Mortality rates for some causes of death are declining for Black Americans, but disparities compared with white people still persist and are widening for some causes, a new study suggests.
For the study, researchers examined death-certificate data collected from 1999 to 2020 by the U.S. Centers for Disease Control and Prevention (CDC) to calculate mortality rates for Black people relative to white people. They looked at the most common causes of death for males and females, including fatalities due to COVID-19 during the pandemic.
Heart Disease and Cancer Deaths Are Down, but Deaths From Assaults, Accidents, and Suicide Are Up
Behind these numbers, there’s a mixed picture of gains and setbacks.
For Black females, excess age-adjusted mortality rates declined by an average of 5.7 percent annually until 2015, driven by improvements in heart disease, diabetes, cancer, accidents, and stroke. After that, gains went away, and COVID-19 contributed to a spike in excess deaths from 2019 to 2020.
Among Black males, excess age-adjusted mortality rates declined by an average of 5.2 percent annually until 2011, driven by lower rates of cancer, heart disease, accidents, and HIV. But over the rest of the study period, those gains stopped, and COVID-19 fatalities led to a surge in excess deaths from 2019 to 2020.
There were also large increases in racial disparities in mortality rates from accidents, heart disease, stroke, and assaults starting in 2012 for Black males and in 2016 for Black females. While stresses imposed by the COVID-19 pandemic likely exacerbated these disparities, it’s clear the problems predated the pandemic, says the lead study author, Adith Arun, of the Yale School of Medicine in New Haven, Connecticut.
“Racial disparities for external causes of death — assaults, accidents, suicide — have increased significantly in recent years,” Arun says. “I think a number of things probably contributed, including but not limited to easier access to firearms, political division, food and housing insecurity, inflation, the rising cost of healthcare, and the unaffordability of daily living.”
The Study Had Some Limitations
One limitation of the study is that death certificates sometimes provide incomplete or inaccurate information about causes of death and demographic characteristics, according to the study.
Beyond this, the study only focused on whether gaps in mortality rates between Black and white people widened or narrowed. Researchers didn’t report on whether, for example, gaps narrowed because of gains for Black people or setbacks for white people in cases where disparities decreased.
Consider high blood pressure, a major risk factor for death from causes like heart disease and stroke. Disparities persist for these causes of death in part because high blood pressure is more common among Black people than other racial or ethnic groups, and also in part because treatment is suboptimal among Black people, says George Howard, DrPH, a public health professor at the University of Alabama at Birmingham who wasn’t involved in the new study.
“The Black-white difference could be reduced by better treatment by physicians to better control blood pressure, particularly in the Black population,” Dr. Howard says. “This is really important to do; however, it does not affect the issue that the prevalence is higher in the Black population.”
How to Lower the Risk of Premature Death
There are steps everyone, of every race and ethnicity, can take to minimize their risk of premature death from many of the causes examined in the study, Arun says.
“Things that I would recommend everybody do is to ask questions about their health, seek care from healthcare providers who listen to them, and engage in preventative measures such as resistance training, eating fresh vegetables and protein, walking, and sleeping eight-plus hours a day,” Arun advises.
