The epidemic of drug overdoses, often perceived as a largely white rural problem, made striking inroads among black Americans last year — particularly in urban counties where fentanyl has become widespread

These are the first numbers from the Centers for Disease Control and Prevention to break down 2016 mortality along geographic and racial lines. They reveal that the drug death rate is rising most steeply among blacks, with those between the ages of 55 and 64 hit hardest. Drug deaths among blacks in urban counties rose by 41% in 2016, far outpacing any other ethnic group. In those same counties, the drug death rate among whites rose by 19%. The data suggests that the common perception of the epidemic as an almost entirely white problem rooted in over-prescription of painkillers is not accurate, as fentanyl, often stealthily, invades broader swaths of the country and its population. Driven by the continued surge in drug deaths, life expectancy in the United States dropped for the second year in a row last year. It is the first consecutive decline in national life expectancy since 1963. Drug overdoses have now surpassed heart disease as the leading cause of death for Americans under the age of 55. Andrew Kolodny, the co-director of opioid policy research at Brandeis University’s Heller School for Social Policy and Management, said it appeared that many of the black deaths were among older men who had become addicted to heroin during a previous epidemic in the 1970s. “Despite beating the odds for the past 40 to 50 years,” he said, “they’re dying because the heroin supply has never been so dangerous — increasingly it’s got fentanyl in it or it’s just fentanyl sold as heroin.” Fentanyl-laced cocaine, too, may be playing a role. A recent study found that cocaine-related overdose deaths were nearly as common among black men between 2012 and 2015 as deaths from prescription opioids in white men over the same period. Cocaine-related deaths were slightly more common in black women during that period than deaths from heroin among white women, according to the study. But it also found that the largest recent increases in overdose deaths among blacks were attributed to heroin. One of the researchers, David Thomas of the National Institute on Drug Abuse, said that he did not know whether some of the cocaine-attributed deaths in the study were from fentanyl. The study, by researchers at the National Cancer Institute and the National Institute on Drug Abuse, also found that the recent rise in overdose death rates was sharpest among older blacks. The same held true last year in New York City. In Ohio, which had the nation’s second-highest overdose rate last year (West Virginia was first), the medical examiner in Cuyahoga County told a U.S. Senate subcommittee in May 2017 that a fast-rising rate of fentanyl-related deaths among blacks was probably a result of drug dealers mixing fentanyl with cocaine. In Cuyahoga County, home to Cleveland, fentanyl contributed to the death of five black people in 2014, 25 in 2015 and 58 in 2016, although both opioids and cocaine still kill far more whites than blacks there.