Years of progress towards reducing disparities in racial/ethnic group mortality rates in the United States came to a halt between 2009 and 2012, according to a new study in the American Journal of Preventive Medicine, published by Elsevier. Prior to this inflection period, improvements in mortality rates within the African American population had largely been closing the gap. Since then, racial/ethnic mortality rate disparities have been widening rather than shrinking among many age groups, especially the very young and middle-aged.
"After years of progress in reducing racial/ethnic mortality disparities, our study shows that progress among most racial/ethnic and age groups has stalled and/or reversed in the US over the last decade. Alarmingly, we found that the mortality rate of infants and children was twice as high for African Americans than whites and is now on the rise again. While the mortality rate of middle-aged white Americans also increased in this period, the rate for the same age group among African Americans and American Indians remained substantially higher," explained lead investigator Keith P. Gennuso, PhD, University of Wisconsin Population Health Institute, University of Wisconsin-Madison, Madison, WI, USA. "The setback is particularly worrisome because it disproportionately affects those with historically poorer health who continue to face societal barriers."
This research project examined the size of racial/ethnic mortality disparities across age groups and investigated how changing mortality trends have affected these disparities. The extent of disparities was measured using between-group variance, a metric that summarizes the total gap between the mortality rates of five racial/ethnic groups (Asian, American Indian/Alaska Native, African American, Hispanic, and white) from the population average. Trend analysis was performed to examine how trends in between group variance changed over the most recent decade of mortality data.
Recent media coverage and research have focused on increasing mortality rates for middle-aged white Americans. This study confirms this alarming trend and recommends addressing its causes, such as the opioid epidemic, as a priority for public health policy. However, investigators also caution that it should not shift the focus away from the disproportionate health burden of other racial/ethnic and age-specific population subgroups.
Dr. Gennuso explained:
The findings of our research are important at this time because, taken together, they suggest that mortality trends among whites are important and influential to the overall mortality rate and racial/ethnic disparities, but they are not the whole story, especially for younger age groups. This study reinforces a strong body of prior research describing pervasive racial/ethnic disparities in mortality in the US."
The study concludes that effectively addressing the increasing disparities requires solutions that attend to root causes and the needs of specific age and racial/ethnic groups. "It will be important for us to apply lessons learned from our years of progress if we hope to regain what was lost and fully realize the Healthy People 2020 goal to achieve health equity, eliminate disparities, and improve the health of all groups," noted Dr. Gennuso.
Source:
Journal reference:
Gennuso, K.P. et al. (2019) Deaths of Despair(ity) in Early 21st Century America: The Rise of Mortality and Racial/Ethnic Disparities. American Journal of Preventive Medicine. doi.org/10.1016/j.amepre.2019.06.018.