Black-White Differences in Avoidable Mortality in the United States, 1980-2005

This article examines differences in avoidable mortality between black and white Americans. The authors examine the overall difference in avoidable mortality rates and the proportionate contribution of different causes of deaths to overall avoidable mortality.

Avoidable mortality, defined as premature mortality of people under age 65, can be categorized into five causes of death:

  • conditions that can be treated with medical care;
  • conditions that can be affected by public policy and behavioral change;
  • HIV/AIDS;
  • ischemic heart disease; and
  • all other causes of death for this age group.

The authors used census data and vital statistics from 1980 though 2005 to construct age-standardized death rates. They calculated rate differences in mortality and the proportionate contribution of various causes of death to assess black-white disparities in avoidable mortality.

Key Findings:

  • In 2005, the largest source of white-black avoidable mortality disparity was death due to conditions amenable to medical care. This cause of death was the source of 30 percent of the disparity between white and black men, and 42 percent of the disparity between white and black women.
  • Deaths from conditions that can be addressed with public policy and behavioral changes are responsible for 20 percent of the avoidable death disparity between white and black men, but only 4 percent of the disparity between white and black women.
  • The absolute disparity on avoidable mortality between whites and blacks has narrowed over time. However, the relative risk of death due to HIV/AIDS has increased substantially for black men and women.

Substantial opportunities exist to narrow the gap between white and black avoidable mortality by  addressing deaths caused by conditions responsive to medical care, public policy and behavior change.