Nativity and National-Origin Disparities in Drug Overdose Mortality Among Hispanic and Black Adults in Florida, 2021-2024.

Abstract

<b>Objectives.</b> To examine overdose mortality by nativity and national origin among Hispanic and Black adults. <b>Methods.</b> We analyzed population-based overdose mortality data from the Florida Department of Health (2021-2024). Hispanic decedents were disaggregated by national origin and nativity; non-Hispanic Black decedents were classified as US-born or Caribbean-born. Age-adjusted mortality rates were calculated by sex. Negative binomial regression models adjusted for age, sex, and education estimated mortality rate ratios (MRRs). <b>Results.</b> Among men, overdose mortality was highest among non-Hispanic Whites (59.5 per 100 000), followed by non-Hispanic Blacks (30.8) and Hispanics (20.5). Within Hispanics, Puerto Rican-born adults (39.6) and US-born Hispanics (33.6) had the highest mortality, whereas foreign-born Hispanic subgroups had lower mortality. Overdose mortality among US-born Blacks exceeded that among Caribbean-born Blacks (40.8 vs 6.3). In adjusted models, mortality was elevated among US-born Hispanics (MRR = 3.8; 95% confidence interval [CI] = 3.0, 4.8) and Puerto Rican-born adults (MRR = 3.8; 95% CI = 2.9, 4.9) relative to South American-born adults, and among US-born Blacks compared with Caribbean-born Blacks (MRR = 6.4; 95% CI = 4.7, 8.6). Lower educational attainment was associated with higher overdose mortality. <b>Conclusions.</b> Overdose mortality in Florida is patterned by nativity and education, with national-origin disaggregation identifying high-risk US-born populations obscured in aggregate analyses. (<i>Am J Public Health</i>. Published online ahead of print July 30, 2026:e1-e4. https://doi.org/10.2105/AJPH.2026.308586).