A sobering report on deaths in Milwaukee County also shows encouraging trends

At first glance, reading the Milwaukee County Medical Examiner’s Office’s new report on deaths in 2023 is sobering.

Deaths from accidents far outnumber natural deaths, with drug overdoses being the main cause. Fatal overdoses involving cocaine and synthetic opioids, including fentanyl and methamphetamine, have increased across all demographic groups. And gun violence is the leading cause of both homicides and suicides.

But for Dr. Ben Weston, the county’s chief health policy adviser and OEM-EMS medical director, there is a glimmer of hope in the trends outlined in the report.

“In 2020, this is bad news for both sides. Opioid-related deaths are rising. COVID deaths are completely out of control. But now, three, four years later, we are starting to see a turnaround in both cases,” he said.

“I hope that given the trends we are seeing, better days lie ahead,” he said.

The number of natural deaths is falling to pre-pandemic levels

According to Karen Domagalski, operations manager for the Medical Examiner’s Office, natural deaths used to be the “largest factor” in the medical examiner’s work.

However, in a recent change, natural deaths became the second leading cause of death countywide in 2023, with 860 deaths reported, according to the report.

“Natural deaths are accidental deaths,” Weston stressed, noting that this is good because it represents a return to the numbers recorded before the Covid-19 pandemic.

In 2019, 850 natural deaths were recorded. In 2020, this number more than doubled to 2,101, falling to 1,916 in 2021 and then to 1,471 in 2022.

While Weston said the county is still seeing far too many Covid-19-related deaths, he explained that the number is declining due to a combination of vaccines and natural immunity, or immunity from infections.

“We are still seeing far too many deaths from Covid-19 than we would like, but we are getting closer to the baseline for natural deaths,” Weston said.

To prevent drug overdoses, the county is increasing resources

The report found that more than 1,100 accidental deaths last year accounted for almost half of the reported deaths.

Of these, 647 were overdose deaths.

“Like other counties and states across the United States, we are impacted by the opioid crisis. Drug overdose deaths have increased significantly. The type of drugs used has also changed over the years,” said the chief. Forensic physician Dr. Wiesława Tłomak told her superiors when presenting the annual report during the October financial meeting.

She said previously heroin and cocaine-related deaths, as well as prescription drug overdoses, were more common. But now fentanyl, a synthetic opioid, and methamphetamine, also known as meth or methamphetamine, have been added to the list, as well as a mixture of fentanyl and cocaine.

The report found increased use of methamphetamine, fentanyl and/or cocaine among Black, Latino and white residents.

The highest crude drug-related death rates were among blacks, at 114.34 per 100,000, and among Latinos, at 60.66 per 100,000. Since 2018, rates in both groups have increased. For white people, the number is starting to decline, with 64.23 per 100,000 reported in 2022 to 59.78 last year.

While the number of accidental deaths and, therefore, fatal overdoses has overall been declining since the spike in 2020, Weston said the numbers are a good indicator of where to focus among certain demographics and communities in Milwaukee County.

“Even though we’re seeing a net decline, when you break it down, we still have a lot of areas that we need to focus on… even with that decline, a lot of communities are still really struggling and that number is actually growing, just like the Black community struggling with deaths caused by opioid use,” Weston said.

Many factors are contributing to the turnaround — and Weston credits efforts at the county level to provide resources for those struggling with substance use disorders.

He pointed to the county’s efforts to provide housing security and other services to the county, as well harm reduction machines and relocating a mental health services center to the city center Mental Health Emergency Center.

“I think that’s what everyone is really looking forward to and expecting: Are we going to have another decline in opioid deaths? Is this a real trend or maybe a blip?” Weston said. “I think we hope that this is a trend and that it’s a result of all the work that so many people are doing in this space.”

The overall trend is downward, but gun violence accounts for a large percentage of homicides and suicides

Last year, there were 201 homicides and 117 suicides, a decrease compared to 2020.

This decline is part of a broader downward trend in Milwaukee related to record high homicide and suicide rates between 2019 and 2022.

However, in both cases, the leading cause of death was gun violence, with more than half of the suicides and approximately 89% of the homicides involving a gun.

2023 Journal Sentinel analysis revealed that 71 out of 100 fatal shootings in Wisconsin are suicides. The finding is part of an 18-year trend of steadily increasing gun deaths in the state.

In 2022 alone, more than 800 people lost their lives to gunshot wounds, representing a 95% increase in the gun death rate since 2004 when adjusted for population growth. Of these deaths, over 500 are suicides.

“Numbers are never good, right? One homicide death is too many, but we can say that the trends are certainly encouraging,” Weston said.

When it comes to gun suicide trends, Weston said there needs to be more emphasis on destigmatizing conversations about mental health, as well as investing in services for residents.

“Suicide is something worth talking about because it is so stigmatized in our society. When someone dies by suicide, the cause of death is often not discussed, right? And that, I think, stigmatizes them even more, puts people even more in the dark when they’re struggling with mental health or having thoughts of self-harm or suicide,” Weston said.

If you or someone you know is struggling or in crisis, call or text the National Suicide Prevention Lifeline at 988 or text “HOPELINE” to the National Crisis Text Line call 741741.

Contact Vanessa Swales at 414-308-5881 or [email protected]. Follow her on X @Vanessa_Swales.