Race now plays smaller role in Americans' risk of dying young

WEDNESDAY, April 25, 2018 -- The racial gap between black and white Americans for dying early has narrowed, but opioid overdose deaths among whites might be fueling part of that otherwise positive trend.

The new findings stem from an analysis of death records between 1990 and 2014, which tracked "years of life lost," meaning the difference between an individual's projected natural life span and the actual age of death.

During that time frame, the years-of-life-lost figure for blacks plummeted by 28 percent, the researchers reported.

"This is largely driven by declining heart disease, HIV and cancer death rates in black adults in their 30s and 40s," explained study author Jeanine Buchanich. She is a research associate and professor of biostatistics at the University of Pittsburgh Graduate School of Public Health.

"We think that this is a positive finding that should be further explored to guide future public health efforts," she added. "And [it] indicates that racial disparities in mortality are not inevitable."

Still, during the same period, some white Americans saw their risk for an early death rise in equally dramatic fashion.

For example, among white women aged 25 to 54, the years-of-life-lost figure jumped 26 percent, likely attributable to the ever-growing opioid crisis in the United States.

Dr. David Katz, director of the Yale University's Prevention Research Center, described the findings as "definitely a good news/bad news scenario."

On the plus side, said Katz, are the fruits of public health efforts to improve access to health care, health care information and social support among those who have traditionally lacked that access.

On the other hand, he noted that "the increased burden of years of lost life for white Americans, especially women, due to substance abuse, is a national tragedy."

Across the entire American population, the annual number of years of life lost dropped by 10 percent during the study time frame.

But digging deeper, the data revealed unique racial trends.

Asian Americans had lower "lost life" numbers than whites and blacks across all age groups and all causes.

But at all ages, white Americans were more likely than blacks to die an early death due to substance abuse, such as opioid painkillers including Oxycontin.

Whites only experienced a 4 percent overall drop in the years-of-life-lost figure because -- although the risk fell among infants, children and seniors -- white adults saw that figure rise by 6 percent.

In contrast, blacks saw their "lost life" numbers fall across all ages, ranging from a drop of 48 percent among children to 25 percent among seniors, and adding up to a 28 percent decrease overall.

Although homicide rates among black men aged 20 to 64 dropped during the 1990s, there was no additional decrease since 2000, the study found. And young blacks are still more likely than young whites to be killed at an early age.

In addition, older blacks are also still more likely to die a premature death due to heart disease than older whites, the researchers noted.

Buchanich stressed that she and her colleagues "are not implying that this finding indicates that the problem has been solved."

But, "if recent trajectories continue, adult black/white disparities in years of lost life will continue to narrow," she said.

Katz, meanwhile, stressed that American health is inevitably a reflection of American society.

"Everything a culture does with implications for wealth and poverty, haves and have-nots, translates into health outcomes," he said. "Perhaps above all, this paper is a timely reminder of the opportunity to improve health by looking beyond health care, to the ramifications of culture and its expressed priorities at large."

The study was published online April 25 in the journal PLOS One.

More information

There's more on American death rates at the U.S. Centers for Disease Control and Prevention.