Black-white differences in avoidable mortality in the USA, 1980-2005

Area of Science:

• Public Health
• Epidemiology
• Health Disparities

Background:

• Avoidable Mortality (AM) encompasses deaths preventable with timely medical care or influenced by public policy and behavior.
• Significant black-white disparities in mortality exist, necessitating analysis of contributing factors.

Purpose of the Study:

• To analyze racial disparities in avoidable mortality between black and white populations.
• To quantify the contribution of different cause-of-death categories to these disparities.

Main Methods:

• Analysis of mortality under age 65 from 1980-2005, categorized by amenability to medical care, policy/behavior influence, ischemic heart disease, HIV/AIDS, and other causes.
• Calculation of age-standardized death rates (ASDRs) for race and sex groups.
• Use of negative binomial regression to model relative risks of death.

Main Results:

• In 2005, mortality amenable to medical care was the largest contributor to absolute black-white mortality disparity (30% for men, 42% for women).
• Policy/behavior-sensitive mortality contributed 20% to disparities in men and 4% in women.
• While absolute disparities decreased for most conditions, relative disparities (rate ratios) remained largely unchanged, except for a substantial increase in HIV/AIDS risks for black individuals.

Conclusions:

• Substantial potential exists to reduce black-white mortality differences by addressing causes amenable to medical care.
• Policy and behavior interventions can further narrow these disparities, particularly for men.