Opioid-, and Stimulant-involved Deaths among Black People in St. Louis: Examining Social Determinants of Health

The opioid epidemic is a growing health crisis. Provisional findings from the CDC’s National Center for Health Statistics demonstrate record high numbers of fatal drug overdose in the U.S. in 2021 (CDC, 2022a). These deaths were largely driven by illicitly manufactured synthetic opioid, fentanyl, and its analogues (herein referred to as fentanyl). Many of these fatal overdoses also involved stimulants such as cocaine, as rates of death co-involving stimulants and opioids have recently increased (CDC, 2022b). Although rates of opioid overdose deaths (OODs) have increased across demographic groups, increases have been particularly stark among Black people. Since the introduction of fentanyl in 2013, deaths among Black individuals have outpaced those of their White counterparts at a rate of two to one, indicating an emerging health disparity (Furr-Holden et al., 2020). Moreover, stimulant-involved OODs, driven largely by cocaine, have disproportionately affected Black people compared to other ethnic and racial groups (Barocas et al., 2019). There is also evidence that increases in Black OOD rates are related to increases in rates of overdoses involving both fentanyl and cocaine among this group (Cano, 2021; Mbabazi et al., 2021). These findings highlight the need for additional research examining differential drivers of OOD, stimulant- involved overdose deaths, and dual opioid/stimulant-involved deaths among Black people. Despite alarming increases in OODs among Black people concurrent with the introduction of fentanyl, little is known about the correlates of opioid- and dual opioid/stimulant-involved deaths among Black people. To address this gap in the literature, the current study will use multinomial logistic regression to test the associations between various social determinants of health and opioid-, stimulant-, and dual opioid/stimulant -involved deaths among Black people in St. Louis, Missouri using drug-involved death data from the Medical Examiner from 2016-2021. Findings regarding the correlates of opioid/stimulant-involved deaths among Black people can help identify targets for overdose prevention among this group. Research Question: What social determinants of health are associated with opioid-, stimulant, and dual opioid/stimulant-involved deaths among Black people in St. Louis, MO (City & County) from 2016-2021?