Residents with physical labor jobs in Massachusetts are more susceptible to substance use, opioid addiction, and fatal overdose. A study published by the Department of Public Health examines opioid-related overdose deaths by industry and occupation from 2011 to 2015. It found that construction workers; farm, fishing, and forest workers; and transportation and warehouse workers have the highest rate of overdose death.

The data included in the study indicate that opioids pose the greatest threat to Hispanics working in natural resources, construction, and maintenance occupations; followed by service occupations. Of Hispanics working in natural resources, construction, and maintenance, there were 76 (or 26%) fatal overdoses recorded, and in service occupations there were 66 (or 22.6%) overdoses recorded. For Black, non-Hispanics in service occupations, there were 51 (or 32.1%) recorded fatal overdoses.

Opioid-related Overdose Deaths by Industry

Data via Department of Public Health

Data via Department of Public Health

When we look at the data from a perspective of income, the risk for Hispanics and Black, non-Hispanics is clearer. The median income ranges with the highest overdose rate was $40,000–$49,999 followed by $20,000–$29,999 and <$20,000.

According to the U.S. Census American Community Survey, in 2010 the per capita income for Hispanics in Massachusetts was $15,098; in 2014 is jumped slightly to $16,889. For Black, non-Hispanics during those same time periods, the per capita income was $19,554 and $21,725.

This means Hispanics and Black, non-Hispanics are susceptible to opioid-related overdoses, even if they aren’t in service or natural resources, construction, and maintenance occupations. Without more access to educational services and opportunities to rise through income levels and tax brackets, Hispanics and Black, non-Hispanics will continue to be at high risk.

Image via Department of Public Health

Image via Department of Public Health


It may come as no surprise that these vulnerable industries and jobs are ones in which workers have high rates of work-related injuries and illness, lower availability of paid sick leave, and lower job security. Because of this, workers who sustain injuries in these professions are widely prescribed opioids to manage the pain.

A 2011 review of studies analyzing the use of prescribed opioids among workers receiving workers’ compensation found the average percent of injured workers prescribed opioids was 31.8%. In addition, 25% of workers’ compensation were for opioid pain medication.

It’s important to note that there was a 24% decline in the average amount of opioid use per injured worker between 2010–2012 and 2013–2015 in Massachusetts, meaning harm reduction strategies are showing signs of effectiveness, according to the Department of Public Health.

“Work-related injuries often serve as the initiation for opioid pain medication, which can subsequently lead to opioid misuse,” said Public Health Commissioner Monica Bharel, MD. “Ensuring that jobs are safe, that the risk of injury is low and that workers have the time for rehabilitation and are not self-medicating to keep working are all key to decreasing opioid overdose deaths among workers.”

But perhaps the biggest takeaway here is that when it comes to the Massachusetts workforce, employees in low-wage, labor-intensive jobs that don’t require extensive higher education are more likely to develop an addiction to opioids and are more likely to suffer an overdose death as a result.

The study reviewed 4,302 opioid-related overdose deaths via Massachusetts death certificates. Statistical data for people who identify as Hispanic and black, non-Hispanic (the populations Gándara Center supports and promotes) may be an underestimate. According to the study, “death certificates among these racial/ethnic groups were more likely to have missing industry and occupation information,” and were therefore excluded.