Socioeconomic inequalities and Black/White disparities in US cocaine-involved overdose mortality risk

Manuel Cano, Christopher P. Salas-Wright, Sehun Oh, Lailea Noel, Dora Hernandez, Michael G. Vaughn

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Purpose: This study examined whether socioeconomic inequalities account for Black/White disparities in: (a) the prevalence of potential risk factors for overdose among adults using cocaine; and (b) national mortality rates for cocaine-involved overdose. Methods: Data from 2162 Non-Hispanic (NH) Black or White adults (26 +) who reported past-year cocaine use in the 2015–2019 National Survey of Drug Use and Health were analyzed to obtain predicted probabilities of potential overdose risk factors by race and sex, using marginal effects via regression analyses, adjusting for age and socioeconomic indicators. Next, National Center for Health Statistics data (for 47,184 NH Black or White adults [26 +] who died of cocaine-involved overdose between 2015 and 2019) were used to calculate cocaine-involved overdose mortality rates by race and sex across age and educational levels. Results: Several potential overdose vulnerabilities were disproportionately observed among NH Black adults who reported past-year cocaine use: poor/fair overall health; cocaine use disorder; more days of cocaine use yearly; hypertension (for women); and arrests (for men). Adjusting for age and socioeconomic indicators attenuated or eliminated many of these racial differences, although predicted days of cocaine use per year (for men) and cocaine use disorder (for women) remained higher in NH Black than White adults. Cocaine-involved overdose mortality rates were highest in the lowest educational strata of both races; nonetheless, Black/White disparities were observed even at the highest level of education, especially for adults ages 50 +. Conclusion: Age and socioeconomic characteristics may account for some, yet not all, of Black/White disparities in vulnerability to cocaine-involved overdose.

Original languageEnglish
Pages (from-to)2023-2035
Number of pages13
JournalSocial Psychiatry and Psychiatric Epidemiology
Issue number10
Publication statusPublished - 2022 Oct

Bibliographical note

Funding Information:
This work was supported by the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health [Award Number K01AA026645; PI: Christopher P. Salas-Wright]. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIAAA or the NIH.

Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Health(social science)
  • Social Psychology
  • Psychiatry and Mental health


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