Abstract
Although the black-white gap in life expectancy has been shrinking in the U.S., national improvement conceals ongoing disparities. Nowhere is this more evident than Washington D.C., where the black-white gap has persistently exceeded 10 years. Using 1999–2017 mortality data from the National Center for Health Statistics, we employed demographic techniques to pursue three aims: first, we created period life tables to examine longevity trends in Washington D.C.; second, we decomposed black-white life expectancy differences into 23 causes of death in three time periods (2000, 2008, 2016); third, we assessed age-specific contributions for each cause of death. Findings revealed that heart disease (4.14 years), homicide (2.43 years), and cancer (2.30 years) contributed most to the 17.23-year gap among males in 2016. Heart disease and cancer contributed most at ages 55–69; homicide contributed most at ages 20–29. Among females in 2016, heart disease (3.24 years), cancer (2.36 years), and unintentional injuries (0.85 years) contributed most to the 12.06-year gap. Heart disease and cancer contributed most at ages 55–69, and unintentional injuries at ages 50–59. Our investigation provides detailed evidence about contributors to the black-white longevity gap in Washington D.C., which can aid in the development of targeted public health interventions.
Highlights
The black-white gap in life expectancy has been shrinking in the U.S, national improvement conceals ongoing disparities
This study found that cardiovascular disease and cancer made the greatest contributions to the black-white life expectancy gap in Washington D.C. in 2013, with injuries making a large contribution among males
Because non-Hispanics are distinct from Hispanics in terms of socioeconomic factors and related health outcomes[9], we focus on mortality disparities between non-Hispanic blacks and non-Hispanic whites
Summary
The black-white gap in life expectancy has been shrinking in the U.S, national improvement conceals ongoing disparities. One recent study assessed how five broadly-defined causes of death (cardiovascular disease, cancer, non-communicable disease, communicable disease, and injury) contributed to the black-white life expectancy gap across all U.S states from 1969–20137. This study found that cardiovascular disease and cancer made the greatest contributions to the black-white life expectancy gap in Washington D.C. in 2013, with injuries making a large contribution among males. The overarching motivation for our investigation is to provide new, detailed evidence about contributors to the black-white longevity gap in Washington D.C., which can be used to create targeted interventions and public health policies
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