“Outside the Skin”: The Persistence of Racial Disparities in Early Life Mortality

• In Event: 3129 - Section on Medical Sociology Refereed Roundtables (1 hour)
  In Refereed Roundtable 60min: Table 14. Research at the Intersection of Race and Health

Abstract

We augment current research surrounding rising extrinsic mortality among young- and middle-aged Americans by emphasizing the importance of race and racism as fundamental determinants of mortality early in the lifecourse. We demonstrate that despite overall declines in early life mortality over past decades, black-white disparities in relative mortality have remained largely unchanged across a broad range of causes – especially those considered to be more “preventable” and/or “avoidable.” This paper documents trends in cause-specific early life mortality using data from the National Vital Statistics System (NVSS) Multiple Cause of Death files, which serve as the numerator, and population counts from the Surveillance, Epidemiology, and End Result Program (SEER), which serve as the denominator. We use age-standardized death rates to show how early life all-cause and cause-specific mortality has changed from 1990 to 2016 for sex- and race-specific groups of adolescents and young adults. Our findings show an early life black-white mortality ratio that never drops below 1.14 for women and 1.58 for men, and that in recent years has been worsening. This ratio is largely driven by higher rates of homicide mortality for black youth. White youth have higher rates of suicide and transport mortality; there are no clear race differences in cancer mortality. We argue that addressing race/ethnic differences in early life mortality may require attention to systemic and institutional factors that operate “outside the skin” to acutely affect mortality.

Authors

• Andrea Tilstra, University of Colorado - Boulder

• Iliya Gutin, The University of North Carolina-Chapel Hill

• Nathan T. Dollar, University of North Carolina at Chapel Hill

• Richard G. Rogers, University of Colorado

• Robert A. Hummer, University of North Carolina, Chapel Hill