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

Objectives. To examine overdose mortality by nativity and national origin among Hispanic and Black adults. Methods. 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). Results. 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. Conclusions. Overdose mortality in Florida is patterned by nativity and education, with national-origin disaggregation identifying high-risk US-born populations obscured in aggregate analyses. (Am J Public Health. Published online ahead of print July 30, 2026:e1-e4. https://doi.org/10.2105/AJPH.2026.308586).