Declining Opioid Overdose Mortality in Chicago: Hyperlocal Differences by Socioeconomic Deprivation and Racial/Ethnic Composition

OBJECTIVE: Opioid overdose mortality rates declined in Chicago between 2023 and 2024. This study examined differential reductions in opioid overdose mortality across Chicago community areas by neighborhood socioeconomic deprivation and racial/ethnic composition. METHODS: Opioid overdose deaths were obtained from the Cook County Medical Examiner and geocoded to Chicago's 77 community areas. Five-year average Area Deprivation Index (ADI) scores were used to characterize community-level socioeconomic disadvantage. Changes in opioid overdose mortality rates between 2023 and 2024 were assessed using multivariable linear regression and spatial analysis. RESULTS: = 0.12). However, controlling for ADI quartile and the opioid mortality rate for 2023, % Black was marginally significant. Greater declines occurred predominantly on the West and North sides of the city. CONCLUSIONS: Despite an overall decline in opioid overdose deaths in Chicago, not all community areas benefited equally. Findings highlight that opioid response efforts targeting geographic areas with a greater impact of opioid misuse, as well as community deprivation, are needed to ensure that continued progress translates into more equitable reductions in opioid overdose mortality across Chicago.