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Mortality Among Black Men in the USA

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Journal of Racial and Ethnic Health Disparities Aims and scope Submit manuscript

Abstract

Importance

Black men have the lowest life expectancy of all major ethnic-sex populations in the USA, yet no recent studies have comprehensively examined black male mortality.

Objective

The purpose of this study was to analyze recent mortality trends for black men, including black to white (B to W) disparities.

Design

The study design was national mortality surveillance for 2000 to 2014.

Setting

The setting was the USA.

Population

All black non-Hispanic males aged ≥15 years old in the USA, including institutionalized persons, were included.

Exposure

The 15 leading causes of death were analyzed.

Main Outcomes and Measures

Linear regression of log-transformed annual age-adjusted death rates was used to calculate average annual percent change (AAPC) in mortality. Black to white (B to W) disparity rate ratios (RR) and 95% confidence intervals (CI) were compared for 2000 and 2014. The most recent available social and economic profile data were obtained from the U.S. Census of Population.

Results

The top five causes of death for black men in 2014, with percentage of total deaths, were (1) heart disease (24.8%), (2) cancer (23.0%), (3) unintentional injuries (5.8%), (4) stroke (5.1%), and (5) homicide (4.3%). Significant mortality declines for 12 of the 15 leading causes occurred through 2014, with the strongest decline for HIV/AIDS (AAPC −8.0, 95% CI −8.8 to −7.1). Only Alzheimer’s disease, ranked #15, significantly increased (AAPC +2.5, 95% CI +1.4 to +3.7). Significant black disadvantage persisted for 10 of the 15 leading causes in 2014, including homicide (RR = 10.43, 95% CI 9.98 to 10.89), HIV/AIDS (RR = 8.01, 95% CI 7.50 to 8.54), diabetes (RR = 1.88, 95% CI 1.82 to 1.93), and stroke (RR = 1.61, 95% CI 1.57 to 1.65). The B to W disparity did not improve for heart disease (RR 1.24 in 2000 vs. RR 1.23 in 2014), but did improve for cancer (RR 1.39 in 2000 vs. 1.20 in 2014). Death rates were significantly lower in black men for five causes, including unintentional injuries (RR = 0.83, 95% CI 0.80 to 0.84), chronic lower respiratory diseases (RR = 0.75, 95% CI 0.73 to 0.78), and suicide (RR = 0.37, 95% CI 0.35 to 0.39).

Conclusions and Relevance

Total mortality significantly declined for black men from 2000 to 2014, and the overall B to W disparity narrowed to RR = 1.21 (95% CI 1.20 to 1.23) in 2014. However, significant black disadvantages relative to white men persisted for 10 leading causes of death.

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Acknowledgements

This study was conducted solely by the author who thanks the anonymous reviewers for their thoughtful suggestions.

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Correspondence to Elizabeth B. Pathak.

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Supplemental Table 1

ICD-10 Cause of Death Codes for the 15 Leading Causes of Death for Black Men in 2014 (DOCX 12.5 kb)

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Supplemental Table 2

All-Cause Mortality Rates (2014) and Average Annual Percent Change (2000–2014) for Statesa, Black Males 15+ Years Old, United States (DOCX 19 kb)

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Pathak, E.B. Mortality Among Black Men in the USA. J. Racial and Ethnic Health Disparities 5, 50–61 (2018). https://doi.org/10.1007/s40615-017-0341-5

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