COVID-19 Reversed Progress Made In Narrowing Racial Mortality Gap

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Following some improvement, excess death rate returned to 1999 levels for Black men and 2005 levels for Black women.

The U.S. made some progress in narrowing its long-standing racial mortality gap during the first decade of this century. But that progress subsequently levelled off and then disappeared entirely in 2020, according to results of a new study.

Researchers used data from the Centers from Disease Control and Prevention (CDC) to compare mortality rates of white and Black Americans between 1999 and 2020. They found that from 1999 to 2011 the excess mortality rate—the difference in the number of Black and white deaths—declined from 404 to 211 per 100,000 individuals for Black males. Among Black females the rate fell from 224 to 87 per 100,000 individuals between 1999 and 2015.

The excess death rate for both genders stayed roughly constant for the next few years before skyrocketing in 2020 due to the start of the COVID-19 pandemic. For Black men the rate increased to 395—its highest since 2000—resulting in 997,623 excess deaths.

The excess death rate for women grew to 192 per 100,000, a rate not seen since 2005, resulting in 628,464 excess deaths compared to whites. All told, the Black population in the US experienced more than 1.63 million excess deaths and more than 80 million excess years of life lost when compared with the White population. Heart disease in both sexes and cancer in men were the largest drivers of differences in excess deaths.

The study also found significant race-based mortality differences among the very young, with Black-white mortality ratios greater than 2.3 for those under one year old.

In addition, the study highlighted the degree to which the COVID-19 pandemic has exacerbated existing racial disparities. The disproportionate vulnerability of the Black population, resulting from higher exposure to infections, financial instability, food insecurity, and psychological distress, contributed to a significant increase in excess mortality compared to the White population.

The authors say their findings should serve as a “call to action,” for policymakers, in that “the sheer scale of the difference [in deaths and years of potential lives lost] requires a revisiting of our national approach to combatting disparities.” The disparities among infants and young children, they add, point to the need for public health policies aimed at early childhood health.

A step towards narrowing the mortality gap, they suggest, would be an annual report of racial differences in mortality and potential lives lost. Such a report could “serve as a major national (and local) gauge of progress toward achieving health equity.”

The study, “Excess Mortality and Years of Potential Life Lost Among the Black Population in the US, 1999-2020” was published May 16 in JAMA1.

This article originally appeared in Medical Economics.

Reference

1. Caraballo C, Massey DS, Ndumele CD, et al. Excess Mortality and Years of Potential Life Lost Among the Black Population in the US, 1999-2020. JAMA. 2023;329(19):1662–1670. doi:10.1001/jama.2023.7022
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