Opioid overdose death rates increased by 38% among non-Hispanic Black individuals in 67 communities in four states between 2018 and 2019. During the same period, the overall opioid overdose death rate in the four states (Kentucky, Massachusetts, New York, and Ohio) had started slowing leveling off, rising 3%, from 38.3 per 100,000 in 2018 to 39.5 per 100,000 in 2019. For people of other races/ethnicities there was no change in the opioid overdose death rate. The 67 communities were participating in the HEALing Communities Study, a large trial testing a community engagement intervention. The . . .