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By Rowena Boulton
Overdoses from opioids have become concentrated in low-income and marginalized communities, where drug use is criminalized and access to treatment is limited. Across America and throughout Alameda County, the structurally racist system of redlining perpetuates a cycle of opioid use that is hard to escape.
Redlining, a discriminatory practice in which banks and financial institutions systematically deny mortgages, insurance, and other financial services to residents of specific neighborhoods based on their race or ethnicity, began in the 1930s.
Color-coded maps re-drew minority communities in red and labeled them as “high risk” for investment, causing housing to be withheld from marginalized communities on the basis of race.
Despite redlining becoming illegal in 1968, its impact on widespread economic disparity continues today. Without generational access to homeownership, the financial progress of minority groups has been severely restricted.
The economic disparity caused by redlining has contributed to the opioid crisis in the United States, as opioid use and overdose rates have climbed in communities impacted by redlining. According to the Journal of American Medical Association (JAMA), “neighborhoods that were exposed to high levels of structural racism in the past (historical redlining) and present (contemporary segregation) had the highest fatal overdose incidence rates before the COVID-19 pandemic.”
This disparity has appeared in Alameda County, where redlining and structural racism has made a clear impact on opioid use in local communities. In a case study, the organization New America reports that “the African American community in certain parts of Alameda County is more impacted by opioids than other races.”
Predominantly Black neighborhoods in West and East Oakland were historically viewed as risky for investment, causing an economic gap to grow between them and other, wealthier regions of the Bay Area. At the same time, Black people in Alameda County are “3.4 times more likely to die of drug poisoning (overdosing) compared to the overall population,” according to the Alameda County Public Health Department.
East Oakland specifically was designated as a “red-zone” for investment due to the high rate of minority groups living in the area. The neighborhood has a predominantly minority population, along with one of the highest overdose rates in Alameda County.
Opioid overdose rates are so high in previously red-lined regions in part due to marginalized communities having inequitable access to drug treatment medication like naloxone, which reverses opioid overdoses. With this lack of access to treatment, the JAMA reports that “Black, Indigenous, and Latino communities are disproportionately affected by the US overdose epidemic.”
Additionally, programs designed to tackle the problem of drug use in the United States have historically targeted predominantly minority communities. The “War on Drugs” campaign of the 1970s criminalized substance use and caused Black and Brown communities to be arrested for drug use two to three times more than white communities, despite the fact that they had similar drug usage rates. This has not only caused a disproportionate incarceration rate for marginalized communities to emerge, but exacerbated a disparity in opioid treatment already amplified by redlining.
The connection between the historic practice of redlining and growing opioid epidemic highlights the impact of systemically racist systems in the United States. Without fair access to opioid use medication and medicines, marginalized communities face higher rates of opioid use and overdose.
If this disparity is not addressed, the opioid treatment gap will only continue to grow.
This article was written as part of a program to educate youth and others about Alameda County’s opioid crisis, prevention and treatment options. The program is funded by the Alameda County Behavioral Health Department and the grant is administered by Three Valleys Community Foundation.
