Racial/ethnic mortality disparities widen among many age groups

A new study in the American Journal of Preventive Medicine demonstrates progress reversals fall disproportionately among African American and American Indian infants and children


Ann Arbor, September 24, 2019

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 shrinking. 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,” explained lead investigator Keith P. Gennuso, PhD, University of Wisconsin Population Health Institute, University of Wisconsin–Madison, WI, USA.

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.

“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,” continued Dr. Gennuso. “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. The setback is particularly worrisome because it disproportionately affects those with historically poorer health who continue to face societal barriers.”

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.

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Notes for editors
The article is “Deaths of Despair(ity) in Early 21st Century America: The Rise of Mortality and Racial/Ethnic Disparities,” by Keith P. Gennuso, PhD, Courtney K. Blomme, RDN, Marjory L. Givens, PhD, MSPH, Elizabeth A. Pollock, PhD, and Anne M. Roubal, PhD (https://doi.org/10.1016/j.amepre.2019.06.018). It will appear in the American Journal of Preventive Medicine, volume 57, issue 5 (November 2019) published by Elsevier.

Support for this research project was provided in part by the Robert Wood Johnson Foundation and the Wisconsin Partnership Program.

Full text of this article is available to credentialed journalists upon request; contact Jillian B. Morgan at +1 734 936 1590 or ajpmmedia@elsevier.com. Journalists wishing to interview the authors should contact Toni Williams at +1 301 280 5737 or twilliams@burness.com.

About the American Journal of Preventive Medicine
The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. The journal features papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women's health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and alcohol and drug abuse. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. The journal also publishes official policy statements from the two co-sponsoring organizations, health services research pertinent to prevention and public health, review articles, media reviews, and editorials. www.ajpmonline.org

About Elsevier
Elsevier is a global information analytics business that helps scientists and clinicians to find new answers, reshape human knowledge, and tackle the most urgent human crises. For 140 years, we have partnered with the research world to curate and verify scientific knowledge. Today, we’re committed to bringing that rigor to a new generation of platforms. Elsevier provides digital solutions and tools in the areas of strategic research management, R&D performance, clinical decision support, and professional education; including ScienceDirect, Scopus, SciVal, ClinicalKey and Sherpath. Elsevier publishes over 2,500 digitized journals, including The Lancet and Cell, 39,000 e-book titles and many iconic reference works, including Gray's Anatomy. Elsevier is part of RELX, a global provider of information-based analytics and decision tools for professional and business customers. www.elsevier.com

Media contact
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