New Hampshire: A Life and Death Tale of Two Health Realities
For two consecutive years, New Hampshire has earned the title of the healthiest state in the country, according to the United Health Foundation. This recognition stems largely from the state’s low rates of homicide, poverty, and unemployment. However, a closer look reveals a more troubling reality when it comes to deaths related to suicide, drugs, and alcohol, the NH Bulletin reports.
A Growing Crisis
A recent report from Trust for America’s Health, a national health policy and research organization, offers a stark picture of New Hampshire’s struggles with substance use and mental health. The Granite State saw alarming increases in deaths related to drugs, alcohol, and suicide between 2021 and 2022, far outpacing the national average in these categories.
Drug Deaths Soar: The report highlights a 13 percent increase in opioid deaths in New Hampshire, compared to just a 1 percent increase nationwide. Deaths due to synthetic opioids, particularly fentanyl, surged by 20 percent, significantly higher than the 4 percent national increase. The situation is equally dire for deaths related to cocaine and other psychostimulants like methamphetamine, which rose by 39 percent and 50 percent, respectively, compared to national increases of 12 percent and 4 percent.
Brandon Reavis, a co-author of the report, emphasizes the role of fentanyl in exacerbating the drug crisis. “These are significant numbers, and I think it really points to the role of fentanyl in increasing the danger of our drug supply,” Reavis said.
The Human Toll
In 2022, New Hampshire recorded 1,014 deaths due to suicide, alcohol, or drugs—a 10 percent increase from the previous year, the largest increase of any state. In contrast, the rest of the country saw a 1 percent decrease in such deaths.
Breaking down these numbers, 247 deaths were attributed to suicide, 486 to drugs, and 295 to alcohol-related causes. The pervasive impact of synthetic opioids like fentanyl is evident, as it played a role in 415 of these drug overdose deaths.
The Impact on Youth
The report also sheds light on the mental health challenges faced by New Hampshire’s youth. Among high school students, 25 percent reported having serious thoughts of suicide in the past year, and 36 percent said their mental health was "not good" most or all of the time—worse than the averages for the rest of New England. Additionally, 16 percent of the state’s children under 17 have experienced at least two adverse childhood experiences, such as abuse, neglect, or living with a parent who has mental health issues.
Policy Recommendations and Challenges
To combat these rising issues, the report recommends a range of policy measures, including improving economic and social factors and reducing adverse childhood experiences, which are strongly linked to substance use disorder and mental health issues later in life.
New Hampshire has made some progress. The state implemented the 988 suicide and crisis lifeline two years ago, though it still lacks permanent funding. Additionally, the state has established mobile crisis response teams in every county, though response times remain a concern.
However, there is still work to be done. Trust for America’s Health suggests that New Hampshire could generate $1.3 million annually for the 988 lifeline by imposing a small fee on telecommunication customers, similar to the funding model for 911.
The state has also made strides in harm reduction, such as legalizing testing strips for fentanyl and xylazine, but efforts to expand these measures have faced legislative resistance. Bills proposing state funding for syringe exchange programs, for example, have failed to pass.
On the Right Track, Almost
Despite these challenges, New Hampshire has taken real steps to address the issues raised in the report. The state has implemented a safe gun law aimed at protecting minors, significantly increased its behavioral health investments, and expanded Medicaid coverage for new mothers. Additionally, New Hampshire has used funds from federal aid and legal settlements to build behavioral health hospitals and support opioid crisis initiatives. But, rent attempts to legalize medical suicide have raised concerns over the impact of validating it.
New Hampshire’s dual reality— as the healthiest state while simultaneously facing a severe substance use and mental health crisis—highlights the complexity of public health. Addressing these deep-rooted issues will require sustained efforts, innovative policies, and a commitment to addressing the underlying causes of addiction and mental illness.
For those in need of help, resources are available through the 988 Suicide and Crisis Lifeline and other state programs. By continuing to invest in prevention, treatment, and support, New Hampshire can hope to reverse these troubling trends and ensure a healthier future for all its residents.