Regional differences in fatal drug overdose deaths among Black and White individuals in the United States, 2012–2021

Abstract

Background and Objectives

The current study examines regional differences in Black/White fatal drug overdoses.

Methods

Black/White overdose mortality data (2012–2021; N = 537,085) were retrieved from CDC WONDER. We used death counts and corresponding Census Bureau population estimates by the decedent's age and race/ethnicity to calculate mortality rate ratios.

Results

From 2012 to 2021, there were 537,085 reported overdose deaths among White (85%) and Black (15%) individuals in the United States. In the South, Black individuals had lower fatal drug overdose deaths than their same-aged White counterparts. In the Northeast, Midwest, and West regions, Black individuals had around 10%–60% lower likelihood of overdoses among younger ages (15–24, 25–34, 35–44) but about 60%–300% higher likelihood of overdoses among older adults (55–64). Increases in overdose deaths during the pandemic (2020–2021) led to changes in Black/White overdose death patterns, whereas Black individuals of all ages in the Midwest and West regions had approximately 15%–425% higher likelihood of fatal overdoses than their same-aged White counterparts. Sex-stratified analysis suggests that Black females in the South had overdose death rates around 50% lower than same-aged White females, and overdose deaths were relatively equal for Black and White females in the Midwest—patterns not seen among males.

Conclusions and Scientific Significance

The findings indicate that the Black/White overdose mortality gap changed after the COVID-19 pandemic across all regions and age cohorts, with state and regional variations in magnitude. Behavioral interventions and policies to curb drug overdose deaths among populations most impacted should consider regional, sex, and age-related differences.