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Premature deaths climbing among Black Americans

The racial divide in excess deaths narrowed in the early 21st century, but has since widened, according to a new study.
Premature deaths climbing among Black Americans
Posted at 11:10 AM, May 16, 2023

In a study published Tuesday in the Journal of the American Medical Association, the U.S. Black population had more than 1.63 million excess deaths when compared with the White population from 1999 to 2020. 

The Centers for Disease Control and Prevention defines excess deaths as "the difference between the observed numbers of deaths in specific time periods and expected numbers of deaths in the same time periods."

The disparities were greater for men compared to women.

The data indicated that the Black population lost more than 80 million excess years of life when compared with White Americans from 1999 to 2020. 

“These are deaths that did not have to be except for the social determinants of our society,” said study author Harlan M. Krumholz of Yale School of Medicine. “Race is a social construct, and this harm is certainly mediated through social determinants, including structural racism.”

Although there was a period of progress in reducing disparities between Black and White Americans, the differences between the two races worsened in 2020, authors noted. 

“Black people in (the) U.S. incur a staggering toll of excess deaths and years lost,” Krumholz wrote. “Recent progress was obliterated early in the pandemic, and it had stalled anyway. We need new thinking, new investments, new action.”

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From 1999 through about 2011, the disparity in excess deaths improved, according to the study. From 2012 through 2019, the data indicated that disparities leveled off before the loss of progress in 2020. The study noted that disparities in the toll COVID-19 took on Black Americans worsened the gap.

“The implications of these findings are important,” the authors wrote. "The Black population in the U.S., regardless of cause or the burden of risk factors, continue to die at much greater rates than the White population, with dramatic long-run consequences when accounting for the effect of premature mortality. These metrics, especially years of potential life lost, are suitable for public reporting and may inspire strategies directed toward more in-depth root-cause analysis and where qualified by evidence of efficacy, implementation of steps to improve these disparities.”

The researchers said heart disease among both men and women as well as cancer deaths among men were huge drivers for the disparities. 

“This study should serve as a call to action — especially for policymakers — as we highlighted and contextualized the substantial toll of structural racism on life in the U.S.,” the authors wrote. “ Although the specific causes and drivers of differences in deaths and years of potential life lost are multifactorial and warrant further study, the sheer scale of the difference requires a revisiting of our national approach to combatting disparities."

Krumholz was joined by nearly a dozen co-authors representing major academic and research institutions including Northwestern, Harvard and UCLA.

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An annual CDC survey found from 2019 through 2021, Black Americans had higher rates of obesity and hypertension. The study found, however, that White Americans had higher cancer rates. One potential reason for this is that cancer most affects seniors. While just 2.2% of people ages 18-44 had cancer in 2021, 22.7% of Americans ages 65-74 had cancer. Cancer rates jumped to 30.9% for Americans over age 75. 

The CDC lists the life expectancy for White Americans at 76.4 years, nearly six years higher than Black Americans.


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