Study documents staggering toll of health disparities for black Americans

A new study reveals a staggering difference in life expectancy between black Americans and their white counterparts between 1999 and 2020. In an analysis of US data, a Yale-led team of researchers found 1.63 million excess deaths among the black population compared to white Americans , amounting to more than 80 million additional years of potentially lost life.

The findings underscore the urgency to achieve health equity and the need for policymakers and health professionals to address structural racism and health disparities, the researchers said. While some progress was made in reducing inequalities in the early 2000s, the racial gap in death rates stopped and then abruptly widened in 2020, coinciding with the outbreak of the COVID-19 pandemic, leaving the US no better lagged behind than in 1999. said.

The research was published today in the Journal of the American Medical Association (JAMA).

To analyze trends in health disparities, the team examined U.S. death certificate data from the Centers for Disease Control and Prevention (CDC), comparing age-adjusted death rates between the black population and the white population. Separately, they estimated the extra years of potential life lost among the black population — and the subsequent loss of human potential — by comparing the age of premature death to typical life expectancy.

“It’s important to remember that this is not an abstract concept. There is a real human toll on these deep-seated inequalities,” said Marcella Nunez-Smith, MD, MHS, associate dean for health equity research at Yale; CNH Long Professor of Internal Medicine, Public Health and Management, and one of the authors. “The impact on families and communities should be unacceptable to all of us.”

“The results of the study are critical,” said Harlan M. Krumholz, MD, Harold H. Hines, Jr. Professor of Medicine, professor of public health, director of the Yale-based Center for Outcomes Research and Evaluation (CORE), and senior author of the study.

“So far, our efforts to address health equity have failed to produce sustainable improvements in the lives and lost years of Black Americans because of disparities in mortality rates across the age spectrum,” he said.

According to the analysis, heart disease was the largest cause of age-adjusted excess mortality for men and women, followed by cancer for men. The largest racial gap in potential life years lost within the population occurs during the first year of life. Another finding was that the COVID-19 pandemic had a disastrous impact after a short period of progress.

“Despite initial progress in the early 2000s, we found continued higher mortality rates among non-Hispanic black adults,” said César Caraballo, MD, a postdoctoral associate at CORE and the study’s lead author. “The abrupt worsening of these disparities in the first year of the pandemic indicates that current efforts to close the gap in mortality have been minimally effective and progress has been fragile.

“We need targeted strategies that target early childhood health and the prevention of heart disease and cancer, some of the main drivers of these inequalities, to build a more equitable future.”