Black Americans experienced 1.6 million excess deaths compared to White population over 22-year period, study finds

New research highlights health gap for Black Americans

Despite years of efforts to reduce health disparities, a new study is calling attention to the drastic differences in mortality that continue to take a toll among Black Americans.

Researchers found the Black population in the United States experienced more than 1.63 million excess deaths — and more than 80 million excess years of life lost — compared to the White population over a recent 22-year period, from 1999 through 2020. 

"After a period of progress in reducing disparities, improvements stalled, and differences between the Black population and the white population worsened in 2020," the authors write in the study, published Tuesday in the medical journal JAMA

"Heart disease had the highest excess mortality rates, and the excess years of potential life lost rates were largest among infants and middle-aged adults," the study notes.

Along with heart disease in both men and women, cancer, especially in males, was a major driver of differences in excess deaths. 

Excess deaths are typically defined as the "difference between the observed numbers of deaths in specific time periods and expected numbers of deaths in the same time periods," according to the Centers for Disease Control and Prevention.

"All the disadvantage that Black people incur ends up being translated both at very young ages and in middle age and older age into enormous amounts of years lost in early death. And this is really, I think, something that's unacceptable," Dr. Harlan Krumholz, an author of the study with Yale School of Medicine, told CBS News.

Race is a social construct, he adds, meaning it doesn't have a strong root in biology. 

"People aren't born predetermined that their life expectancies are going to be shorter, but by where they live, the exposures that they have, the way the medical care system treats them simply because of their race," he says.

In 2020, the last year included in the study, COVID-19 emerged as a leading cause of death that also took a disproportionate toll on Black Americans. COVID had the highest age-adjusted excess mortality rate among Black men that year and was second-highest, after heart disease, among Black women.

"It led us back to a situation where we were no better than we were 20 years ago," Krumholz says. "These are preventable deaths and it's just up to us to configure society in a way that's responsive to the needs of this community and can recognize our obligation to eliminate these disparities "

The authors say these findings show the need to assess progress and indicates a need for new approaches to promote health equity in the U.S. They also called out the troubling impact of health disparities on children.

"The sobering disparity noted in this study among infants and during childhood accounted for a markedly elevated number of excess deaths and an even more pronounced disparity in years of potential life lost," they wrote.

Using national data from the CDC, the study focused on differences between non-Hispanic Black and non-Hispanic White populations to understand recent trends in disparities between these two specific groups.  "Subsequent studies using data from other racial, ethnic and socioeconomic groups would be needed to have a complete understanding of mortality inequities in the U.S." the authors note.

Racial disparities in health outcomes and death rates have been seen in a number of specific areas in prior studies.

The number of women who die during or shortly after childbirth, for example, is higher in the U.S. than any other developed nation, particularly among women of color. 

U.S. maternal mortality hit six-decade high in COVID, highest in Black women

Determining the cause of that racial disparity poses "essentially one of the biggest challenges of public health," Dr. Henning Tiemeier, the director of Harvard's Maternal Health Task Force, told CBS News' "Face the Nation" last year. Every year in the U.S., roughly 700 women die while in labor or within the first month of giving birth, Tiemeier said, noting that most of these deaths are "preventable."

"We see that as a top of the iceberg of poor health in women and poor health in Black women," Tiemeier added. "And there are several reasons, there seems to (be), from poverty to discrimination to poor care for this group of women."

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