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Estimating Avertable Deaths Based on Comparisons With Healthier Racial and Ethnic Populations 2001-2023
Steven H Woolf1, Derek A Chapman2
1Department of Family Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
Introduction:
Prior efforts to estimate the lives lost to racial-ethnic mortality disparities have focused on the Black-White mortality gap. This study expanded the approach by estimating avertable deaths for multiple racial-ethnic populations and drawing on multiple reference populations for comparisons. Trends over time, by sex, and by state were also examined.
Methods:
Mortality data and population counts for 2001-2023 were obtained in 2025 from the Centers for Disease Control and Prevention for non-Hispanic Black, non-Hispanic White, Hispanic, and non-Hispanic Asian/Pacific Islander populations. Avertable deaths were calculated by direct standardization, drawing comparisons with multiple racial-ethnic populations with lower mortality rates. Temporal, sex-, and state-specific trends in age-adjusted avertable death rates were also examined.
Results:
During 2001-2023, the non-Hispanic Black, non-Hispanic White, and Hispanic populations experienced 1.7-4.5 million, 12.3-21.5 million, and 1.2 million avertable deaths, depending on the reference population used for comparison. Avertable death rates decreased in the first decade of the century but then increased after 2010 in the non-Hispanic White population and after 2013 in the non-Hispanic Black and Hispanic populations, primarily in men, and surged in all populations during the COVID-19 pandemic. States with the highest avertable death rates among non-Hispanic Black, non-Hispanic White, and Hispanic populations were concentrated in the Midwest, South, and Southwest, respectively.
Conclusions:
Racial-ethnic disparities in mortality rates affect multiple U.S. populations and account for an enormous death toll. Using reference populations other than the non-Hispanic White population provides new insights about avertable deaths. Efforts to reduce racial-ethnic disparities will require attention to root causes and socioecologic context.
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