Reductions in the death rate from homicide, HIV disease, unintentional injuries - and among women, heart disease - have contributed to narrowing the life expectancy gap between blacks and whites in the United States, although substantial inequalities and challenges remain, according to a study in the March 21 issue of JAMA.

Life expectancy at birth has generally been increasing in the United States since at least the late 19th century. For as long as data have been reported by race/ethnicity, life expectancy of blacks has been lower than that of whites, according to background information in the article. Since the early 1980s, the black-white life expectancy gap increased sharply, then subsequently declined. But the causes of these changes have not been investigated.

Sam Harper, Ph.D., of McGill University, Montreal, Quebec, and colleagues conducted a study to determine the contribution of specific age groups and causes of death to changes in the black-white life expectancy gap from 1983 to 2003. They analyzed data from the U.S. National Vital Statistics System, maintained by the National Center for Health Statistics, which collects information on all deaths occurring in the United States each year.

The authors report that after widening during the late 1980s, the black-white life expectance gap has declined because of relative mortality improvements in homicide, HIV disease, unintentional injuries - and among women, heart disease.

"For females, heart disease made by far the largest contribution to the overall life expectance gap, accounting for 1.4 years (28 percent) of the gap in 1983, 1.6 years (28 percent) in 1993, and 1.3 years (30 percent) in 2003," the authors write. "Other important causes of the 4.5-year gap in 2003 include diabetes (0.5 years), stroke (0.4 years), and perinatal death (0.4 years)."

"Among males, the largest contribution to the gap was homicide in 1983 (1.1 years) and 1993 (1.6 years)
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Contact: Lisa Van Dusen
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JAMA and Archives Journals
16-Mar-2007