Mortality gaps between Black and white Americans diminish — except for infants

Americans are extending their lifespans more than ever. Additionally, the gap in overall mortality statistics between Black and white Americans has diminished since the 1950s. However, concerning infants, the division has expanded, with Black infants facing mortality at twice the rate of their white counterparts, as detailed in a recent study.

A group of scholars, including Associate Professor Soroush Saghafian, who leads the Public Impact Analytics Science Lab at Harvard, compiled and evaluated data throughout the U.S. from 1950 to 2019 to observe how mortality rates and disparities have evolved over time.

Overall, life expectancy has improved for both Black Americans (rising from 60.5 years in the 1950s to 76 years in the 2010s, marking a 20.4 percent increase) and white Americans (from 69 years in the 1950s to 79.3 years in the 2010s, reflecting a 13 percent growth), as indicated by the new findings. The racial gap has also shown improvement, although Black adults still experience an 18 percent higher mortality rate.

The scenario for Black infants is considerably more dire. Although mortality rates among both Black and white infants have declined, the disparity has intensified. The mortality rate for Black infants in the 1950s was 92 percent higher compared to their white counterparts, a difference that has now escalated to 115 percent. Medical complications during pregnancy emerged as the foremost contributing factor to excess mortality in the 2010s.

In a modified dialogue, Saghafian elaborates on where these disparities continue to exist and what measures are necessary to address them.

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Life expectancy has trended upward for 70 years, yet the contrast in mortality between Black and white infants has actually worsened. What has occurred since the 1950s?

There is a societal recognition that healthcare has progressed over time in the U.S., and that life expectancy and other healthcare indicators are improving. This study reveals that, although that is indeed true, significant gaps remain between different races, particularly between Black and white Americans.

Focusing on adults, we see positive developments. However, regarding Black infants, they now die at double the rate of white infants, a tremendously concerning statistic. The worsening situation since the 1950s is a pressing matter. Public policy and health authorities ought to prioritize closing such gaps. Ideally, we would standardize these measures across races. Nonetheless, improvements are still feasible.

What contributes to the disparity in infant mortality rates?

We investigated the causes of death and discovered that, for infants, the predominant reasons for excessive mortalities are medical in nature. There exists a regrettable amount of healthcare inequity that is multidimensional. Issues include access to care as well as the quality of care available. A variety of factors contribute to these disparities.

The primary aim of this particular research was not to delve into the reasons but rather to highlight the significant discrepancies. The aspiration is that it will guide further studies to uncover the reasons and advise policymakers on necessary actions. Our work raises an urgent query as to why, over seventy years following World War II, we have yet to find a viable solution for this substantial issue.

Numerous shorter-term studies have also indicated mortality rate disparities among races. What insights does this study provide that others have overlooked?

This is, to my understanding, the first instance where comprehensive data spanning seven decades—entirely from the postwar period—has been compiled and examined. Analyzing shorter periods may obscure the complete reality.

By evaluating an extended timeframe, we can scrutinize all the assertions claiming, “Look, healthcare is advancing”—which is generally accurate. Nonetheless, we are still witnessing improvements in healthcare for both Black and white Americans across multiple aspects.

The challenge lies in the comparisons. For instance, are conditions improving for Black individuals as opposed to white individuals? When we survey metrics like excessive infant and childhood mortality among Black Americans throughout this seven-decade span, it becomes evident not only that conditions haven’t improved, but in fact, they have deteriorated. However, had you only looked at, say, a thirty-year range, you might not grasp this full reality.

Your findings suggest that 5 million Black American lives could have been preserved over the last 70 years. With the disparities now highlighted, what should come next?

As I noted, we didn’t delve into the specifics of the causes, and I believe that requires significant attention from both researchers and public policy and health authorities. Concurrently, our findings generate vital questions for both researchers and policymakers.

This represents a critical alert. Our findings are indicating: Look, we could have preserved 5 million Black Americans’ lives if they had had the same opportunities as white Americans. This in turn raises a crucial question: What should be the priorities for public policy and health officials moving forward in the coming decades?