The Evolution of the Racial Gap in U.S. Life Expectancy
Population health in the United States has improved dramatically over the past century. At the beginning of 1900, a person born in the United States was expected to live 47.3 years, compared with 78.6 years in 2017. Life expectancy went down by about 28% from 1914 to 1918, as a result of World War I and the 1918 Spanish flu claiming 117,465 and about 675,000 American lives, respectively.
The past few decades have seen a plateauing of life expectancy of Americans along with a rise in deaths due to various causes—including Alzheimer, Parkinson and hypertension* and, more recently, suicide, alcoholism and drug overdose.These deaths were coined “deaths of despair” by Angus Deaton and Anne Case, in their book Deaths of Despair and the Future of Capitalism. And a new cause has emerged: As per the National Center for Health Statistics (NCHS) of the Centers for Disease Control and Prevention (CDC), the COVID-19 pandemic has contributed to the decrease in life expectancy by 1.5 years. How lasting are the effects of COVID-19 on U.S. life expectancy remains to be seen in the coming years.
Life expectancy is defined as the average number of years a person is expected to live given a certain age. Life expectancy at birth (LEB)Life expectancy as shown in figure is period life expectancy. Period life expectancy estimates use mortality rates at one point in time (e.g., a specific year) instead of mortality rates that change throughout a cohort’s lifetime. in the United States from 1900 to 2017 is shown in the figure below (the blue line).
Life Expectancy at Birth, by Race
SOURCES: NCHS, National Vital Statistics System and authors’ calculations.
NOTES: Data end in 2017. For 1900 to 1969, Black life expectancy is based on data for the nonwhite population. From 1970 onward, the Black life expectancy is based on data for the Black or African American population. Both white and Black definitions include people of Hispanic and non-Hispanic origin.
Improving and Converging
Health outcomes have improved for all Americans. Because of systemic differences in access to health (PDF), Black Americans in 1900 were expected to live only 33 years—14.6 fewer years than white Americans. We saw remarkable convergence until 2017 (latest data available), when Black Americans were expected to live 75.3 years—3.5 fewer years than white Americans. While important and large systemic differences still exist, the dramatic closing of the gap mirrors convergence in other measures of well-being, such as education and income.
What Is Driving the Convergence?
Although we can see that there has been a convergence in LEB by race, it is important to know what is driving that change. Recently there have been studies into the convergence of life expectancy in Black and white Americans.
The table below shows that while heart-related improvements were the largest contributors to the increased life expectancy from 1980s to 2000s, cancer and accidents (including homicides) were the largest contributors to the convergence (the narrowing gap) in life-expectancy from 1980s to 2000s. Over that period, Black Americans increased their life expectancy by almost as much as white Americans for certain causes of death; in the case of heart-related deaths, it was 3.2 years versus 3.3 years, respectively. For other causes, Black Americans improved their life-expectancy by more than the gains experienced by white Americans, possibly because of improved access to health care system; in the case of cancer, the increase was one year versus six months, respectively.
Similarly, largely due to lower homicide rates (PDF), which are included under accidents, Black Americans have gained roughly seven months relative to white Americans. Another study uses geographical data from 1990 to 2018 and age-specific death rates to find that on top of cancer and homicides, HIV and fetal or infant mortality are the additional contributors to the closing of the gap in life expectancy across white and Black Americans.
|White Americans||Black Americans|
|Total Change in Years||3.2||4.9|
|By Cause of Death|
|All Other Causes||-0.6||-0.2|
|SOURCE: Sanghi, Siddhartha. “Health Inequality: The Role of Insurance and Technological Progress (PDF)” Unpublished manuscript, Dec. 31, 2021.|
|NOTES: Life expectancy is conditional on surviving until the age of 20. 1980s is computed by the U.S. Census Bureau’s National Longitudinal Mortality Study (NLMS) 6a wave 6-year average mortality rates; 2000s is computed by NLMS 6c wave 6-year average mortality rates. Individual contributions don’t necessarily add to the total because they don’t include the iteration terms in the decomposition.|
There have been huge gains in Black LEB compared to white LEB since 1900, likely because of improved access to the health care system and higher education as well as increased income. While there still exists large systemic racial differences in economic opportunity and overall health and well-being, it is important to understand and learn from the dramatic convergence over the past century.
* This post was updated to note other causes of death rising in recent decades.
Notes and References
- These deaths were coined “deaths of despair” by Angus Deaton and Anne Case, in their book Deaths of Despair and the Future of Capitalism.
- Life expectancy as shown in figure is period life expectancy. Period life expectancy estimates use mortality rates at one point in time (e.g., a specific year) instead of mortality rates that change throughout a cohort’s lifetime.