Bhagavathula Akshaya S, Daglis Theodoros, Nishimura Yoshito
Department of Public Health, College of Health and Human Services, North Dakota State University, Fargo, North Dakota, USA.
Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA.
Am J Addict. 2025 Jan;34(1):93-100. doi: 10.1111/ajad.13654. Epub 2024 Oct 9.
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.
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.
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) 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.
Racial/ethnic and geographic disparities in SUD mortality have widened significantly from 2000 to 2019, highlighting priority areas for prevention efforts.
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.
物质使用障碍（SUD）是美国主要的公共卫生问题。本研究调查了2000年至2019年美国SUD死亡率的种族/族裔和州层面差异。
获取了2000年至2019年按州和性别划分的5个种族/族裔群体（白人受访者、黑人受访者、拉丁裔、亚太岛民[API]、美国印第安人/阿拉斯加原住民[AIAN]）的SUD年龄标准化死亡率。采用连接点回归分析对总体及按人口统计学因素划分的时间趋势进行建模。
2000年至2019年，所有群体的总体死亡率从每10万人8.0例死亡增至28.8例死亡。2019年AIAN的死亡率最高（每10万人57.8例），其次是黑人受访者、白人受访者、拉丁裔和亚太岛民。所有种族/族裔群体的死亡率均显著上升，白人受访者（6.7%；95%置信区间[CI]：6.2%-7.3%）、亚太岛民（6.0%，95%CI：5.6%-6.2%）和AIAN（5.9%，95%CI：5.6%-6.2%）的平均年度百分比变化（AAPC）最大。在白人受访者、AIAN、黑人受访者和拉丁裔中，女性的死亡率增长速度高于男性。出现了显著的州层面差异，2019年死亡率最高的是西弗吉尼亚州、哥伦比亚特区、特拉华州、俄亥俄州和宾夕法尼亚州。
2000年至2019年，SUD死亡率的种族/族裔和地理差异显著扩大，突出了预防工作的重点领域。
本研究详细洞察了美国SUD死亡率在种族、族裔和地理方面的长期差异趋势，为有针对性的预防和干预策略提供了依据。
