Fatal Opioid Overdoses by Historical and Contemporary Neighborhood-Level Structural Racism

To what extent is there a spatial association between neighborhood-level structural racism and opioid-involved overdose deaths?This cross-sectional study of 796 census tracts (2017-2019) and 792 census tracts (2020-2022) in Chicago, Illinois, found that neighborhoods that were exposed to high levels of structural racism in the past (historical redlining) and present (contemporary segregation) had the highest fatal overdose incidence rates before the COVID-19 pandemic (2017-2019). Neighborhoods that experienced high levels of contemporary racism had the highest fatal overdose incidence rates during the pandemic (2020-2022).This serial cross-sectional study provides preliminary empirical evidence that heightened neighborhood-level structural racism could potentially be a driver of opioid-involved overdose deaths in urban settings.

Corresponding Author: Mudia Uzzi, PhD, MSc, Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, 750 E Pratt St, Baltimore, MD 21202 (mudia.uzzi@jhmi.edu).

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