Black infants still face significantly greater risk for death vs. white infants

Key takeaways:

• Mortality rates were 92% higher in Black vs. white infants in the 1950s and 115% higher in the 2010s.
• Nearly 690,000 deaths among Black youth could have been avoided if mortality rates were equal.

Black infants have consistently faced a risk for mortality almost twice that of white infants in the United States over the past 70 years, an analysis in Annals of Internal Medicine showed.

Researchers said millions of avoidable deaths among Black Americans have occurred as a result.

The data are consistent with those of other studies investigating mortality rates among diverse groups in the U.S. One review showed that Black individuals had the lowest life expectancy at birth from 2006 to 2019 and the highest mortality rate from ages 15 to 80 years in 2019.

“The question of whether this excess burden of death contributes to persistent disparities in both childhood and adult mortality is important for the optimal targeting of policy and public health interventions,” Angel Paternina-Caicedo, MD, MSc, from the National University of Colombia in Colombia, and colleagues wrote.

However, such an inquiry “has been addressed only by studies focused on recent and relatively limited time periods,” they added.

In the current analysis, the researchers analyzed 1950 to 2019 mortality data taken from the U.S. Census Bureau and CDC to calculate life expectancy, mortality rates and potential years of life lost among white and Black Americans, and determine the age- and sex-specific excess mortality burden.

The gap in life expectancy between white and Black Americans decreased over the study period, with life expectancy at birth among Black Americans rising by 15.5 years for a 20.4% increase.

However, Paternina-Caicedo and colleagues reported that the mortality rates in the 1950s for Black and white infants were 5,185 and 2,703 deaths per 100,000 people, respectively, for an excess mortality ratio of 1.92 (95% CI, 1.91-1.93).

“This means 92% greater mortality in Black infants,” Paternina-Caicedo and colleagues wrote.

In the 2010s, the mortality rates for Black and white infants were 1,073 and 499 deaths per 100,000, respectively. This translates to a 115% increase in mortality in Black infants vs. white infants, and an excess mortality ratio of 2.15 (95% CI, 2.13-2.17).

Overall, 5 million excess deaths among Black Americans — including 689,724 among infants and those aged 1 to 19 years — could have been avoided over the last several decades if mortality rates among Black and white children were equal, according to the researchers.

They explained that the causes of these findings “are embedded in a history of race-based inequity and discrimination against the Black population of the U.S.”

They pointed out that several social determinants of health among Black Americans are associated with higher mortality, including lower education and income, food insecurity and worse health insurance coverage.

Paternina-Caicedo and colleagues acknowledged some study limitations, such as possible underreporting of deaths and, thus, underestimation of excess burden of disease among Black Americans.

Regarding addressing the inequities tied to these racial disparities, “we recommend both redoubled public health efforts [and] innovative social, economic, and health care policies such as increasing the transparency of quality-of-care outcomes,” they concluded.