At first glance, national data suggest that Latinx people are suffering fewer fatal overdoses compared to other racial groups. Upon closer inspection, as a new study provides, disparities exist along ethnic and geographic lines within this population, bringing into focus particular issues demanding anti-overdose responses.
Nationally, Hispanic people, the category selected by data, see far lower rates of overdose deaths than non-Hispanic white people. But Hispanic people are not a monolith, and there is concerning variation within the broad category. In fact, Puerto Ricans died at a slightly higher rate from drugs in 2017 than non-Hispanic whites, according to a study by Manuel Cano, professor of social work at University of Texas, San Antonio, published in Substance Use & Misuse on July 25.
Cano suggests that this could be related to where most Puerto Ricans reside in the United States and the types of drugs they’re using. The eastern part of the country, where many live, has been “inundated with deadly synthetic opioids such as fentanyl that elevate risk of fatal overdose,” he wrote. Accordingly, Puerto Ricans, who have by far the highest rate of fatal overdose among Hispanic people, had the largest proportion of deaths (65 percent) involving synthetic opioids.
Fatalities involving specific drugs were differently distributed across national heritage. Psychostimulants, which usually means methamphetamine, were most involved in fatal overdoses among Mexican-Americans, the only Hispanic community where synthetic opioids like fentanyl were not involved in the highest proportion of deaths. In contrast, nearly half (47 percent) of Dominican-Americans’ deaths involved cocaine.
The demographic characteristics of Hispanic overdose deaths differed from those of non-Hispanic populations in other ways. More than three-quarters of Hispanic overdoses were among men, in contrast to non-Hispanic white men’s 64 percent share.
Additionally, Hispanic people with an education level of eighth-grade or lower comprised almost 10 percent of all deaths. For Central Americans, this educational category’s proportion of deaths was much higher cross-section was even higher—it constitute one-quarter of their deaths. Meanwhile their non-Hispanic white counterparts made up just 2 percent of that racial group’s overdose victims.
Gender and education should be taken into account when providing overdose prevention interventions, says Cano. Specifically, he recommends considering “the cultural and gender-relevant stigma attached to self-disclosure, seeking help, or admitting a concern that may be construed as a weakness.”
For Mexican-Americans, in particular, he suggests “capitaliz[ing] on the important, lifelong role of mothers in Mexican culture (as revered figures and important influences for health decision-making) by emphasizing the impact of risky behavior (or overdose) not only on the individual but also on their mother.”
Interventions, he says, should be mindful of educational access so as to be most “effectively communicating information related to overdose prevention, risk factors for overdose, and treatment options for addiction.”
Certain localities have completely bucked national trends. In New York City, Latinx people are dying more frequently than any other racial group. Despite an overall decline in deaths between 2017 and 2018, Latinx New Yorkers are the only ones who’ve seen an increase in their fatal overdose rate.
The study has a potent lesson for public health agencies, Cano believes. “An effective and equitable response to the overdose crisis should not overlook the unique characteristics of ethnic minority groups in the US, including Hispanic communities.”