Study on addiction trends in the US indicates growing disparities in substance use disorders mortality

A newly published study by Akshaya Bhagavathula, NDSU associate professor of epidemiology, highlights the growing disparities in substance use disorders (SUD) mortality in the United States.

The research, titled “Trends in Racial, Ethnic, and Geographic Disparities in Substance Use Disorder Mortality in the U.S. (2000–2019),” appears in the latest edition of the American Journal on Addictions.

“Our findings are critical for informing public health policies,” Bhagavathula said. “As a community, we need to engage in meaningful discussions on how to dismantle these health disparities. I hope this research will drive policy changes that make health care access and treatment more inclusive and equitable.”

The study identified demographic trends and disparities from national to county level of SUD mortality over two decades. It showed that from 2000 to 2019, the national mortality rate linked to SUD surged from eight to 28.8 deaths per 100,000 people.

American Indian and Alaska Native populations experienced the highest mortality rates, with 57.8 deaths per 100,000 people in 2019. Black and white populations followed, underscoring ongoing racial health disparities in the U.S., Bhagavathula said.

West Virginia, Ohio and Pennsylvania recorded the highest mortality rates. Cass County in North Dakota ranked among the top 10 counties nationwide for substance use disorder mortality rates with 169 deaths per 100,000 people among American Indian and Alaska Native populations.

“These disparities should serve as a call to action, urging us to develop and implement targeted public health interventions that address not only the SUD itself but also the underlying factors that contribute to such high mortality rates,” said Tracie Newman, NDSU associate professor of practice and Cass County Public Health officer.

“We must engage with these communities in a culturally sensitive manner, ensuring that prevention, treatment and recovery programs are accessible, effective and equitable. This includes expanding access to health care services, improving social determinants of health, and promoting harm reduction strategies that are tailored to the unique needs of these populations.”

The study also shows men had higher mortality rates than women across all racial and ethnic groups, and mortality rates among women rose at a faster pace than men in many populations.

Bhagavathula said his research underscores the need for urgent, targeted public health interventions to address disparities through a health equity approach. Marginalized groups, including American Indian and Alaska Native communities, currently face significant barriers to accessing health care and culturally appropriate treatment options, he added.

“This publication will open doors to opportunities for future collaboration with American Indian and Alaska Native communities in Cass County, tribal nations and urban AIAN populations in North Dakota, public health professionals, and North Dakota State University to reduce and prevent SUDs and SUD mortality rates within Cass County and statewide,” said Mikalen Belgarde, an NDSU Indigenous health doctoral student and a public health education project manager for the American Indian Public Health Resource Center.