Racial differences in health in the United States: A long-run perspective

The United States has a long and ongoing history of racial inequality. This chapter surveys the literature on one aspect of that history: long-run trends in racial differences in health. We focus on standard measures such as infant mortality and life expectancy but also consider available data on specific diseases and chronic conditions. Our basic conclusion is that large improvements have occurred in the average health of African Americans during the 20th century, both in absolute terms and relative to whites. These health advancements occurred steadily throughout the 20th century, with the peak period of improvement between 1920 and 1945 (infant mortality) and 1940 and 1960 (overall life expectancy). We attribute the improvements to successful efforts to fight specific diseases, improvements in public health, and narrowing of racial gaps in education and income. Although racial inequality in health outcomes has fallen in the long term, significant disparities remain today.