or Pacific Islander
1,082
5,819,903
18.6
22.8
1,176
5,944,057
19.8
23.6
1,218
6,182,931
19.7
22.9
3,476
17,946,891
19.4
23.1
Black or African American
16,349
21,365,279
76.5
83.5
18,125
21,604,442
83.9
89.0
19,110
21,896,080
87.3
91.5
53,584
64,865,801
82.6
88.1
White
117,167
87,893,706
133.3
108.5
124,807
88,417,351
141.2
114.5
129,069
89,113,852
144.8
116.3
371,043
265,424,909
139.8
113.1
429,771
351,493,887
122.3
105.2
Taken from CDC Wonder query. All 13 USET states

3. What we don’t know: Deaths Population Crude Rate Per 100,000
Age Adjusted Rate Per 100,000
AI/AN
Alabama (01) 12
37,424
Unreliable
Florida (12) 70
116,826
59.9
60.0
Louisiana (22) 26
40,081
64.9
65.6
Maine (23) 22
11,343
194.0
207.8
Massachusetts (25) 24
39,944
60.1
77.0
Mississippi (28) 10
19,128
New York (36) 83
227,929
36.4
40.5
North Carolina (37)
222
172,072
129.0
153.9
Rhode Island (44)
12,358
South Carolina (45) 16
29,992
Texas (48) 74
318,447
23.2
30.0
Virginia (51) 14
51,489
CDC Wonder query. All 13 USET states. CT not listed. Probably no data yet for 2017

4. Why we don’t know: Purchased and Referred Care (PRC) Private insurance
No federally recognized population in state data sets
Racial misclassification
Coordination between departments
Technological challenges
Reluctance to answer
CDC Wonder query. All 13 USET states. CT not listed. Probably no data yet for 2017

5. Improving the data: Data sovereignty
An epidemiology center operated by a grantee pursuant to a grant awarded under subsection (d) shall be treated as a public health authority…for purposes of the Health Insurance Portability and Accountability Act
The Secretary shall grant to each epidemiology center…access to use of the data, data sets, monitoring systems, delivery systems, and other protected health information in the possession of the Secretary.