Reparations for African enslavement in the United States and Black survival using the panel study of income dynamics

Activists, policymakers, and scholars increasingly have advocated for reparations payments to Black Americans to redress the harms of enslavement and discriminatory practices that followed. This study examined the effects of a hypothetical monetary reparations intervention on all-cause premature and overall mortality among Black adults in the United States. We used the Black-white wealth gap to calculate monetary costs, modeling the effects of wealth influxes of $905 426.10 (in 2019 USD) to each Black household (the amount necessary to eliminate the mean Black-white wealth gap), distributed over 10 years. We applied a target trial emulation framework to data in the Panel Study on Income Dynamics (n = 16 010). Each Black household head or spouse/partner was followed from baseline until death, incomplete follow-up, 18 years after baseline, or the end of follow-up in 2019, whichever occurred first. Using the g-formula to account for time-fixed and time-varying confounders, we found a 29% reduction in premature mortality and a 25.6% reduction in overall mortality among Black adults under the reparations intervention. Our findings provide evidence that reparations are a lifesaving and justice-promoting social policy that could significantly contribute to efforts to eliminate health inequities. This article is part of a Special Collection on Methods in Social Epidemiology.