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Gap Between Black and White Life Expectancy Has Nearly Halved Since 1990 – But (There’s Always a “But”)

Gap Between Black and White Life Expectancy Has Nearly Halved Since 1990 – But (There’s Always a “But”)

Persistent gaps in life expectancy between Black and white Americans have been highlighted by the COVID-19 pandemic. Yet, this gap has narrowed by nearly 50% in three decades, largely due to improvements among Black Americans, according to a study published in the Proceedings of the National Academy of Sciences  (PNAS).

Co-authored by researchers at Princeton University’s Center for Health and Wellbeing, the study analyzed data from 1990 to 2018 to compare mortality rates between Black and White Americans, through the lens of place. They also compared the United States with Europe to provide a benchmark comparison.

They found that in 1990, Black Americans lived seven years fewer than whites. But by 2018, that number dropped to 3.6 years. Life-expectancy improvements in the poorest counties particularly helped narrow the gap, largely because Black Americans are more likely to live in the poorest areas. Reductions in Black deaths caused by cancer, HIV, homicide, and fetal and neonatal conditions were especially important in closing the gaps.

Yet, life expectancy has stalled for all groups in the United States since 2012, and, white Americans have lost ground relative to Europeans in both rich and poor areas. The U.S. opioid epidemic is one important cause of these declines, but the researchers suggest that more work should be done to investigate additional factors. If improvements had continued at the earlier rate, the racial gap in life expectancy would have closed by 2036.

“It is important to recognize the very real gains that have occurred over the past 30 years, and to understand the reasons for them” said Janet M. Currie, , the Henry Putnam Professor of Economics and Public Affairs and co-director of Princeton’s Center for Health and Wellbeing. “Improved access to health care and safety-net programs all contributed to improvements in life expectancy among Black Americans. Yet, there is this perplexing reversal of the positive trends for all groups since 2012 that we need to better understand.”

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Both the COVID-19 pandemic and the Black Lives Matter movement highlighted the disproportionate health gap between Black and white Americans, but the researchers wanted to quantify these differences in terms of trends in life expectancy in the years before the pandemic struck. To do this, they analyzed data from the National Vital Statistics System and the National Center for Health Statistics run by U.S. Centers for Disease Control and Prevention.

Their goal was to see whether racial differences in life expectancy have evolved differently in richer and poorer parts of the United States. They ranked American counties based on their poverty rates and placed them into groups of fixed population size. This allowed them to analyze trends across ages and race in places with the same relative poverty rates. Factoring in age is important in order to account for whether changes in life expectancy are based on a person’s stage of life; for example, people older than 65 qualify for Medicare, which could play a role in extending life expectancy.

They also wanted to understand how the United States compared to Europe to determine whether mortality in richer parts of the country is more similar to that of European countries, or whether both rich and poor Americans tend to lag behind. They collaborated with researchers in nine European countries, including Czech Republic, England, Finland, France, Germany, Netherlands, Norway, Portugal and Spain in order to analyze all of the data in a similar framework. These countries represent a range of economic conditions.

During the past three decades, white Americans have increasingly fallen behind Europeans. Within Europe, even relatively poor countries like Portugal, were able to catch up with richer countries by 2018 in terms of life expectancy, while the United States lagged behind. At the same time, life expectancy for Black Americans started far below both European and white American rates in 1990, but grew at a faster rate than European life expectancy.

Similar to the United States, European life expectancy also has stalled after 2014, suggesting that there may be a common element. Past work has linked the flattening of life expectancy in the U.S. to a lack of further improvement in the fight against cardiovascular disease, and this may also be true in Europe, the authors suggest.

Interestingly, there have been significant health improvements for infants and children, in all three groups, though especially among Black Americans. Safety-net programs such as Medicaid, the Supplemental Nutrition Assistance Program (SNAP), and the Earned Income Tax Credit, as well as lower levels of pollution in poor areas, are all important contributors to reduced mortality. There also is potential for the U.S. to catch up to Europe by investing in maternal and child health.

The paper, “Inequality in Mortality between Black and White Americans by Age, Place and Cause, and in Comparison to Europe, 1990-2018,” first appeared online Sept. 28 in the Proceedings of the National Academy of Sciences.

Co-authors of the study are from Northwestern University, Erasmus School of Economics, University of Manchester, University of Verona, Norwegian School of Economics, Institute for Fiscal Studies, University of Coimbra, Universitat Pompeu Fabra, University of Milan, Aalto University,  VATT Institute for Economic Research, University of Munich, Lund University, Université Paris 1, and University of Halle.

New Study: Covid-19 Shaved Up to 8 Years From Average Lifespan

New Study: Covid-19 Shaved Up to 8 Years From Average Lifespan

At its peak, COVID-19 drastically reduced the average human lifespan — by as much as nine years in one U.S. state — according to a new longevity metric developed at UCLA. 

Sociology professor Patrick Heuveline devised the metric, called the mean unfulfilled lifespan, to assess the impact of temporary “shocks” like the novel coronavirus on average length of life. To date, the pandemic has claimed the lives of more than 4.2 million people worldwide.    

The tool allows demographers to conduct fine-grained analyses in specific regions over various periods of time, offering a new and more dynamic way of gauging how different areas of the country and the world experience decreases in lifespans over the course of the pandemic, Heuveline said.

Heuveline’s analysis, published online  in the open-access journal PLOS One, suggests, for example, that as COVID-19 peaked in New Jersey in mid-April 2020, the average lifespan in the state plummeted by almost nine years, the most dramatic example from the U.S.

UCLA sociologist Patrick Heuveline
UCLA sociologist Patrick Heuveline

Demographers typically calculate lifespan using a metric known as period life expectancy at birth, or PLEB, which is the average number of years a person born at a certain time would be expected to live if future death rates remained at present levels. When researchers factor in the impacts of a given cause of death — a steady increase in heart attacks or car accidents, for instance — they see how these factors can reduce PLEB.

However, calculating changes to life expectancy in this way cannot adequately capture the effect of large, temporary shocks like natural disasters or the COVID-19 pandemic, in which mortality conditions are rapidly shifting, Heuveline said.

To more clearly illustrate the impact of such phenomena, Heuveline’s mean unfulfilled lifespan measures the difference between the average age at death of individuals who died within a given time frame and the average age these people would have been expected to reach had there not been a temporary shock.

“As did a few other demographers, I initially tried to convey the mortality impact of COVID-19 by assessing how much life expectancies would decline during the pandemic,” he said. “When mortality conditions are continuously changing, however, life expectancies are hard to interpret, and I wanted to provide a more intuitive indicator of that mortality impact.” 

► Read about Patrick Heuveline’s previous research on COVID-19 and life expectancy.

Heuveline demonstrated the mean unfulfilled lifespan by applying it to COVID-19 mortality data from regions with similarly sized populations, including New Jersey, Mexico City, Lombardy in Italy, and Lima, Peru. He compared decreases in life expectancy by calendar quarter (from March 31, 2020 to March 31, 2021) and using rolling seven-day windows (from March 15 to June 15, 2020). The latter analysis suggested that the mean unfulfilled lifespan peaked at 8.91 years in New Jersey, 6.24 years in in Mexico City, 6.43 years in Lombardy and 2.67 in Lima. 

In addition, his study found that during the month of April 2020, the mean unfulfilled lifespan may have reached 12.7 years in the Guayas province of Ecuador.

Heuveline noted that uncertainties in calculating mean unfulfilled lifespan may arise from potential differences between deaths related to temporary shocks like the pandemic and actual or excess deaths — differences that, when accounted for, may push the peak unfulfilled lifespan figures seen in the study even higher. His analysis demonstrates how these issues can be factored into calculations.

Heuveline said he hopes the new metric will eventually be applied broadly as researchers seek to better understand the impact of epidemics, natural disasters and even violence on life expectancy.