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

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Summary

Introduction

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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