A new report from a study spanning from 2000 to 2019, published Thursday in The Lancet, shows a familiar pattern of racial and ethnic group mortality gaps in the U.S. across 19 different causes of death. The study, examined data from the U.S. National Vital Statistics system and population data from the U.S. National Center for Health Statistics to estimate mortality by age, sex, county, and racial–ethnic group. In total, the researchers collected data from 3,110 counties.
The reports shows that mortality rates of American Indian or Alaska Native (AIAN) and Black populations were substantially higher than among White populations, both nationally and in most of the counties studied. The Black population exhibited higher mortality rates in nearly all counties for diabetes, kidney disease, maternal and neonatal disorders than their White counterparts, while both AIAN and Black populations exhibited higher mortality rates for HIV/AIDS and sexually transmitted infections.
“The consistency of these patterns strongly suggests shared root causes and highlights the widespread, perpetual, and negative impact of systemic racism on health,” said study author Laura Dwyer-Lindgren, PhD, assistant professor at the Institute for Health Metrics and Evaluation (IHME), a Seattle-based research organization whose goal is to provide an evidence-based picture of health trends to help information policy makers, researchers, and funding organizations.
The analysis revealed that for some causes of death there were extremely high disparities in mortality compared to their White counterparts. For instance, the Black populations maternal and neonatal mortality rate of 8.9 per 100,000 is more than two-and-a-half times higher than the rate for the Latino population (3.4 per 100,000) and more than double the rate of the AIAN population (4.2 per 100,000). The AIAN mortality rate of 86.2 per 100,000 of population more than doubled the rate of 35.5 for the White population and national mortality rate of 34.5 per 100,000.
First and second leading causes of death across every racial-ethnic group in the study was from cardiovascular diseases and neoplasms, respectively. The only cause of death among the 19 different causes studied among the White populations was from neurological disorders, which ranked number three for the AIAN and Black populations.
Mortality among Asian and Latino populations nationally, and in many of the counties studied were lower than the White population for most causes of death. The investigator noted that prior research has noted the role played by emigration among these populations which showed that those in good health are more likely to emigrate than those with poor health.
Geographically, the concentration of higher-than-average mortality rates for HIV/AIDS and sexually transmitted infections were found to be concentrated in counties along the Gulf Coast and Atlantic Coast from Texas to North Carolina, as well as in large metropolitan areas across the country. Mortality from substance use disorders were concentrated in counties in Appalachia, with other hotspots in counties in the Eastern U.S., Oklahoma, the Southwest and portions of the Pacific Coast, including Alaska.
Health disparities are well documented but persist in the U.S. and other countries, this new researcher is intended to provide both the racial-ethnic and geographic basis for these disparities with a hope to inform future action.
“The time for intervention was yesterday,” said Ali Mokdad, PhD, professor of Health Metrics Sciences at IHME and chief strategy officer of Population Health at the University of Washington. “Every day that goes by without equitable health care, better programs, and new policies, the U.S. records more unnecessary deaths, especially from diseases that are preventable.
