In the seven-state Great Plains region, drug-induced deaths, mostly attributable to overdoses, accounted for 4,542 deaths in 2020.  Relative to population size, the drug-induced death rate of 21.1 deaths per 100,000 population in the region was nearly 28% lower than the national average.  This gave the Great Plains the second-lowest regional drug-induced death rate in 2020.  There was, however, a very wide disparity in the drug-induced death rates between urban and rural populations in the region, with death rates in smaller communities and rural areas being much lower than in larger urban areas.  Despite the region having an overall low drug-induced death rate in comparison to the nation as a whole, large central metro areas in the region collectively had a higher drug-induced death rate than the national average.  Further study of data from the CDC's National Center for Health Statistics (NCHS) yields the following details about urban vs. rural drug-induced death rates in the Great Plains region:

Urban vs. Rural Drug-Induced Death Rates in the Great Plains Region

County Classification	Deaths	Population	Death Rate*
Large Central Metro	1,008	2,819,881	35.7
Large Fringe Metro	1,247	5,016,579	24.9
Medium Metro	788	3,793,143	20.8
Small Metro	528	3,430,748	15.4
Micropolitan (Nonmetro)	515	3,140,344	16.4
NonCore (Nonmetro)	456	3,281,139	13.9
Region	4,542	21,481,834	21.1
Nationally	96,096	329,484,123	29.2

(*) number of drug-induced deaths per 100,000 population

Report Period: 2020

States in region:  Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, South Dakota

See the 2013 NCHS Urban-Rural Classification Scheme for additional information on population categories, including a map of which U.S. counties fall in which categories.

Source: CDC Wonder. Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death 1999-2020 on CDC WONDER Online Database, released in 2021. Data are from the Multiple Cause of Death Files, 1999-2020, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed on March 18, 2023