Cause-specific contributions to black-white differences in male mortality from 1960 to 1995

Abstract

Between 1960 and 1995 the black-white difference in male life expectancy in the United States increased from 6.7 years to 8.2 years. To provide insights into why mortality trends have been more adverse for black men than for white men, we investigate which causes of death were principally responsible for changes in the blackwhite difference in male mortality at ages 15-64 between 1960 and 1995. We find that black-white differences in male mortality varied substantially during this period. The gap increased in the 1960s, declined in the 1970s, and widened in the 1980s-early 1990s. Our findings reveal considerable variation in black-white disparities by cause of death and by age, as well as changes in the relative importance of various causes of death to the black-white male mortality disparity over time. The results suggest that consequences of black-white differences in socioeconomic status, access to quality health care, living conditions, and residential segregation vary by cause of death.

Cause-specific contributions to sex differences in adult mortality among whites and African Americans between 1960 and 1995

“…The fifth section considers medical and non-medical factors that may have influenced mortality trends and sex differences in mortality over time. We also relate our findings to those of a previous study on cause-specific contributions to black-white differences in male mortality (Elo and Drevenstedt 2004). The paper thus builds upon and complements previous analyses of cause-specific contributions to black-white and sex differences in all-cause mortality.…”

“…We further find that homicide also made a large contribution to the sex mortality difference and to changes in this difference over time for young African Americans. Homicide also largely explained changes in black-white differences in male mortality over this same period (Elo and Drevenstedt 2004). These results can be traced to large fluctuations in homicide mortality among young African American men.…”

“…Our results suggest that these behavioral changes and improved medical technologies have benefited white men more than white women. In our earlier work, we also found that the decline in cardiovascular disease mortality was more pronounced for white men than for black men, particularly after 1983 (Elo and Drevenstedt 2004). We hypothesize that new methods of treatment and prevention were first available to and adopted by better educated and well off white men and that medical interventions have been slower to benefit individuals from disadvantaged backgrounds.…”

“…A separate model is estimated for each cause of death, and the sum of the slope coefficients, b i , from these models sum to one (see also Elo and Drevenstedt 2004).…”

Losses of Expected Lifetime in the United States and Other Developed Countries: Methods and Empirical Analyses

“…In particular, the U.S. population is characterized by unexpectedly high diversity in age at death compared with the average life span because of relatively high proportions of deaths at ages that are much younger and much older than the average life span. It was also found that during a period of emergence of certain public health problems between the mid-1980s and the mid-1990s (Elo and Drevenstadt 2004;Kochanek et al 1994), the relative interindividual difference in age at death for ages 15 and older increased (Shkolnikov et al 2003). Edwards and Tuljapurkar (2005) carried out an extensive study of potential reasons for temporal changes in the standard deviation of age at death for ages 10 and older (S 10 ), with special focus on its high value in the United States.…”