Life expectancy gap between Black and white Americans has closed nearly 50% in 30 years, study finds
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 had 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."
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.
More information: "Inequality in mortality between Black and White Americans by age, place, and cause and in comparison to Europe, 1990 to 2018," PNAS (2021). DOI: 10.1073/pnas.2104684118 , www.pnas.org/content/118/40/e2104684118
"""Pengo la matarajio ya maisha kati ya Wamarekani weusi na wazungu limezidi 50% katika miaka 30,"" utafiti unaonyesha ""Pengo la matarajio ya maisha kati ya Wamarekani weusi na wazungu limeonyeshwa na janga la COVID-19.""" "Hata hivyo, pengo hilo limepungua kwa karibu asilimia 50 katika miongo mitatu, hasa kwa sababu ya maendeleo kati ya Wamarekani weusi, kulingana na utafiti uliochapishwa katika ""Proceedings of the National Academy of Sciences"" (PNAS)." Utafiti huo uliofanywa na watafiti wa Chuo Kikuu cha Princeton, ulichunguza data kutoka mwaka 1990 hadi 2018 ili kulinganisha viwango vya vifo kati ya Wamarekani weusi na wazungu. Pia walilinganisha Marekani na Ulaya ili kutoa kulinganisha kwa kiwango. Katika mwaka wa 1990, watu weusi wa Marekani waliishi miaka saba chini ya wazungu. Lakini kufikia mwaka 2018, idadi hiyo ilikuwa imeshuka hadi miaka 3.6. Uboreshaji wa matarajio ya maisha katika kaunti maskini hasa imesaidia kupunguza pengo, hasa kwa sababu Wamarekani weusi ni uwezekano mkubwa wa kuishi katika maeneo maskini. Kupungua kwa vifo vya weusi vinavyosababishwa na kansa, VVU, mauaji, na hali za kiinitete na watoto wachanga kulikuwa muhimu hasa katika kufunga mapungufu. Hata hivyo, muda wa kuishi kwa watu wa jamii zote nchini Marekani umepungua tangu mwaka 2012, na wazungu wa Marekani wamepoteza nafasi kwa kulinganishwa na Wazungu katika maeneo tajiri na maskini. Ugonjwa wa opioid nchini Marekani ni moja ya sababu muhimu za kupungua kwa idadi ya watu wanaotumia dawa za kulevya, lakini watafiti wanasema kwamba kazi zaidi inapaswa kufanywa ili kuchunguza sababu nyingine. Kama maendeleo yangeendelea kwa kiwango cha awali, pengo la rangi katika matarajio ya maisha lingekuwa limezidi kufikia 2036. "Ni muhimu kutambua mafanikio halisi ambayo yametokea katika miaka 30 iliyopita, na kuelewa sababu za mafanikio hayo, ""alisema Janet M. Currie, Profesa wa Uchumi na Masuala ya Umma wa Henry Putnam na mkurugenzi mwenza wa Kituo cha Afya na Ustawi cha Princeton." "Upatikanaji uliozidi kuwa bora wa huduma za afya na programu za usalama wote ulichangia uboreshaji wa muda wa kuishi miongoni mwa Wamarekani weusi. "Hata hivyo, kuna mabadiliko haya ya kushangaza ya mwenendo mzuri kwa makundi yote tangu 2012 ambayo tunahitaji kuelewa vizuri zaidi. """ "Wakati wa janga la COVID-19 na harakati ya ""Black Lives Matter,"" tofauti kubwa ya afya kati ya Wamarekani weusi na wazungu ilionyeshwa, lakini watafiti walitaka kupima tofauti hizi katika suala la mwenendo wa matarajio ya maisha katika miaka kabla ya janga hilo." Kwa kufanya hivyo, walichanganua data kutoka kwa Mfumo wa Kitaifa wa Takwimu za Maisha na Kituo cha Kitaifa cha Takwimu za Afya kinachoendeshwa na Vituo vya Udhibiti na Kuzuia Magonjwa vya Marekani. Utafiti huo ulifanyika ili kujua kama tofauti za rangi katika muda wa kuishi zimekuwa tofauti katika maeneo tajiri na maskini ya Marekani. Waliorodhesha kaunti za Marekani kulingana na viwango vyao vya umaskini na kuziweka katika vikundi vya ukubwa wa idadi ya watu. Hii iliwaruhusu kuchambua mwenendo katika umri na jamii katika maeneo yenye viwango sawa vya umaskini. Kwa mfano, watu wenye umri wa zaidi ya miaka 65 wanastahili Medicare, ambayo inaweza kuwa na jukumu katika kupanua maisha. Pia walitaka kuelewa jinsi Marekani ilivyolinganishwa na Ulaya ili kuamua kama vifo katika sehemu tajiri za nchi ni sawa na ile ya nchi za Ulaya, au kama wote wawili matajiri na maskini Wamarekani huwa nyuma. Watafiti kutoka nchi tisa za Ulaya, ikiwa ni pamoja na Czech Republic, Uingereza, Finland, Ufaransa, Ujerumani, Uholanzi, Norway, Ureno na Uhispania, walifanya kazi kwa pamoja ili kuchanganua data zote katika mfumo kama huo. Nchi hizi zinawakilisha hali mbalimbali za kiuchumi. Katika miongo mitatu iliyopita, Wamarekani weupe wamekuwa wakishindwa zaidi na zaidi kuliko Wazungu. Nchini Ulaya, hata nchi maskini kama Ureno ziliweza kukutana na nchi tajiri kufikia mwaka 2018 katika muda wa maisha, wakati Marekani ilibaki nyuma. Kwa upande mwingine, matarajio ya maisha ya Wamarekani weusi yalianza chini sana ya viwango vya Ulaya na wazungu wa Amerika mnamo 1990, lakini ilikua kwa kasi zaidi kuliko matarajio ya maisha ya Ulaya. Kwa mujibu wa ripoti hiyo, muda wa kuishi katika Ulaya pia umepungua baada ya mwaka 2014, na hilo linaonyesha kuwa kuna sababu ya kuathiri maisha ya watu wengi. Utafiti wa hivi karibuni umeunganisha kupungua kwa muda wa kuishi nchini Marekani na ukosefu wa maendeleo zaidi katika kupambana na magonjwa ya moyo na mishipa ya damu, na hii inaweza pia kuwa kweli katika Ulaya. Kwa kushangaza, kuna maendeleo makubwa katika afya ya watoto wachanga na watoto katika makundi yote matatu, ingawa hasa miongoni mwa Wamarekani weusi. Programu za usalama kama vile Medicaid, Programu ya Msaada wa Lishe ya Ziada (SNAP), na Mikopo ya Kodi ya Mapato ya Kupata, pamoja na viwango vya chini vya uchafuzi katika maeneo maskini, zote ni mchango muhimu kwa kupunguza vifo. Marekani ina uwezo wa kufikia Ulaya kwa kuwekeza katika afya ya mama na mtoto. "Uchunguzi wa ""Usawa katika vifo kati ya Wamarekani weusi na wazungu kwa umri, mahali, na sababu na kwa kulinganisha na Ulaya, 1990 hadi 2018"" (PANAS 2021) " "Kama ilivyoelezwa katika taarifa ya ""P.O. No. 1010713-P.O. No. 101068418-P.O. No. 111068418-P.O. No. 111068418-P."