Inequality in mortality between Black and White Americans by age, place, and cause and in comparison to Europe, 1990 to 2018

Hannes Schwandt, Janet Currie, Marlies Bär, James Banks, Paola Bertoli, Aline Bütikofer, Sarah Cattan, Beatrice Zong Ying Chao, Claudia Costa, Libertad González, Veronica Grembi, Kristiina Huttunen, René Karadakic, Lucy Kraftman, Sonya Krutikova, Stefano Lombardi, Peter Redler, Carlos Riumallo-Herl, Ana Rodríguez-González, Kjell G. SalvanesPaula Santana, Josselin Thuilliez, Eddy van Doorslaer, Tom van Ourti, Joachim K. Winter, Bram Wouterse, Amelie Wuppermann

Research output: Contribution to journalReview articlepeer-review

Abstract

Although there is a large gap between Black and White American life expectancies, the gap fell 48.9% between 1990 and 2018, mainly due to mortality declines among Black Americans. We examine age-specific mortality trends and racial gaps in life expectancy in high- and low-income US areas and with reference to six European countries. Inequalities in life expectancy are starker in the United States than in Europe. In 1990, White Americans and Europeans in high-income areas had similar overall life expectancy, while life expectancy for White Americans in low-income areas was lower. However, since then, even high-income White Americans have lost ground relative to Europeans. Meanwhile, the gap in life expectancy between Black Americans and Europeans decreased by 8.3%. Black American life expectancy increased more than White American life expectancy in all US areas, but improvements in lower-income areas had the greatest impact on the racial life expectancy gap. The causes that contributed the most to Black Americans’ mortality reductions included cancer, homicide, HIV, and causes originating in the fetal or infant period. Life expectancy for both Black and White Americans plateaued or slightly declined after 2012, but this stalling was most evident among Black Americans even prior to the COVID-19 pandemic. If improvements had continued at the 1990 to 2012 rate, the racial gap in life expectancy would have closed by 2036. European life expectancy also stalled after 2014. Still, the comparison with Europe suggests that mortality rates of both Black and White Americans could fall much further across all ages and in both high-income and low-income areas.

Original languageEnglish (US)
Article numbere2104684118
JournalProceedings of the National Academy of Sciences of the United States of America
Volume118
Issue number40
DOIs
StatePublished - Oct 5 2021

All Science Journal Classification (ASJC) codes

  • General

Keywords

  • Age-specific mortality
  • Area-level socioeconomic status
  • International comparison
  • Life expectancy
  • Racial divide

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