African Americans have made significant gains in life expectancy, and the mortality gap between white and black Americans has been cut in half since 1999, the Centers for Disease Control and Prevention reported Tuesday.
Blacks experienced a 25 percent drop in their overall death rate, compared to a 14 percent decrease for whites, between 1999 and 2015. Deaths from heart disease, cancer and stroke declined sharply among blacks 65 and older, and in that age group, blacks now have a lower death rate than whites, the CDC said.
But its report shows that the United States has a long way to go before it achieves health equity. Blacks in every age group under 65 continue to have significantly higher death rates than whites. Black life expectancy at birth is about 3½ years lower than that of whites.
“The disparity in deaths between black and white populations is closing,” Leandris Liburd, associate director of the CDC’s Office of Minority Health and Health Equity, said in a teleconference with reporters. “Even so, critical disparities remain.”
The CDC looked at multiple health and mortality trends among blacks and whites and found that, over the 17-year period, the racial disparity in “all-cause” mortality among whites and blacks had narrowed from 33 percent to 16 percent. The report does not address to what extent the change was affected by eroding health and rising death rates among midlife white Americans, much of which has been attributed to “diseases of despair” such as drug overdoses, suicide and alcohol-related liver diseases.
Embedded within the trends for African American health are some troubling statistics. Although blacks are now far less likely to die of HIV than in 1999, they are seven to nine times more likely than whites to succumb to the disease. And blacks have seen no significant improvement in the rate of deaths from homicide during the period examined.
They still are far more likely than whites to live in poverty, be unemployed, and/or lack home ownership. They're also more likely to report that they can't afford medical care. Their obesity rate is higher.
At relatively young ages — in their 20s, 30s and 40s — blacks have relatively high death rates from diseases such as diabetes and heart disease that among whites are found more commonly at older ages, according to the report.
“For example, blacks in age groups 18-34 and 35-49 were nearly twice as likely to die from heart disease, stroke, and diabetes as whites,” it notes. “These findings are generally consistent with previous reports that use the term 'weathering' to suggest that blacks experience premature aging and earlier health decline than whites, and that this decline in health accumulates across the entire life span and potentially across generations, as a consequence of psychosocial, economic, and environmental stressors.”
Stressed Liburd: “We know there is more work to be done.”
Laudan Aron, a senior fellow with the Urban Institute, said researchers will need to dig more deeply into the data to get a full understanding of what's happening with American mortality trends.
"It’s great that the all-cause mortality gap between blacks and whites fell from 33% in 1999 to 16% in 2015, but much of this narrowing appears to have happened prior to 2009," she said in an email. "The opioid epidemic, increases in suicide, a drop in U.S. life expectancy for the first time in two decades are all pointing to dramatic changes in the health and survival of Americans. The real story, including disparities by race, is much more complicated than this report suggests."
Ellen Meara, a professor at the Dartmouth Institute for Health Policy & Clinical Practice, also had a mixed response to the new report.
"My enthusiasm for these impressive gains in mortality is dampened by the stunning mortality gap between blacks and whites that remains in 2015," she wrote in an email. "Combined with an uptick in deaths due to external causes (accidental injuries, homicides, drug poisonings and related causes) between 2014 and 2015 offsetting some of the mortality gains since 1999, those reading this report should be vigilant to ensure continued survival gains among black Americans."