Health Equity in the Response to Drug Overdose

Fatal drug overdoses have long been a public health crisis in the United States. From 1999 – 2018, nearly 450,000 people died from overdoses in the United States.[i] In 2019, there were more than 70,000 drug overdose deaths. While public health efforts have brought attention to drug addiction as a disease and have improved access to substance use disorder (SUD) treatment and services, many health inequities have not been addressed.

The Division of Overdose Prevention (DOP) and National Center for Injury Prevention and Control (NCIPC) at the Centers for Disease Control and Prevention (CDC) partnered with the National Association of County and City Health Officials (NACCHO) on a project to investigate the literature available on this topic, as well as tools and resources which could provide guidance for health departments on addressing drug overdose through the use of a health equity lens.

Through this review, it was concluded that more attention to upstream factors of drug overdose health inequities would likely have a positive effect on downstream factors including overdose. It was, also, found that most sources focused primarily on inequities along racial and ethnic lines. In addition to race and ethnicity more attention to health inequities within and across populations, including but not limited to LGBTQIA+, adolescent, aging, sex and gender-based, and immigrant populations is also warranted. Thus, the resources and tools listed on this page have been provided to help health departments consider root causes and the interconnected system of upstream inequities when addressing drug overdoses in their jurisdictions.

LAC Checklist Cover Photo

Equity Considerations for Local Health Departments on Opioid Settlement Funds Checklist

The Legal Action Center (LAC), with the support of the National Association of County and City Health Officials (NACCHO), has crafted the Equity Considerations for Local Health Departments on Opioid Settlement Funds Checklist. This valuable resource aims to guide county and city health officials through decision-making for the allocation and distribution of opioid settlement funds, highlighting health equity principles such as community engagement, oversight and accountability, and cultural humility. The resource is divided into five critical sections, each offering strategies for LHDs to improve access to services; remove funding constraints; tailor support for priority communities; collect data for the promotion of health equity; and community education. For any questions about this checklist or other resources related to integrating health equity into overdose prevention, please contact us at [email protected].

The Health Equity in the Response to Drug Overdose Online Training is new virtual learning resource developed by Health Research Toolbox (HEART) and available through our NACCHO University platform.

The Health Equity in the Response to Drug Overdose Online Training is a 12-module, free online course designed to guide health practitioners in their integration of fundamental health equity concepts and methodologies into their local drug overdose prevention and response efforts. Through the course of this learner-centered training, participants will walk through key health equity concepts and methodologies while engaging in a range of interactive features, from practical exercises and worksheets to short videos and knowledge checks.

To learn more and register for the course, please visit NACCHO University and access the course here. If you have any questions about the course or how to engage, please reach out to Jasmine Akuffo at [email protected].

With support from the Division of Overdose Prevention (DOP) in the National Center for Injury Prevention and Control (NCIPC) at the Centers for Disease Control and Prevention (CDC), the National Association of County and City Health Officials (NACCHO) has released the Integrating Health Equity Into Overdose Prevention and Response: An Environmental Scan, designed to identify existing barriers and facilitators local and state health departments face to advancing health equity in their overdose prevention or response efforts. This environmental scan captures knowledge gained through high-level key informant interviews with state and local health departments to identify current activities, gaps, and innovative strategies currently being leveraged to address health equity and the social determinants of health within drug overdose prevention and response. State and local health departments can use this resource to inform the development of strategies, trainings, and other resources that can better combat existing health inequities in drug overdose.

Title Type Level Source Description
PolicyLink Health Equity Webpage National Policy Link A guide developed to support health equity leaders seeking to transform public health institutions and embed health equity into their day-to-day practices.
Promoting Health Equity: A Resource to Help Communities Address Social Determinants of Health Resource repository National Centers for Disease Control and Prevention A workbook for public health practitioners and partners interested in addressing social determinants of health.
Local & regional Government Alliance on Racial Equity: Tools & Resources Webpage National Racial Equity Alliance A resource outlining tools for racial equity that capture an overall approach to integrating racial equity into routine decision making.
Reducing Harms: Recognizing and Responding to Opioid Overdoses in Your Organization Report International Canadian Mental Health Association A resource equipping community service providers with current, accessible and relevant information that can be used to inform and develop an opioid overdose protocol.
"Sweet" Tools to Advance Health Equity Resource repository State The Colorado Department of Public Health and Environment The CDPHE Office of Health Equity created these tools as a resource for government agencies, non-profit organizations, and community based organizations.
Title Type Level Source Description
Achieving Health Equity Resource repository National Robert Wood Johnson Foundation A repository built to provide resources on how entities can work towards achieving health equity.
Adverse Community Experiences and Reslience: A Framework for Addressing and Preventing Community Trauma Framework/ Guidance National Prevention Institute This report offers a groundbreaking framework for understanding the relationship between community trauma and violence.
Colorado Department of Public Health & Environment: Equity Action Guide Webpage State The Colorado Department of Public Health and Environment The CDPHE Office of Health Equity, developed a Colorado Equity Action Guide that looks at the root causes of inequity across Colorado.
Michigan Safer Opioid Prescribing Toolkit: Health Disparities in Prescribing Opioids Resource repository State Michigan Safer Opioid Prescribing Toolkit A comprehensive resource hub launched in conjuction with University of Michigan providing resources for clinical practice.
National Overdose Prevention Network: Health Equity Tool Guideline/Framework National National Overdose Prevention Network A health equity tool developed by the National Overdose Prevention Network to organize organizational responses to health equity challenges.
Minnesota Department of Health: Social Determinants of Substance Use & Overdose Prevention Webpage State Minnesota Department of Health A webpage from the Minnesota Department of Health providing background on social determinants of health, social-ecologic model (SEM) mapping, and health inequities in relation to overdose prevention.
Health Equity Frameworks to Inform Responses to Opioid Overdose Report International Canadian Institute for Substance Use Research (CISUR) A systematic scoping review identifying and describing literature which use "a health equity-oriented approach for preventing and reducing the harms of stigma or overdose for people who use illicit drugs or misuse prescription opioids." (Bruce et al., 2021)
The Health Equity Framework: A Science and Justice-Based Model for Public Health Researchers and Practitioners Framework / Guidance National ETR In this article, ETR describes their " science- and justice-based framework for promoting health equity designed for researchers and practitioners working across public health and social science fields." (Peterson et al. 2020)
Title Type Level Source Description
Frameworks Institute: Equity Resource repository National Frameworks A resource repository providing information on issues ranging from justice reform, to residential segregation, and health disparities.
Prevention Institute: Health Equity & Racial Justice Webpage National Prevention Institute The Prevention Institute developed practical, free-to-use tools to guide practitioners, advocates, and policymakers in planning and implementing prevention strategies.
Healthier Washington Collaboration Portal: Health Equity Concerns Webpage State Washington State Department of Health A webpage of health equity concerns developed by the Washington State Department of Health.
Office of Health Equity and Minority Health: Michigan Webpage State Michigan Department of Health & Human Services The Michigan Office of Equity and Minority Health supports and initiates programs, policies, and applied research to address social determinants of health that contribute to health inequities for racial and ethnic minority populations in Michigan.
Tamarack Institute: Resource Library Resource repository International Tamarack Institute The Tamarack Institute develops and supports collaborative strategies that engage citizens and institutions to solve major community issues across Canada and beyond.
The Colorado Department of Public Health and Environment Tools & resources Webpage State The Colorado Department of Public Health and Environment A resource repository of tools and and guidance developed by the Colorado Department of Public Health & Environment
Health Equity: A Guide to Language, Narrative and Concepts Guide National American Medical Association This guide was prepared by the AMA and AAMC.
IVP drug Overdose Response Img1

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Behavioral Health Equity

Resources on the preservation of equity across health and health care. From SAMHSA.

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Behavioral Health Equity

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Annual Surveillance Report of Drug-Related Risks & Outcomes

This report provides the latest statistics on data related to opioid overdose nationally.

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Annual Surveillance Report of Drug-Related Risks & Outcomes

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Addressing the Opioid Epidemic in Minority Communities

This video, produced on April 25, 2018, highlights efforts to combat the opioid epidemic and address behavioral health in minority populations.

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Addressing the Opioid Epidemic in Minority Communities

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Addressing the Opioid Epidemic in Minority Communities

Provided context and a brief data overview of the opioid epidemic in Black and Hispanic/Latinx communities and strategies to address it.

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Addressing the Opioid Epidemic in Minority Communities

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Promoting Health Equity and Addressing SDoH

For public health practitioners and partners interested in addressing social determinants of health in order to promote health and equity.

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Promoting Health Equity and Addressing SDoH

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Health Equity and Social Justice

Learn about NACCHO's resources to help your department address health inequities

Health Equity and Social Justice

https://www.cdc.gov/nchs/data/databriefs/db394-H.pdf Centers for Disease Control and Prevention. Drug Overdose Deaths in the United States, 1999–2019. Retrieved March 31, 2020, from https://www.cdc.gov/nchs/data/databriefs/db394-H.pdf.

Centers for Disease Control and Prevention. Drug Overdose Deaths in the United States, 1999-2018. Retrieved September 1, 2020, from https://www.cdc.gov/nchs/products/databriefs/db356.htm.

Community Health Program

Stacy Stanford

Senior Director, Overdose, Injury, and Violence Prevention

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