Racial Disparities in Premature Death Rate Discovered

Findings from a new study suggest that premature death rates are decreasing among Hispanics, blacks, and Asian/Pacific Islanders, but are increasing among whites and American Indian/Alaska natives.

The declining rates are in line with trends seen in Canada and the United Kingdom, and show the success of public health programs to improve health, according to a study published by The Lancet. However, increasing mortality rates highlight the need for more public health initiatives to address the problem in these populations.

In the study, the investigators examined death rates in the United States from 1999 to 2014 among individuals aged 25 to 64. They found that premature death among Hispanics, blacks, and Asian/Pacific Islanders was decreasing due to fewer deaths from cancer, heart disease, and HIV.

During this time, medical advances led to earlier diagnoses and treatments, and anti-smoking campaigns drove down smoking rates. Whites also saw less premature deaths from cancer, and heart disease.

Despite decreasing mortality, premature death rates were higher for black men and women compared with whites, according to the study. During this time, the researchers discovered that premature deaths among whites and American Indian/Alaska natives increased due to accidents, such as drug overdoses, suicide, and liver disease.

Up to a 5% annual increase in mortality was observed among whites and American Indians/Alaska natives aged 25 to 30, which is comparable to the increases seen during the AIDS epidemic, the authors wrote.

“The results of our study suggest that, in addition to continued efforts against cancer, heart disease, and HIV, there is an urgent need for aggressive actions targeting emerging causes of death, namely drug overdoses, suicide, and liver disease,” said study lead author Meredith Shiels, PhD, MHS.

Since the authors gathered data from death certificates, the actual impact may be much higher due to potential errors.

These findings suggest that increased efforts to reduce premature deaths are needed. States may choose to implement more stringent opioid laws to prevent deaths related to opioid overdoses. Advocacy groups may continue to expand education about heart disease, and how it can be prevented through healthy diet and exercise, which are easily implemented at a younger age.

“Death at any age is devastating for those left behind, but premature death is especially so, in particular for children and parents,” concluded Amy Berrington, DPhil. “We focused on premature deaths because, as Sir Richard Doll, the eminent epidemiologist and my mentor, observed: ‘Death in old age is inevitable, but death before old age is not.’ Our study can be used to target prevention and surveillance efforts to help those groups in greatest need.”