Racial/Ethnic Disparities in Opioid-Related Mortality in the USA, 1999-2019: the Extreme Case of Washington DC

J Urban Health. 2021 Oct;98(5):589-595. doi: 10.1007/s11524-021-00573-8. Epub 2021 Oct 18.


In 2019, there were nearly 50,000 opioid-related deaths in the US, with substantial variation across sociodemographic groups and geography. To systematically investigate patterns of racial/ethnic inequities in opioid-related mortality, we used joinpoint regression models to estimate the trajectory of the opioid epidemic among non-Hispanic Black versus non-Hispanic white residents in Washington DC, 45 states, and 81 sub-state areas. We highlight the unique inequities observed in Washington DC. In 2019, the observed opioid-related mortality rate among Black DC residents was 11.3 times higher than white DC residents, resulting in 56.0 more deaths per 100,000 (61.5 vs. 5.5 per 100,000). This inequity was substantially higher than any other jurisdiction on both the relative and absolute scales. Most opioid-related deaths in DC involved synthetic opioids, which was present in 92% (N=198) of deaths among Black DC residents and 69% (N=11) of deaths among white DC residents. Localized, equitable, culturally-appropriate, targeted interventions are necessary to reduce the uniquely disproportionate burden of opioid-related mortality among Black DC residents.

Supplementary Information: The online version contains supplementary material available at 10.1007/s11524-021-00573-8.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Analgesics, Opioid*
  • Ethnicity
  • Health Status Disparities
  • Healthcare Disparities
  • Humans
  • Racial Groups*
  • United States / epidemiology


  • Analgesics, Opioid