Young Black men in cities across America died of drug overdoses at high rates in the 1980s and 1990s. During the recent fentanyl crisis, older Black men in many cities have been dying at unusually high rates.

They’re all from the same generation.

An investigation of millions of death records — in a partnership between The New York Times, The Baltimore Banner, Big Local News and nine newsrooms across the country — reveals the extent to which drug overdose deaths have affected one group of Black men in dozens of cities across America at nearly every stage of their adult lives.

In recent years, the opioid epidemic has brought dangerous drugs to every corner of the country, and overdoses have risen among younger, whiter and more rural populations.

That huge tide now appears to be ebbing — but not for this group of Black men. In the 10 cities examined in this partnership, including Baltimore, Chicago, San Francisco, Washington, Milwaukee, Philadelphia and Newark, New Jersey, Black men ages 54 to 73 have been dying from overdoses at more than four times the rate of men of other races.

“They were resilient enough to live through a bunch of other epidemics — HIV, crack, COVID, multi-drug-resistant tuberculosis — only to be killed by fentanyl,” said Tracie M. Gardner, the executive director of the National Black Harm Reduction Network.

In all, the analysis identified dozens of cities, mostly in the Northeast and Midwest, where a generation of Black men were at higher risk of overdose deaths throughout their lives. In many of those places, cities have done little to distribute resources to this population.

The details vary from city to city.

• In Chicago, there is no focused effort in nearly $1.3 billion of state opioid settlement money to help older Black men, despite a heavy death toll for this group, the Chicago Sun-Times found.

• In Pittsburgh, Black men in jail with opioid use disorders have been less likely to receive medications to combat their addictions than white men, a PublicSource investigation has found, though local officials are working to close the gap.

• In San Francisco, many of the men vulnerable to overdoses use both opioids and cocaine, a combination that may make treating their addictions more complex, according to an analysis of mortality data by The San Francisco Standard.

• In Baltimore, hundreds of men have been dying in senior housing, The Baltimore Banner found.

• In Philadelphia, older Black men were actually less likely to die than their white peers — until recently. By 2018, their death rate had shot up, according to a Philadelphia Inquirer analysis.

— In Washington, local regulations and insurers have prevented doctors from giving longtime opioid users effective doses of drugs meant to curb their cravings, reporters for The 51st found.

‘Dying for Decades’

Black men of this generation, born from 1951 to 1970, came of age at a time of wide economic disparities between Black and white people in their cities. Some of them served in Vietnam, where they were first exposed to heroin. In cities where heroin was available, others started using the drug closer to home in the 1970s and ‘80s, and became addicted.

Many have continued to use drugs on and off for decades.

Mark Robinson, 66, grew up in Washington and now runs a syringe exchange program in the city.

He estimates he knows 50 people who have died over the years from overdoses, including one of his best friends.

“Black men didn’t just start dying,” he said. “We’ve been dying for decades as a direct result of opioid use disorder.”

The cities with this pattern of drug deaths tend to be places with large Black populations, intense residential segregation and heroin markets that were active in the 1970s, when the oldest of these men were young and first became exposed to illicit drugs, according to Dr. Dan Ciccarone, a professor of family and community medicine at UC San Francisco.

‘Heroin epidemic’

“Heroin has become an endemic problem,” he said. “It never went away.”

In addition to the risk of overdose, men of this generation lived through convulsions in public health and criminal justice. In the 1980s, some became exposed to HIV through drug injections. In the 1990s, more aggressive sentences for drug crimes meant many of them spent time in jails or prisons.

Several public health researchers said widespread incarceration may have reduced these men’s chances of staying clean. “You’re basically disarming them from having a good life,” said Ricky Bluthenthal, a professor of public health atUSC, who has studied injection drug users for decades.

“They lose girlfriends, they lose houses, they lose connections to their children.”

They have lived through the social upheavals of COVID-19, a period of isolation that coincided with an increase in the overdose rate for nearly all groups.