Death rate gap between Black, White Americans hits a 20-year high

By Madison Muller

The gap in death rates between Black and White Americans remained wide over the last two decades and worsened during the pandemic, according to a study finding massive differences in excess mortality between the populations.
 

Black people in the US saw more than 1.6 million excess deaths when compared to the country’s White population over the last two decades, resulting in roughly 80 million extra years of potential life lost during that time, according to the findings published Tuesday in the Journal of the American Medical Association. Age-adjusted death rates ranged from 21% to 40% higher among Black males and from 13% to 31% higher among Black females compared with their White counterparts.

The US had made some progress toward improving health outcomes for Black Americans in the early 2000s, but it soon faltered, the researchers said. At the onset of the Covid-19 pandemic in early 2020, excess death rates among Black Americans skyrocketed to their highest rate since 1999, erasing signs of recovery seen over the last two decades, a team led by Yale University researchers found. 

“A considerable and recalcitrant health gap remains entrenched for Black Americans,” said Harlan Krumholz, a cardiologist at the university and Yale New Haven Hospital who helped write the study. “The takeaway message: Time to make health equity a reality.”

The team examined more than 20 years of US death certificate data from the Centers for Disease Control and Prevention to make the comparison. By comparing the age of premature death against typical life expectancy for Black Americans, the researchers were also able to estimate total years of potential life lost among the Black population. Their findings reveal the enormous toll that continued, overlapping health crises have had on Black Americans for whom there is often an outsized impact due to “structural racism, unmet social needs, and systemic bias,” the authors said.

“This study should serve as a call to action — especially for policymakers,” they said.

In the two decades the study looked at, deaths from heart disease were the largest overall contributor to excess mortality rates between Black and White Americans. For both men and women, excess death rates from other leading causes like cancer and diabetes generally decreased over the study period, although deaths due to assault increased for Black men. 

Covid’s pernicious impact on Black Americans in the first year of the pandemic indicates that efforts to decrease health disparities between Black and White Americans have been “minimally effective and that progress has been fragile,” said César Caraballo, a postdoctoral associate at Yale New Haven and the study’s lead author.

At the beginning of the pandemic, Covid death rates for Black Americans were nearly three times higher than death rates among White Americans. Vaccines and treatments have since helped to close that gap, but government data show that Black Americans are still about 1.6 times more likely to die of Covid than their White counterparts. Black children died of Covid-19 at almost three times the rate of White children, according to a study published in March. 

Differences in loss of life were most prominent among infants. The US Centers for Disease Control and Prevention estimates that infant mortality rates for Black babies are about 2.4 times higher than rates for White babies.