For decades, black Americans have been dying at a higher rate than white Americans.
That's still true overall. But now there's some good news about this long, disturbing trend: The overall death rate for black Americans fell 25 percent between 1999 and 2015, according to a report released Tuesday by the U.S. Centers for Disease Control and Prevention.
The overall death rate dropped for white people as well, but the decrease among black Americans was far greater, narrowing the gap in the death rate between white and black Americans from 33 percent in 1999 to 16 percent in 2015, the report shows.
"This report is definitely good news," says Joseph Betancourt, who runs the Disparities Solutions Center at the Massachusetts General Hospital in Boston, Ma. "Efforts over the last 15 to 17 years that have focused on addressing and eliminating disparities have definitely provided some significant results."
Between 1999 and 2015, the death rate among black Americans fell from 1,135.7 to 851.9 per 100,000. For white Americans, the rate fell from 854.6 to 735 per 100,000 in the same time period.
"Prior to this, there was very little progress in the decline in the gap between African-Americans and whites in United States," says Timothy Cunningham, a CDC epidemiologist who led the report. It was published in the agency's Morbidity and Mortality Weekly Report.
The report did not examine the reason the gap narrowed, but Cunningham says it's probably due to black people benefiting more from decreases in the number of deaths from a variety of diseases, including AIDS and tobacco-related illnesses.
"The major drivers of this are decreases in many of the leading causes of death, such as heart disease, cancer and stroke," Cunningham says.
The drop in the death rate was most striking among those 65 and older. In that group, the death rate for black people fell 27 percent, compared to 17 percent for white people. As a result, by 2010 the death rate for black Americans in this age group fell slightly below the rate for white Americans, according to the report.
"We're talking about African-Americans who were pretty young during in the 1960s and 1970s," Cunningham says. "And one thing we have to consider is that there have been significant improvements in socioeconomic status that are associated with civil rights policies."
Cunningham stresses that the overall death rate among black people remains higher than for white people. As a group, black Americans have an overall life expectancy that's still four years less than white Americans.
And the picture is especially troubling for younger black people, who are still developing, and dying from, major health problems such as high blood pressure, diabetes, heart disease and stroke at younger ages than their white counterparts.
"Many younger African-Americans in their 20s, 30s and 40s are living and dying with chronic conditions that we more typically see in the older population," Cunningham says. "There's still work to do."
That finding is consistent with previous reports that indicate some black Americans experience a phenomenon known as "weathering." That's when a person develops signs of premature aging and an earlier deterioration in health, the report notes.
Weathering can be caused by a variety of factors, including living in poverty, living in violent neighborhoods and encountering racism on a regular basis, Betancourt says.
"Racism and experiencing racism — thinking about your race every day — contributes to this weathering effect," he says. "You're in fight-or-flight mode. That has a real significant biological effect that contributes to premature aging."
KELLY MCEVERS, HOST:
There's some positive news today from the Centers for Disease Control and Prevention about the health of African-Americans. Their overall death rate has gone down a lot over nearly two decades. NPR health correspondent Rob Stein reports.
ROB STEIN, BYLINE: For decades, the death rate among blacks has been much, much higher than for whites. But Timothy Cunningham of the CDC says that's finally starting to change.
TIMOTHY CUNNINGHAM: Our data show that the overall death rate for African-Americans has decreased by 25 percent from 1999 to 2015.
STEIN: The death rate for whites dropped, too, but not nearly as much. And so the gap between blacks and whites has narrowed.
CUNNINGHAM: The gap in 1999 between African-Americans and whites in overall mortality was about 33 percent. And in 2015, it has decreased to about 16 percent.
STEIN: So it's been cut almost in half. The biggest drop was among the elderly. Blacks 65 and older are now actually dying at a slightly lower rate than whites in that age group.
CUNNINGHAM: We're talking about African-Americans who were pretty young during the 1960s and the 1970s. And one thing we have to consider is that there have been significant improvements in socioeconomic status that are associated with civil rights policies.
STEIN: But Cunningham stresses that overall, blacks still tend to die about four years younger than whites, and the picture among younger blacks remains disturbing.
CUNNINGHAM: Many younger African-Americans are in their 20s, 30s and 40s, and they're living and dying with chronic conditions that we typically see at much older ages in the general population.
STEIN: Like high blood pressure, diabetes, heart disease. There are lots of reasons for this. But Joseph Betancourt of the Massachusetts General Hospital says one is known as weathering. It's the toll that things like stress and poverty can take on someone's health.
JOSEPH BETANCOURT: Clearly racism and experiencing racism - that also contributes to this kind of, you know, weathering effect. You're in fight or flight mode, and so that has a real significant biological effect that contributes to premature aging.
STEIN: So there's clearly a lot more that needs to be done to continue to close the gap between the health and well-being of blacks and whites in the United States. Rob Stein, NPR News. Transcript provided by NPR, Copyright NPR.