Black-White Life Expectancy Gap Narrows

MONTREAL, March 16 -- White Americans still have longer life expectancies than black Americans, but the gap has narrowed in recent years, researchers here reported.

In the decade from 1993 to 2003 the female gap narrowed by about a year, from 5.59 years to 4.54 years, according to a study in the March 21 issue of the Journal of the American Medical Association. For men the time of narrowing was almost twice as great.

These findings suggest a reversal of trend observed during the 1980s, when the gap between black and white life expectancy increased by 0.5 years for women and by two years for men, said Sam Harper, Ph.D., of McGill University.

Dr. Harper and colleagues analyzed U.S. vital statistics data from the U.S. National Vital Statistics System, a database maintained by the National Center for Health Statistics.

They calculated mortality rates by age and cause of death using software from the National Cancer Institute's Surveillance Research Program. Those data were then analyzed using standard life expectancy table techniques in order to sort specific racial changes in age-specific mortality according to relative changes in the distribution of causes of death.

Dr. Harper said most of that widening gap during the 1980s half can be explained by mortality due to HIV and significant cardiovascular mortality.

By contrast, the one-year narrowing of the gap between black and white women reflected reduced cardiovascular mortality, a reduction in homicides, and fewer fatal accidents.

Among men, 91% of the decline occurred among males ages 15 to 49. The improvement was attributable to fewer deaths from homicide, HIV, and fewer fatal accidents.

For men, the narrowing of the gap was stalled by a lack of improvement in heart disease mortality among older black men. Cardiovascular disease was the leading cause of differences in black-white life expectancy.

"If all cardiovascular causes and diabetes are considered together, they account for 35% and 52% of the gap for males and females, respectively," he said.

Moreover, "unfavorable trends in nephritis and septicemia are currently contributing to widening the gap," he said.

The researchers concluded that "future efforts to reduce the black-white gap should be aimed at reducing existing inequalities in cardiovascular risk factors, particularly hypertension, and improving access to effective treatment for existing disease that remain underused."