Trends in racial/ethnic and geographic disparities in substance use disorders mortality in the United States, 2000-2019.

Background and objectives: Substance use disorders (SUD) are a major public health concern in the United States. This study examined racial/ethnic and state-level disparities in SUD mortality in the United States from 2000 to 2019.

Methods: Age-standardized mortality rates for SUD were obtained for 5 racial/ethnic groups (White respondents, Black respondents, Latino, Asian-Pacific Islander [API], American Indian/Alaska Native [AIAN]) by state and sex from 2000 to 2019. Joinpoint regression analysis was used to model temporal trends overall and by demographic factors.

Results: From 2000 to 2019, the overall mortality rate increased from 8.0 to 28.8 deaths per 100,000 population across all groups. AIANs had the highest mortality in 2019 (57.8 per 100,000), followed by Black respondents, White respondents, Latinos, and APIs. Significant increases occurred across all racial/ethnic groups, with the greatest average annual percentage change (AAPC_2000-2019) among White respondents (6.7%; 95% confidence interval [CI]: 6.2%-7.3%), APIs (6.0%, 95% CI: 5.6%-6.2%), and AIANs (5.9%, 95% CI: 5.6%-6.2%). Mortality rates increased more rapidly for females than males among White respondents, AIANs, Black respondents, and Latinos. Substantial state-level variation emerged, with the highest mortality rates in 2019 seen in West Virginia, the District of Columbia, Delaware, Ohio, and Pennsylvania.

Discussion and conclusions: Racial/ethnic and geographic disparities in SUD mortality have widened significantly from 2000 to 2019, highlighting priority areas for prevention efforts.

Scientific significance: This study provides detailed insights into long-term trends in racial, ethnic, and geographic disparities in SUD mortality across the United States, informing targeted prevention and intervention strategies.