Age-specific disparities in fatal drug overdoses highest among older black adults and American Indian/Alaska native individuals of all ages in the United States, 2015-2020.

Age-specific disparities in fatal drug overdoses highest among older black adults and American Indian/Alaska native individuals of all ages in the United States, 2015-2020.
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2015 年至 2020 年,美国各年龄段的老年黑人和美洲印第安人/阿拉斯加原住民中致命药物过量的年龄差异最高。

DOI:
10.1016/j.drugpo.2023.103977
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发表时间:
2023
期刊:
The International journal on drug policy
影响因子:
--
通讯作者:
El-Bassel,Nabila
El-Bassel,Nabila
中科院分区:
--
文献类型:
--
作者:
Jones,Abenaa;Santos-Lozada,Alexis;Perez-Brumer,Amaya;Latkin,Carl;Shoptaw,Steve;El-Bassel,Nabila

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引言种族/民族内部和之间在用药过量死亡方面的差异日益扩大,凸显了识别驱动因素和模式以优化用药过量预防策略的必要性。我们评估了2015-2019年和2020年按种族/民族划分的药物过量死亡的年龄特异性死亡率(ASMR)。方法数据来自CDC Wonder,包括美国N = 411,451名死者的信息(2015-2020年)药物过量导致的死亡(ICD-10编码:X40-X44、X60-X64、X85、Y10-Y14)。我们编制了过量死亡人数的年龄,种族/民族,人口估计,以获得ASMRs,死亡率比(MRR),和队列effects.ResultsThe ASMRs为非西班牙裔黑人成年人(2015-2019)遵循不同的模式比其他种族/民族群体低ASMRs年轻人和55-64岁之间的峰值,在2020年加剧的模式。2020年,年轻的非西班牙裔黑人个体的MRR低于年轻的非西班牙裔白色个体,但老年非西班牙裔黑人成年人的MRR远高于老年非西班牙裔白色成年人(45- 54岁:126%; 55- 64岁:197%; 65- 74岁:314%; 75-84岁:148%)。在大流行前年份(2015-2019年)编制的死亡计数中,美洲印第安人/阿拉斯加原住民成年人的MRR高于非西班牙裔白色成年人;然而,MRR在2020年增加(15- 24岁:134%,25- 34岁:132%,35- 44岁:124%,45- 54岁:134%,55- 64岁:118%)。队列分析表明,在15-24岁和65- 74岁的非西班牙裔黑人个体中,致死性药物过量率呈双峰分布。结论和相关性药物过量死亡对所有年龄段的老年非西班牙裔黑人成年人和美洲印第安人/阿拉斯加原住民人群的影响前所未有,偏离了非西班牙裔白色个体的模式。研究结果强调了有针对性的纳洛酮和低阈值丁丙诺啡计划,以减少种族差异的必要性。
IntroductionIncreasing disparities within and between racial/ethnic groups in overdose deaths underscore the need to identify drivers and patterns to optimize overdose prevention strategies. We assess age-specific mortality rates (ASMR) in drug overdose deaths by race/ethnicity in 2015-2019 and 2020.MethodsData were from the CDC Wonder, and included information forN= 411,451 deceased individuals in the United States (2015-2020) with a drug overdose-attributed cause of death (ICD-10 codes: X40–X44, X60–X64, X85, Y10–Y14). We compiled overdose death counts by age, race/ethnicity, and population estimates to derive ASMRs, mortality rate ratios (MRR), and cohort effects.ResultsThe ASMRs for Non-Hispanic Black adults (2015-2019) followed a different pattern than other racial/ethnic groups—low ASMRs among young individuals and peaking between 55-64 years—a pattern exacerbated in 2020. Younger Non-Hispanic Black individuals had lower MRRs than young Non-Hispanic White individuals, yet, older Non-Hispanic Black adults had much higher MRRs than older Non-Hispanic White adults (45-54yrs:126%, 55-64yrs:197%; 65-74yrs:314%; 75-84:148%) in 2020. American Indian/Alaska Native adults had higher MRRs than Non-Hispanic White adults in death counts compiled from pre-pandemic years (2015-2019); however, MRRs increased in 2020 (15-24yrs:134%, 25-34yrs:132%, 35-44yrs:124%, 45-54yrs:134%, 55-64yrs:118%). Cohort analyses suggested a bimodal distribution of increasing fatal overdose rates among Non-Hispanic Black individuals aged 15-24 and 65-74.Conclusions and RelevanceOverdose fatalities unprecedently impact older Non-Hispanic Black adults and American Indian/Alaska Native populations of all ages, deviating from the pattern found for Non-Hispanic White individuals. Findings highlight the need for targeted naloxone and low-threshold buprenorphine programs to reduce racial disparities.
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