For the first time in seven years, fatal overdoses are declining in New York City—a trend also provisionally observed on the national level. Although the total numbers could suggest a turning tide, they also reveal significant shifts in the extents to which different demographics are vulnerable.
New York City’s total 2018 death toll of 1,444 represented a fall of 38 deaths from 2017, according to a new brief published by the Department of Health and Mental Hygiene on August 26. Although this is “promising,” as Health Commissioner Dr. Oxiris Barbot said in a press release, “far too many New Yorkers are still dying.”
Latinx New Yorkers were hit the hardest last year, seeing a 5 percent increase and suffering 24.8 overdose deaths per 100,000 residents. Meanwhile rates among Black (21.9 per 100,000) and white (23.8 per 100,000) New Yorkers fell, by 13 percent and 5 percent respectively. (In contrast, between 2016 and 2017, whites’ and Asians’ fatal overdose rates flipped downward, while Black New Yorkers’ skyrocketed by nearly 25 percent and Latinx people’s rose by 2 percent.)
The Department of Health and Mental Hygiene told Filter that it was unable to comment on the factors that might be driving these changes. But one reason, as seen in the numbers, could be the growing divide between who is dying from fentanyl-involved overdoses. In 2018, overdoses among Latinx New Yorkers were more likely to involve fentanyl (66 percent) compared with 2017 (61 percent). Latinx New Yorkers had a higher rate of fentanyl-involved deaths in 2018 (16.6 per 100,000 residents) than their white (14.9) or Black (11.0) peers.
The data also showed significant geographic disparities. People in the Bronx (34.1 deaths per 100,000 residents) suffer the highest rate of fatal overdose in the five boroughs, seeing a 9 percent increase from 2017. Staten Island had the second-highest rate (31.5 per 100,000)—an increase of 18 percent from 2017. But the single neighborhood with the highest rate was East Harlem in Upper Manhattan (56.1 per 100,000), where a majority identifies as Hispanic.
Broken down by gender, women New Yorkers suffered a 7 percent increase in overdose deaths in 2018, to 9.1 per 100,000 residents. The rate for men (33.0 per 100,000) remains more than three times higher, but fell by 6 percent last year.
In addition to aiming to distribute 100,000 naloxone kits annually and connect an additional 20,000 New Yorkers to addiction medications like methadone and buprenorphine, the health department says it will be working to address social determinants of addiction and overdose—like housing, infant mortality, reproductive health, food access, clean air and water, and mental health.
“We remain firmly committed to expanding life-saving services and caring for New Yorkers who use drugs,” said Dr. Barbot.
Photograph of a “funeral procession” march to the NYC Morgue on International Overdose Awareness Day 2017; by VOCAL-NY via Katal Center