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The Contribution of Health Care and Other Interventions to Black–White Disparities in Life Expectancy, 1980–2007

Abstract

Black–white mortality disparities remain sizable in the United States. In this study, we use the concept of avoidable/amenable mortality to estimate cause-of-death contributions to the difference in life expectancy between whites and blacks by gender in the United States in 1980, 1993, and 2007. We begin with a review of the concept of “avoidable mortality” and results of prior studies using this cause-of-death classification. We then present the results of our empirical analyses. We classified causes of death as amenable to medical care, sensitive to public health policies and health behaviors, ischemic heart disease, suicide, HIV/AIDS, and all other causes combined. We used vital statistics data on deaths and Census Bureau population estimates and standard demographic decomposition techniques. In 2007, causes of death amenable to medical care continued to account for close to 2 years of the racial difference in life expectancy among men (2.08) and women (1.85). Causes amenable to public health interventions made a larger contribution to the racial difference in life expectancy among men (1.17 years) than women (0.08 years). The contribution of HIV/AIDS substantially widened the racial difference among both men (1.08 years) and women (0.42 years) in 1993, but its contribution declined over time. Despite progress observed over the time period studied, a substantial portion of black–white disparities in mortality could be reduced given more equitable access to medical care and health interventions.

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Fig. 1

Notes

  1. 1.

    Tuberculosis, cervical cancer, rheumatic heart disease, hypertension, stroke, and appendicitis.

  2. 2.

    Maternal and perinatal mortality, Hodgkin’s disease, cervical and breast cancer, tuberculosis, asthma, appendicitis, cholelithiasis, cholecystitis and abdominal hernia, ischemic heart disease, hypertension and cerebrovascular disease, and peptic ulcers.

  3. 3.

    Tuberculosis, cervical cancer, Hodgkin’s disease, rheumatic heart disease, hypertensive disease, acute respiratory disease, pneumonia and bronchitis, influenza, asthma, appendicitis, hernias, and cholecystitis.

References

  1. Abreu, D. M. X., Cesar, C. C., & France, E. B. (2007). The relationship between deaths that are avoidable with adequate health care and the implementation of the unified health system in Brazil. Revista Panamericana de Salud Publica, 21, 282–291.

    Article  Google Scholar 

  2. Adler, G. S. (1978). Measuring the quality of medical care. New England Journal of Medicine, 298, 574.

    Google Scholar 

  3. Arriaga, E. (1984). Measuring and explaining the change in life expectancies. Demography, 21, 83–96.

    Article  Google Scholar 

  4. Ashton, C. M., Haidet, P., Paterniti, D. A., Collins, T. C., Gordon, H. S., O’Malley, K., et al. (2003). Racial and ethnic disparities in the use of health services: Bias, preferences, or poor communication? Journal of General Internal Medicine, 18, 146–152.

    Article  Google Scholar 

  5. Bailey, C. J., & Kodack, M. (2011). Patient adherence to medication requirements for therapy of type 2 diabetes. International Journal of Clinical Practice, 65, 314–322.

    Article  Google Scholar 

  6. Beltrán-Sánchez, H. (2011). Avoidable mortality: A review. In R. R. Rogers & E. M. Crimmins (Eds.), International handbook of adult mortality (pp. 491–508). Dordrecht: Springer.

    Chapter  Google Scholar 

  7. Beltrán-Sánchez, H., Preston, S. H., & Canudas-Romo, V. (2008). An integrated approach to cause-of-death analysis: Cause-deleted life tables and decompositions of life expectancy. Demographic Research, 19, 1323–1350.

    Article  Google Scholar 

  8. Berndt, S. I., Carter, H. B., Schoenberg, M. P., & Newschaffer, C. J. (2007). Disparities in treatment and outcome for renal cell cancer among older black and white patients. Journal of Clinical Oncology, 25, 3589–3595.

    Article  Google Scholar 

  9. Berz, J. P., Johnston, K., Backus, B., Doros, G., Rose, A. J., Pierre, S., et al. (2009). The influence of black race on treatment and mortality for early-stage breast cancer. Medical Care, 47, 986–992.

    Google Scholar 

  10. Burgess, A. M., Jr, Colton, T., & Peterson, O. L. (1966). Avoidable mortality. Some practical aims for regional medical programs. Archives of Environmental Health, 13, 794–798.

    Article  Google Scholar 

  11. Charlton, J. R., Hartley, R. M., Silver, R., & Holland, W. W. (1983). Geographical variation in mortality from conditions amenable to medical intervention in England and Wales. Lancet, 1, 691–696.

    Article  Google Scholar 

  12. Commonwealth Fund. (2007). Aiming higher: Results from a state scorecard on health system performance. Washington, DC: Commonwealth Fund. http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=494551.

  13. Desai, M., Nolte, E., Karanikolos, M., Khoshaba, B., & McKee, M. (2011). Measuring NHS performance 1990-2009 using amenable mortality: Interpret with care. Journal of the Royal Society of Medicine, 104, 370–379.

    Article  Google Scholar 

  14. Eitle, D., D’Alessio, S. J., & Stolzenberg, L. (2006). Economic segregation, race, and homicide. Social science quarterly, 87, 638–657.

    Article  Google Scholar 

  15. Elo, I. T., & Drevenstedt, G. L. (2002). Educational differences in cause-specific mortality in the United States. In Yearbook of population research in Finland (pp. 37-54). Helsinki: The Population Research Institute.

  16. Elo, I. T., & Drevenstedt, G. L. (2004). Cause-specific contributions to black-white differences in adult male mortality between 1960 and 1995. Demographic Research-Special Collection Determinants of Diverging Trends in Mortality, 2, 255–276.

    Article  Google Scholar 

  17. Elo, I. T., & Drevenstedt, G. L. (2006). Black-white differentials in cause-specific mortality in the United States in the 1980s: The role of medical care and health behaviors. PSC Working Paper Series PSC 06-02.

  18. Ford, E. S., Ajani, U. A., Croft, J. B., Critchley, J. A., Labarthe, D. R., Kottke, T. E., et al. (2007). Explaining the decrease in us deaths from coronary disease, 1980–2000. New England Journal of Medicine, 356, 2388–2398.

    Article  Google Scholar 

  19. Ford, E. S., & Capewell, S. (2011). Proportion of the decline in cardiovascular mortality disease due to prevention versus treatment: Public health versus clinical care. Annual Review of Public Health, 32, 5–22.

    Article  Google Scholar 

  20. Garrett, B., & Yemane, A. (2006). Racial and ethnic differences in insurance coverage and health care access and use: A synthesis of findings from the assessing the new federalism project. Washington, DC: The Urban Institute.

    Google Scholar 

  21. Gay, J. G., Paris, V., Devaux, M., & de Looper, M. (2011). Mortality amenable to health care in 31 OECD countries estimates and methodological issues. OECD Health Working Papers. Paris: OECD Publishing.

  22. Geronimus, A. T., Bound, J., & Colen, C. G. (2011). Excess black mortality in the United States and in selected black and white high-poverty areas, 1980–2000. American Journal of Public Health, 101, 720–729.

    Article  Google Scholar 

  23. Geronimus, A. T., Bound, J., & Waidmann, T. A. (1999). Poverty, time, and place: Variation in excess mortality across selected U.S. populations, 1980-1990. Journal of Epidemiology and Community Health, 53, 325–334.

    Article  Google Scholar 

  24. Geronimus, A. T., Bound, J., Waidmann, T. A., Hillemeier, M. M., & Burns, P. B. (1996). Excess mortality among blacks and whites in the United States. New England Journal of Medicine, 335, 1552–1558.

    Article  Google Scholar 

  25. Geruso, M. (2012). Black-white disparities in life expectancy: How much can the standard SES variables explain. Demography, 49, 553–574.

    Article  Google Scholar 

  26. Harper, S., Lynch, J., Burris, S., & Smith, G. D. (2007). Trends in the black-white life expectancy gap in the United States, 1983–2003. Journal of the American Medical Association, 297, 1224–1232.

    Article  Google Scholar 

  27. Hayward, M. D., Crimmins, E. M., Miles, T. P., & Ang, Y. (2000). The significance of socioeconomic status in explaining the racial gap in chronic health conditions. American Sociological Review, 65, 910–930.

    Article  Google Scholar 

  28. Heijink, R., Koolman, X., & Westert, G. P. (2012). Spending more money, saving more lives? The relationship between avoidable mortality and healthcare spending in 14 countries. European Journal of Health Economics, 14(3), 527–538.

    Article  Google Scholar 

  29. Ho, J. Y., & Elo, I. T. (2012). The contribution of smoking to black-white differences in mortality. Demography, 50(2):545–568.

    Google Scholar 

  30. Holland, W. W. (Ed.). (1988). The European community atlas of “avoidable death”. Oxford: Oxford University Press.

    Google Scholar 

  31. Holland, W. W. (Ed.). (1991). European community atlas of ‘avoidable death’. Oxford: Oxford University Press.

    Google Scholar 

  32. Holland, W. W. (Ed.). (1993). European community atlas of ‘avoidable death’. Oxford: Oxford University Press.

    Google Scholar 

  33. Humblet, P. C., Lagasse, R., & Leveque, A. (2000). Trends in Belgian premature avoidable deaths over a 20 year period. Journal of Epidemiology and Community Health, 54, 687–691.

    Article  Google Scholar 

  34. James, P. D., Manuel, D. G., & Mao, Y. (2006). Avoidable mortality across Canada from 1975 to 1999. BMC Public Health, 6, 137.

    Article  Google Scholar 

  35. King, G., Polednak, A., Bendel, R. B., Vilsaint, M. C., & Nahata, S. B. (2004). Disparities in smoking cessation between African Americans and whites: 1990–2000. American Journal of Public Health, 94, 1965–1971.

    Article  Google Scholar 

  36. Kjellstrand, C. M., Kovithavongs, C., & Szabo, E. (1998). On the success, cost and efficiency of modern medicine: An international comparison. Journal of Internal Medicine, 243, 3–14.

    Article  Google Scholar 

  37. Kochanek, K. D., Maurer, J. D., & Rosenberg, H. M. (1994). Why did black life expectancy decline from 1984 through 1989 in the United States? American Journal of Public Health, 84, 938–944.

    Article  Google Scholar 

  38. Korda, R. J., & Butler, J. R. (2006). Effect of healthcare on mortality: Trends in avoidable mortality in Australia and comparisons with Western Europe. Public Health, 120, 95–105.

    Article  Google Scholar 

  39. Korda, R. J., Butler, J. R., Clements, M. S., & Kunitz, S. J. (2007). Differential impacts of health care in Australia: Trend analysis of socioeconomic inequalities in avoidable mortality. International Journal of Epidemiology, 36, 157–165.

    Article  Google Scholar 

  40. Krivo, L. J., & Peterson, R. D. (2000). The structural context of homicide: Accounting for racial differences in process. American Sociological Review, 65, 547–559.

    Article  Google Scholar 

  41. Kunitz, S. J., & Pesis-Katz, I. (2005). Mortality of white Americans, African Americans, and Canadians: The causes and consequences for health of welfare state institutions and policies. Milbank Quarterly, 83, 5–39.

    Article  Google Scholar 

  42. LaVeist, T. A., Thorpe, R. J., Galarraga, J. E., Bower, K. M., & Gary-Webb, T. L. (2009). Environmental and socio-economic factors as contributors to racial disparities in diabetes prevalence. Journal of General Internal Medicine, 24, 1144–1148.

    Article  Google Scholar 

  43. Levine, R. S., Briggs, N. C., Kilbourne, B. S., King, W. D., Fry-Johnson, Y., Baltrus, P. T., et al. (2007). Black white mortality from HIV in the United States before and after introduction of highly active antiretroviral therapy in 1996. American Journal of Public Health, 97, 1884–1892.

    Article  Google Scholar 

  44. Levy, D. E., Byfield, S. D., Comstock, C. B., Garber, J. E., Syngal, S., Crown, W. H., et al. (2011). Underutilization of BRCA1/2 testing to guide breast cancer treatment: Black and hispanic women particularly at risk. Genetics in Medicine, 13, 349–355.

    Article  Google Scholar 

  45. Lillie-Blanton, M., & Hoffman, C. (2005). The role of health insurance coverage in reducing racial/ethnic disparities in health care. Health Affairs, 24, 398–408.

    Article  Google Scholar 

  46. Lizotte, A. J. (1986). The costs of using gun control to reduce homicide. Bulletin of the New York Academy of Medicine, 62, 539–549.

    Google Scholar 

  47. Macinko, J., & Elo, I. T. (2009). Black–white differences in avoidable mortality in the USA, 1980–2005. Journal of Epidemiology and Community Health, 63, 715–721.

    Article  Google Scholar 

  48. Mackenbach, J. P. (1996). The contribution of medical care to mortality decline: Mckeown revisited. Journal of Clinical Epidemiology, 49, 1207–1213.

    Article  Google Scholar 

  49. Mackenbach, J. P., Looman, C. W., Kunst, A. E., Habbema, J. D., & van der Maas, P. J. (1988). Post-1950 mortality trends and medical care: Gains in life expectancy due to declines in mortality from conditions amenable to medical intervention in the Netherlands. Social Science and Medicine, 27, 889–894.

    Article  Google Scholar 

  50. Mackenbach, J. P., Bouvier-Colle, M. H., & Jougla, E. (1990). "Avoidable" mortality and health services: A review of aggregate data studies. Journal of Epidemiology and Community Health, 44, 106–111.

    Google Scholar 

  51. Manton, K. G., Patrick, C. H., & Johnson, K. W. (1987). Health differentials between blacks and whites: Recent trends in mortality and morbidity. Milbank Quarterly, 65, 129–199.

    Article  Google Scholar 

  52. Manuel, D. G., & Mao, Y. (2002). Avoidable mortality in the United States and Canada, 1980–1996. American Journal of Public Health, 92, 1481–1484.

    Article  Google Scholar 

  53. Marshall, S. W., Kawachi, I., Pearce, N., & Borman, B. (1993). Social class differences in mortality from diseases amenable to medical intervention in New Zealand. International Journal of Epidemiology, 22, 255–261.

    Article  Google Scholar 

  54. Massey, D. S. (1995). Getting away with murder: Segregation and violent crime in urban America. University of Pennsylvania Law Review, 143, 1203–1232.

    Article  Google Scholar 

  55. Mayberry, R. M., Mili, F., & Ofili, E. (2000). Racial and ethnic differences in access to medical care. Medical Care Research Review, 57, 108–145.

    Google Scholar 

  56. McDowall, D., Loftin, C., & Wiersema, B. (1995). Easing concealed firearms laws: Effects on homicide in three states. The Journal of Criminal Law and Criminology, 86, 193–206.

    Article  Google Scholar 

  57. Moy, B., Polite, B. N., Halpern, M. T., Stranne, S. K., Winer, E. P., Wollins, D. S., et al. (2011). American society of clinical oncology policy statement: Opportunities in the patient protection and affordable care act to reduce cancer care disparities. Journal of Clinical Oncology, 29, 3816–3824.

    Article  Google Scholar 

  58. National Cancer Institute. (2011). U.S. population data 1969–2009. Retrieved January 2012, from http://seer.cancer.gov/popdata/download.html.

  59. Niti, M., & Ng, T. P. (2001). Temporal trends and ethnic variations in amenable mortality in Singapore 1965-1994: The impact of health care in transition. International Journal of Epidemiology, 30, 966–973.

    Article  Google Scholar 

  60. Nolte, E., & McKee, M. (2003). Measuring the health of nations: Analysis of mortality amenable to health care. British Medical Journal, 327, 1129.

    Article  Google Scholar 

  61. Nolte, E., & McKee, M. (2004). Does healthcare save lives? Avoidable mortality revisited. London: The Nuffield Trust.

    Google Scholar 

  62. Nolte, E., & McKee, C. M. (2008). Measuring the health of nations: Updating an earlier analysis. Health Affairs, 27, 58–71.

    Article  Google Scholar 

  63. Nolte, E., & McKee, M. (2011). Variations in amenable mortality—Trends in 16 high-income nations. Health Policy, 103, 47–52.

    Article  Google Scholar 

  64. Nolte, E., & McKee, C. M. (2012). In amenable mortality—Deaths avoidable through health care—Progress in the US lags that of three European countries. Health Affairs, 31, 2114–2122.

    Article  Google Scholar 

  65. Pampalon, R. (1993). Avoidable mortality in Quebec and its regions. Social Science and Medicine, 37, 823–831.

    Article  Google Scholar 

  66. Paradies, Y. (2006). A systematic review of empirical research on self-reported racism and health. International Journal of Epidemiology, 35, 888–901.

    Article  Google Scholar 

  67. Petersen, L. A., Wright, S. M., Peterson, E. D., & Daley, J. (2002). Impact of race on cardiac care and outcomes in veterans with acute myocardial infarction. Medical Care, 40, 86–96.

    Google Scholar 

  68. Peterson, E. D., Shaw, L. K., DeLong, E. R., Pryor, D. B., Califf, R. M., & Mark, D. B. (1997). Racial variation in the use of coronary-revascularization procedures—Are the differences real? Do they matter? New England Journal of Medicine, 336, 480–486.

    Article  Google Scholar 

  69. Phelan, J. C., Link, B. G., Diez-Roux, A., Kawachi, I., & Levin, B. (2004). “Fundamental causes” of social inequalities in mortality: A test of the theory. Journal of Health and Social Behavior, 45, 265–285.

    Article  Google Scholar 

  70. Piers, L. S., Carson, N. J., Brown, K., & Ansari, Z. (2007). Avoidable mortality in Victoria between 1979 and 2001. Australian and New Zealand Journal of Public Health, 31, 5–12.

    Article  Google Scholar 

  71. Plug, I., Hoffmann, R., Artnik, B., Bopp, M., Borrell, C., Costa, G., et al. (2012). Socioeconomic inequalities in mortality from conditions amenable to medical interventions: Do they reflect inequalities in access or quality of health care? BMC Public Health, 12, 346.

    Article  Google Scholar 

  72. Poikolainen, K., & Eskola, J. (1986). Mortality from causes amenable to health services intervention. Lancet, 1, 1386–1387.

    Article  Google Scholar 

  73. Pollard, J. H. (1982). The expectation of life and its relationship to mortality. Journal of Institute of Actuaries, 109, 225–240.

    Article  Google Scholar 

  74. Preston, S. H., Elo, I. T., Rosenwaike, I., & Hill, M. (1996). African American mortality at older ages: Results of a matching study. Demography, 33, 193–209.

    Article  Google Scholar 

  75. Preston, S. H., Heuveline, P., & Guillot, M. (2001). Demography. Measuring and modeling population processes. Malden, MA: Blackwell.

    Google Scholar 

  76. Preston, S. H., & Wang, H. (2006). Sex mortality differences in the United States: The role of cohort smoking patterns. Demography, 43, 631–646.

    Article  Google Scholar 

  77. Rockett, I. R. H., Samora, J. B., & Coben, J. H. (2006). The black–white suicide paradox: Possible effects of misclassification. Social Science and Medicine, 63, 2165–2175.

    Article  Google Scholar 

  78. Rogers, R. G. (1992). Living and dying in the U.S.A: Sociodemographic determinants of death among blacks and whites. Demography, 29, 287–303.

    Article  Google Scholar 

  79. Rogers, R. G., Hummer, R. A., & Nam, C. B. (2000). Living and dying in the U.S.A: Behavioral, health, and social differentials of adult mortality. New York: Academic Press.

  80. Ronzio, C. R., Pamuk, E., & Squires, G. D. (2004). The politics of preventable deaths: Local spending, income inequality, and premature mortality in US cities. Journal of Epidemiology and Community Health, 58, 175–179.

    Article  Google Scholar 

  81. Rosenberg, H. M. (1999). Cause of death as a contemporary problem. Journal of the History of Medicine, 54, 133–153.

    Google Scholar 

  82. Rubin, M. S., Colen, C. G., & Link, B. G. (2010). Examination of inequalities in HIV/AIDS mortality in the United States from a fundamental cause perspective. American Journal of Public Health, 100, 1053–1059.

    Article  Google Scholar 

  83. Rutstein, D. D., Berenberg, W., Chalmers, T. C., Child, C. G., 3rd, Fishman, A. P., & Perrin, E. B. (1976). Measuring the quality of medical care. A clinical method. New England Journal of Medicine, 294, 582–588.

    Article  Google Scholar 

  84. Rutstein, D. D., Berenberg, W., Chalmers, T. C., Fishman, A. P., Perrin, E. B., & Zuidema, G. D. (1980). Measuring the quality of medical care: Second revision of tables of indexes. New England Journal of Medicine, 302, 1146.

    Google Scholar 

  85. Saenz, M. (2010). Health disparities and the affordable care act. NCSL Legisbrief, 18, 1–2.

    Google Scholar 

  86. Salihu, H. M., Stanley, K. M., Mbah, A. K., August, E. M., Alio, A. P., & Marty, P. J. (2010). Disparities in rates and trends of HIV/AIDS during pregnancy across the decade, 1998–2007. Journal of Acquired Immune Deficiency Syndromes, 55, 391–396.

    Article  Google Scholar 

  87. Sanders-Phillips, K., Settles-Reaves, B., Walker, D., & Brownlow, J. (2009). Social inequality and racial discrimination: Risk factors for health disparities in children of color. Pediatrics, 124(Suppl 3), S176–S186.

    Article  Google Scholar 

  88. Schoenbaum, S. C., Schoen, C., Nicholson, J. L., & Cantor, J. C. (2011). Mortality amenable to health care in the United States: The roles of demographics and health systems performance. Journal of Public Health Policy, 32, 407–429.

    Article  Google Scholar 

  89. Schwartz, E., Kofie, V. Y., Rivo, M., & Tuckson, R. V. (1990). Black/white comparisons of deaths preventable by medical intervention: United States and the District of Columbia 1980–1986. International Journal of Epidemiology, 19, 591–598.

    Article  Google Scholar 

  90. SEER. (2011). SEER*Stat Database: Incidence—SEER 17 REGS Research Data + Hurricane Katrina impacted Louisiana cases, Nov 2010 sub (1973–2008 varying)—Linked to county attributes—Total U.S., 1969–2009 counties. Released April 2011 (updated 2010/2028/2011), based on the November 2010 submission.). National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch: National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch.

  91. Siahpush, M., Singh, G., Jones, P., & Timsina, L. (2010). Racial/ethnic and socioeconomic variations in duration of smoking: Results from 2003, 2006 and 2007 tobacco use supplement of the current population survey. Journal of Public Health, 32, 210–218.

    Article  Google Scholar 

  92. Simonato, L., Ballard, T., Bellini, P., & Winkelmann, R. (1998). Avoidable mortality in Europe 1955–1994: A plea for prevention. Journal of Epidemiology and Community Health, 52, 624–630.

    Article  Google Scholar 

  93. Smedley, B. D., Stith, A. Y., & Nelson, A. R. (2003). Unequal treatment: Confronting racial and ethnic disparities in health care. Washington, DC: National Academy Press.

    Google Scholar 

  94. Soneji, S., Iyer, S. S., Armstrong, K. B. A., & Asch, D. A. (2010). Racial disparities in stage-specific colorectal cancer mortality: 1960–2005. American Journal of Public Health, 100, 1912–1916.

    Article  Google Scholar 

  95. Sonel, A. F., Good, C. B., Mulgund, J., Roe, M. T., Gibler, W. B., Smith, S. C., Jr., et al. (2005). Racial variations in treatment and outcomes of black and white patients with high-risk non-st-elevation acute coronary syndromes: Insights from crusade (can rapid risk stratification of unstable angina patients suppress adverse outcomes with early implementation of the ACC/AHA guidelines?). Circulation, 111, 1225–1232.

    Article  Google Scholar 

  96. Song, Y. M., & Byeon, J. J. (2000). Excess mortality from avoidable and non-avoidable causes in men of low socioeconomic status: A prospective study in Korea. Journal of Epidemiology and Community Health, 54, 166–172.

    Article  Google Scholar 

  97. Stirbu, I., Kunst, A. E., Bos, V., & Mackenbach, J. P. (2006). Differences in avoidable mortality between migrants and the native Dutch in the Netherlands. BMC Public Health, 6, 78.

    Article  Google Scholar 

  98. Sudano, J. J., & Baker, D. W. (2006). Explaining us racial/ethnic disparities in health declines and mortality in late middle age: The roles of socioeconomic status, health behaviors, and health insurance. Social Science and Medicine, 62, 909–922.

    Article  Google Scholar 

  99. Tehranifar, P., Neugut, A. I., Link, B. G., Liao, Y., Terry, M. B., Phelan, J. C., et al. (2009). Medical advances and racial/ethnic disparities in cancer survival. Cancer Epidemiology, Biomarkers and Prevention, 18, 2701–2708.

    Google Scholar 

  100. Tobias, M., & Jackson, G. (2001). Avoidable mortality in New Zealand, 1981–97. Australia and New Zealand Journal of Public Health, 25, 12–20.

    Article  Google Scholar 

  101. Transportation Research Board. (2010). Achieving traffic safety goals in the United States: Lessons from other nations. Washington, DC: Transportation Research Board.

    Google Scholar 

  102. van Ryn, M., Burgess, D., Malat, J., & Griffin, J. (2006). Physicians’ perceptions of patients’ social and behavioral characteristics and race disparities in treatment recommendations for men with coronary artery disease. American Journal of Public Health, 96, 351–357.

    Article  Google Scholar 

  103. Virnig, B. A., Baxter, N. N., Habermann, E. B., Feldman, R. D., & Bradley, C. J. (2009). A matter of race: Early-versus late-stage cancer diagnosis. Health Affairs, 28, 160–168.

    Article  Google Scholar 

  104. Westerling, R. (1992). “Avoidable” causes of death in Sweden 1974–85. Quality Assurance in Health Care, 4, 319–328.

    Google Scholar 

  105. Westerling, R., & Rosén, M. (2002). ‘Avoidable’ mortality among immigrants in Sweden. European Journal of Public Health, 12, 279–286.

    Article  Google Scholar 

  106. Wheller, L., Baker, A., Griffiths, C., & Rooney, C. (2007). Tends in avoidable mortality in England and Wales, 1993-2005. Health Statistics Quarterly, 6-25.

  107. Williams, D. R., & Mohammed, S. A. (2009). Discrimination and racial disparities in health: Evidence and needed research. Journal of Behavioral Medicine, 32, 20–47.

    Article  Google Scholar 

  108. Williams, D. R., & Sternthal, M. (2010). Understanding racial-ethnic disparities in health: Sociological contributions. Journal of Health and Social Behavior, 51(Suppl), S15–S27.

    Article  Google Scholar 

  109. Woolhandler, S., Himmelstein, D., Silber, R., Bader, M., Harnly, M., & Jones, A. (1985). Medical care and mortality: Racial differences in preventable deaths. International Journal of Health Services, 15, 1–11.

    Article  Google Scholar 

  110. Xu, J. Q., Kochanek, K. D., Murphy, S. L., & Tejada-Vera, B. (2010). Deaths: Final data for 2007. National vital statistics reports. Hyattsville, MD: National Center for Health Statistics.

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Acknowledgments

We thank anonymous reviewers for their comments and Ye Wang for programming assistance. Irma T. Elo and James Macinko were supported by a grant (R21 HD060175-01A1) from Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Health. Hiram Beltran-Sanchez acknowledges financial support from the National Institute on Aging (T32AG000037), the Harvard Center for Population and Development Studies and the Center for Demography, Health and Aging at the University of Wisconsin-Madison.

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Correspondence to Irma T. Elo.

Appendix

Appendix

See Tables 4 and 5.

Table 4 Life expectancy by race and sex, US 1980, 1993, and 2007
Table 5 Definitions of cause-of-death categories

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Elo, I.T., Beltrán-Sánchez, H. & Macinko, J. The Contribution of Health Care and Other Interventions to Black–White Disparities in Life Expectancy, 1980–2007. Popul Res Policy Rev 33, 97–126 (2014). https://doi.org/10.1007/s11113-013-9309-2

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Keywords

  • Health disparities
  • Life expectancy
  • Health Care
  • Amenable mortality
  • Demographic methods
  • Race