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Long-Term Trends in Adult Mortality for U.S. Blacks and Whites: An Examination of Period- and Cohort-Based Changes

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Demography

Abstract

Black–white differences in U.S. adult mortality have narrowed over the past five decades, but whether this narrowing unfolded on a period or cohort basis is unclear. The distinction has important implications for understanding the socioeconomic, public health, lifestyle, and medical mechanisms responsible for this narrowing. We use data from 1959 to 2009 and age-period-cohort (APC) models to examine period- and cohort-based changes in adult mortality for U.S. blacks and whites. We do so for all-cause mortality among persons aged 15–74 as well as for several underlying causes of death more pertinent for specific age groups. We find clear patterns of cohort-based reductions in mortality for both black men and women and white men and women. Recent cohort-based reductions in heart disease, stroke, lung cancer, female breast cancer, and other cancer mortality have been substantial and, save for breast cancer, have been especially pronounced for blacks. Period-based changes have also occurred and are especially pronounced for some causes of death. Period-based reductions in blacks’ and whites’ heart disease and stroke mortality are particularly impressive, as are recent period-based reductions in young men’s and women’s mortality from infectious diseases and homicide. These recent period changes are more pronounced among blacks. The substantial cohort-based trends in chronic disease mortality and recent period-based reductions for some causes of death suggest a continuing slow closure of the black-white mortality gap. However, we also uncover troubling signs of recent cohort-based increases in heart disease mortality for both blacks and whites.

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Notes

  1. Midyear population estimates for years 1959–1969 were obtained from the U.S. Census Bureau Population Estimates, 1900–1979 files (http://www.census.gov/popest/archives/pre-1980/PE-11.html). Estimates for years 1970–1989 were obtained from the U.S. Centers for Disease Control CDC Wonder, Census Population, 1970–2000 files (http://wonder.cdc.gov/wonder/help/Census1970-2000.html). Finally, estimates for years 1990–2009 were obtained from the U.S. Centers for Disease Control CDC Wonder, Bridged-Race Population Estimates (Vintage 2009) files (http://wonder.cdc.gov/bridged-race-population.html). ICPSR Study No. 20680 contains Multiple Cause of Death Files for years 1959–1967; ICPSR Study No. 3905 contains Multiple Cause of Death Files for years 1968–1973; ICPSR Study No. 3906 contains Multiple Cause of Death Files for years 1974–1978; and ICPSR Study No. 4640 contains Multiple Cause of Death Files for years 2000–2002. The ICPSR makes other individual Multiple Cause of Death Files separately available up to year 2005. Multiple Cause of Death Files for years 2006 through 2009 were obtained from the National Vital Statistics System Data, which are available online (http://www.cdc.gov/nchs/data_access/Vitalstatsonline.htm).

  2. To assess the validity of mortality rate estimates from our final data set, we compared race- and sex-specific five-year age-specific mortality rates for years 1968 to 1992 with corresponding five-year estimates made available in the Berkeley Mortality Database (BMD) (http://demog.berkeley.edu/~bmd/states.html). Our yearly estimates between ages 15–19 and 70–74 are nearly identical to those made available in the BMD, save for estimates of black men’s and women’s mortality rates for 1970–1974. Across these years, our estimates are more stable than the BMD estimates. All tables and figures comparing our estimates of U.S. black and white men’s and women’s five-year age-specific mortality rates between 1968 and 1992 with BMD’s respective estimates are available upon request.

  3. Age-period-cohort analyses were performed on an older sample composed of age groups 60–64, 65–69, 70–74, 75–79, and 80–84.

  4. We omitted 1963 from the 1960–1964 period because only one-quarter of deaths were officially recorded in 1963.

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Acknowledgments

This research was supported by grant 1 R01MD00425 from the National Institute for Minority and Health Disparities (principal investigator Brian K. Finch); the Robert Wood Johnson Foundation Health and Society Scholars Program; the MacArthur Foundation Network on an Aging Society (Jack Rowe, Director); and infrastructure Grants 5 R24HD042849 and 5 R24HD066613-04 from the Eunice Kennedy Shriver National Institute of Child Health, Human Development to the Population Research Center at the University of Texas at Austin, and the Colorado Population Research Center at the Institute of Behavioral Science at the University of Colorado at Boulder, respectively. We thank the National Center for Health Statistics for making the data that we use here publicly available, and the reviewers, Editor, and Guest Editor Stew Tolnay for their very helpful comments and suggestions.

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Authors and Affiliations

  1. Department of Sociology and Institute of Behavioral Science, University of Colorado at Boulder, UCB 327 Ketchum 214, Boulder, CO, 80309, USA

    Ryan K. Masters

  2. Department of Sociology and Population Research Center, University of Texas at Austin, Austin, TX, USA

    Robert A. Hummer & Daniel A. Powers

  3. Department of Sociology and Center for Health Equity Research and Policy, San Diego State University, San Diego, CA, USA

    Audrey Beck

  4. Institute for Behavioral and Community Health (IBACH), San Diego State University, San Diego, CA, USA

    Shih-Fan Lin

  5. Department of Sociology and Southern California Population Research Center, University of Southern California, Los Angeles, CA, USA

    Brian Karl Finch

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Masters, R.K., Hummer, R.A., Powers, D.A. et al. Long-Term Trends in Adult Mortality for U.S. Blacks and Whites: An Examination of Period- and Cohort-Based Changes. Demography 51, 2047–2073 (2014). https://doi.org/10.1007/s13524-014-0343-4

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