The Contribution of Health Care and Other Interventions to Black–White Disparities in Life Expectancy, 1980–2007

Abstract

Black–white mortality disparities remain sizable in the United States. In this study, we use the concept of avoidable/amenable mortality to estimate cause-of-death contributions to the difference in life expectancy between whites and blacks by gender in the United States in 1980, 1993, and 2007. We begin with a review of the concept of “avoidable mortality” and results of prior studies using this cause-of-death classification. We then present the results of our empirical analyses. We classified causes of death as amenable to medical care, sensitive to public health policies and health behaviors, ischemic heart disease, suicide, HIV/AIDS, and all other causes combined. We used vital statistics data on deaths and Census Bureau population estimates and standard demographic decomposition techniques. In 2007, causes of death amenable to medical care continued to account for close to 2 years of the racial difference in life expectancy among men (2.08) and women (1.85). Causes amenable to public health interventions made a larger contribution to the racial difference in life expectancy among men (1.17 years) than women (0.08 years). The contribution of HIV/AIDS substantially widened the racial difference among both men (1.08 years) and women (0.42 years) in 1993, but its contribution declined over time. Despite progress observed over the time period studied, a substantial portion of black–white disparities in mortality could be reduced given more equitable access to medical care and health interventions.

Homicides In Mexico Reversed Life Expectancy Gains For Men And Slowed Them For Women, 2000–10

“…16,17 We grouped causes of death into eight categories (for details on the International Classification of Diseases [ICD] codes for each cause, see online Appendix Table 1). 18 …”

“…We analyzed homicide, diabetes, ischemic heart disease, and HIV/AIDS separately from other conditions because homicide and diabetes represent major causes of death in Mexico, 5 and all of these conditions are amenable to both health behavior change and medical service. 16 …”

“…19 And third, health care and policy or behavior interventions tend to be more effective at younger ages. 16 …”

Black–White Disparities in Adult Mortality: Implications of Differential Record Linkage for Understanding the Mortality Crossover

“…The black-white disparity in U.S. mortality rates is wide and enduring throughout much of the life course as a result of the socioeconomic disadvantages, barriers to quality healthcare, and institutional- and individual-level discrimination experienced by the black population (Elo et al 2014; Jackson et al 2011; Rogers et al 2000; Williams and Sternthal 2010). In 2014, life expectancy at birth was 75.2 years among non-Hispanic black (hereafter “black”) individuals and 78.8 years among non-Hispanic white (hereafter “white”) individuals, a difference of 3.6 years (Kochanek et al 2016).…”

The Healthy Community Neighborhood Initiative: Rationale and Design

“…[11][12][13][14] There is limited understanding, however, of the best strategies for improving individual health outcomes and reducing health disparities in communities where physical and social conditions undermine efforts to prevent and manage chronic conditions. [15][16][17][18][19] An emerging literature suggests that interventions developed through community-academic partnerships have the potential to translate Objective: To describe the design and rationale of the Healthy Community Neighborhood Initiative (HCNI), a multicomponent study to understand and document health risk and resources in a low-income and minority community.…”