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Development of a Rural Recovery Ecosystem Index

Senior man receiving a advice during a psychotherapy
The nation’s first-ever county-level index of a community’s substance use recovery ecosystem
  • Client
    HRSA Federal Office of Rural Health Policy
  • Dates
    September 2021 - August 2023


A lack of local data on substance use recovery ecosystems.

The term "Recovery Ecosystem" describes the factors in a community that support recovery from substance use disorder. Limited data are available describing the recovery ecosystem's strength at the local level. 


A data visualization tool that measures the strength of recovery ecosystems.

On behalf of the Fletcher Group, with funding from the HRSA Federal Office of Rural Health Policy, NORC and East Tennessee State University (ETSU) developed the Recovery Ecosystem Index Mapping Tool. The tool lets users measure the strength of substance use recovery ecosystems in every county in the United States and explore associations with overdose deaths and other sociodemographic and economic factors. 

Community organizations, policymakers, researchers, substance use treatment providers, other decision-makers, and the general public can explore county-level maps and create data dashboards to see where additional resources are most needed to support individuals in recovery. Insights from this tool can help target resources and interventions to enhance recovery ecosystems. 


Insights to strengthen community-level recovery ecosystems.

The Recovery Ecosystem Index comprises 14 indicators that impact the strength of a recovery ecosystem, organized into three components - SUD Treatment, Continuum of SUD Support, and Infrastructure and Social Factors. The tool also allows users to create data overlays that show the association between the Recovery Ecosystem Index and factors such as overdose mortality rates, sociodemographics, and economic factors such as poverty rate, education, and race and ethnicity.

Learn More About the Map

The Recovery Ecosystem Index Mapping Tool allows users to assess important elements of the recovery ecosystem in their communities.

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