Disclosures: The authors report no relevant financial disclosures.
October 11, 2021
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Life expectancy gap between Black and white Americans diminishes by 48.9%

Disclosures: The authors report no relevant financial disclosures.
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The gap in life expectancy between Black and white Americans has narrowed over the past 3 decades from 7 years to 3.6 years, according to a study published in the Proceedings of the National Academy of Science.

Precisely, the life expectancy for Black Americans has improved from 69.1 years in 1990 to 74.9 years in 2018, while white Americans had a life expectancy of 76.1 years in 1990 and 78.5 years in 2018, Janet M. Currie, MA, PhD, the Henry Putnam Professor of Economics and Public Affairs and co-director of Princeton’s Center for Health and Wellbeing, told Healio Primary Care.

Graphical depiction of data included in article.
Schwandt H, et al. Proc Natl Acad Sci USA. 2021;doi:10.1073/pnas.2104684118.

Meanwhile, the U.S. has lagged behind many European countries, including poorer nations, in life expectancy.

“Although there is still a gap between Black and white life expectancy, the gap closed by 48.9% between 1990 and 2018. This is largely because life expectancy improved for Black Americans,” Currie said. “Black Americans gained relative to Europeans, while white Americans in rich areas began with similar life expectancy to Europeans but then fell behind.”

Janet M. Currie

Currie and colleagues analyzed national and international mortality rates from 1990 to 2018 to determine age-specific mortality trends and racial gaps in life expectancy in high- and low-income counties in the U.S. compared with England, France, Germany, the Netherlands, Norway and Spain. The researchers stratified age groups by 0 to 4, 5 to 19, 20 to 64 and 65 to 79 years.

Changes in life expectancy by age group

In 1990, the life expectancy gap between Black and white children in the youngest age group was “huge,” according to Currie and colleagues. Among children aged 0 to 4 years, the mortality rate was 4.2 deaths per 1,000 Black children compared with 1.82 deaths per 1,000 white children. Both mortality rates decreased by 2018 to 2.31 per 1,000 Black children and 1.13 per 1,000 white children. Improvements in life expectancy occurred more rapidly between 1990 and 2005, followed by “slow progress” from 2005 to 2018, the researchers wrote.

Children aged 5 to 19 years in the U.S. had higher levels of mortality during the study period compared with children in the same age group in Europe. By 2005, the gap between European children and white American children was wider than the gap between Black and white American children, according to the researchers.

Among adults aged 20 to 64 years, the mortality rate of Black Americans fell rapidly, particularly in the lowest-income areas, Currie and colleagues reported. In the highest-income areas of the U.S., the mortality gap between Black and white Americans had declined to 0.7 deaths per 1,000 persons by 2018. In contrast, the gap was 1.47 per 1,000 persons in the lowest-income areas.

The data further showed that Black and white adults aged 65 to 79 years experienced mortality declines in high- and low-income areas. In 2018, white Americans had an overall mortality rate of 27 deaths per 1,000 persons. Black Americans in low-income areas had a mortality rate of 32 deaths per 1,000 persons.

Life expectancy for Black and white Americans converged between 1990 and 2012. During this period, the researchers found that Black individuals’ life expectancy improved at a faster rate than white Americans. However, improvements in both groups stalled after 2014, first plateauing and then falling between 2015 and 2018. While European life expectancy also fell during this period, it remained higher than American life expectancy. The lack of improvements in life expectancy may have been driven by “the plateauing of mortality improvements due to cardiovascular disease,” Currie and colleagues wrote. They also attributed recent declines in U.S. life expectancy to the opioid epidemic, gun violence and high levels of infant mortality. Meanwhile, improvements in cancer care and HIV prevention had the largest impact on improving life expectancy in the U.S., they wrote.

Recent reductions in life expectancy

Healio Primary Care previously reported that life expectancy in the U.S. fell more so during 2019 to 2020. CDC data indicated that life expectancy for Americans declined by 1.5 years, overall. COVID-19 was a primary cause of the decline, as well as unintentional injuries, homicide, diabetes, chronic liver disease and cirrhosis. The life expectancy among Black individuals in the U.S. decreased from 74.7 years to 71.8 years. Among white individuals, life expectancy decreased from 79.9 years to 77.6 years.

Moreover, the COVID-19 pandemic has shortened aggregate life expectancy by more than 9 million years, according to findings published in Annals of Internal Medicine. Researchers found that Black and Hispanic individuals lost more than twice as many quality-adjusted life years per capita compared with white individuals.

“Despite the strong mortality improvements among Black Americans over the past three decades, a dramatic gap remains, and this gap has increased again in recent years,” Currie and colleagues wrote. “It is important to understand which medical, social and policy developments helped to increase the longevity of Black Americans through 2012 and how these positive changes can be reinforced over the coming decades with the ultimate goal of fully closing the racial longevity gap in the U.S.”

References:

Life expectancy gap between black and white Americans closes nearly 50% in 30 years. https://spia.princeton.edu/news/life-expectancy-gap-between-black-and-white-americans-closes-nearly-50-30-years. Published Sept. 28, 2021. Accessed Oct. 5, 2021.

Provisional life expectancy estimates for 2020. https://www.cdc.gov/nchs/data/vsrr/vsrr015-508.pdf. Published July 2021. Accessed Oct. 6, 2021.

Schwandt H, et al. PNAS. 2021;doi:10.1073/pnas.2104684118.