Racial/Ethnic Disparities in Injection Drug Use in Large US Metropolitan Areas

Purpose Because blacks and Latinos bear a disproportionate burden of injection-related health problems compared with whites, we sought to describe black/white and Latino/white disparities in injecting drugs in 94 US metropolitan statistical areas (MSAs) in 1998. Methods Using US Census data and three databases documenting injectorsʹ use of different healthcare services (drug treatment, HIV counseling and testing, and AIDS diagnoses), we calculated database-specific black/white and Latino/white disparities in injecting in each MSA and created an index of black/white and Latino/white disparities by averaging data across the three databases. Results The median black/white injecting disparity in the MSAs ranged from 1.4 to 3.7 across the three databases; corresponding median Latino/white injecting disparities ranged from 1.0 to 1.1. Median black/white and Latino/white index disparity values were 2.6 and 1.0, respectively. Conclusions Although whites were the majority of injectors in most MSAs, database-specific and index black/white disparity scores indicate that blacks were more likely to inject than whites. While database-specific and index disparity scores indicate that Latinos and whites had similar injecting rates, they also revealed considerable variation in disparities across MSAs. Future research should investigate these disparitiesʹ causes, including racial/ethnic inequality and discrimination, and study their contributions to the disproportionate burden of injection-related health problems borne by blacks and Latinos.