Premature Death Racial Disparity in United States

United States

Rates of disease and early death are higher among racial and ethnic minority populations across the country. The Centers for Disease Control and Prevention (CDC) recognizes racism as a fundamental cause of health disparities, including reduced life expectancy among certain racial and ethnic groups. This is due to its impact on resources needed for achieving optimal health. Social factors such as low education, poverty, health insurance, racial segregation and inadequate social support also contribute to premature death.

Premature death is a measure of years of potential life lost due to death occurring before the age of 75. It is a key marker of overall health and well-being. Deaths at younger ages contribute more to the premature death rate than deaths occurring closer to age 75. For example, a person dying at age 70 would lose five years of potential life, whereas a child dying at age five would lose 70 years of potential life. 

According to the National Center for Health Statistics WISQARS Leading Causes of Death Visualization Tool, unintentional injury (including drug overdose deaths), cancer, heart disease, suicide, COVID-19, homicide, liver disease, perinatal deaths, diabetes and cerebrovascular deaths were, in order, the 10 leading causes of years of potential life lost before age 75 in 2022. 

Risk factors for premature death include obesity, smoking and exposure to environmental hazards such as poor air quality. Risk factors for heart disease, such as high blood pressure, high cholesterol, Type 2 diabetes and physical inactivity, are also risk factors for premature death. Occupational hazards and risky behaviors like not wearing seatbelts and motorcycle helmets and misusing drugs can increase the risk of unintentional injuries and premature death.

According to America’s Health Rankings analysis, the racial/ethnic groups with the largest disparities in premature death include:

• American Indian/Alaska Native populations, who have premature death rates 40% greater than non-Hispanic white populations. Infant mortality rates are 2.6 and 2.0 times higher among American Indian/Alaska Native infants compared with Asian and white infants, respectively and are a major contributor to the premature death rate. American Indian/Alaska Native populations also have a disproportionately high rate of unintentional injury deaths due to several factors, including living in rural environments, lack of traffic safety and higher rates of alcohol-related accidents. 
• Black populations, whose premature mortality rates were consistently double those of white populations from 1960 through 2009, and remain higher than most other racial/ethnic groups today. Racial disparities in cardiovascular disease and homicide have long been the leading drivers of higher rates of premature mortality among Black populations, as well as staggering and persistent gaps in birth outcomes. Black populations have the highest infant mortality rate in the United States — more than double non-Hispanic white and Asian populations.

Increasing access to care for currently underserved minority populations is critical for decreasing premature death rates. More research is needed to determine effective methods of increasing access to behavioral health and primary care for racial and ethnic minority populations. In addition, the CDC is gathering evidence to help better understand how racism impacts health and is working toward identifying solutions. 

The CDC has sponsored many health equity interventions, including:

• The Traditional Foods Project, aimed at reducing rates of Type 2 diabetes in American Indian/Alaska Native populations.
• The Boston Children’s Hospital’s Community Asthma Initiative, an intervention for Black and Hispanic children at risk of asthma complications.
• Initiatives funded by the CDC’s Colorectal Cancer Control Program (CRCCP), which implements multicomponent interventions to increase colorectal cancer screening among racial and ethnic minority populations. 

The conditions that contribute to premature death differ from community to community and local solutions need to be found that account for specific health needs. Health officials can encourage lifestyle changes to help prevent premature deaths by reducing risk factors. These may include changes in diet, exercise, alcohol consumption and tobacco use, as well as medical treatment for chronic conditions such as depression, diabetes or hypertension.

Intervention strategies that encourage individuals to seek preventive medical care and achieve healthy lifestyles can be effective in reducing premature death by:

• Screening for certain health risks, such as alcohol misuse, diabetes, depression, high blood pressure, and breast, cervical and colorectal cancers.
• Raising vaccination rates. Vaccines are a safe and cost-effective way of protecting infants, adolescents and adults from potentially life-threatening preventable diseases. A complete list of vaccine-specific recommendations is available from the Advisory Committee on Immunization Practices and the CDC publishes vaccine schedules by age.

One of the overarching goals of Healthy People 2030 is to “attain healthy, thriving lives and well-being free of preventable disease, disability, injury and premature death.” While Healthy People 2030 does not have a specific goal for reducing premature death, it does set goals for many contributors to premature death, including:

• Reducing cancer-related illness and death. 
• Preventing unintentional injuries. 
• Reducing deaths related to smoking. 
• Preventing obesity. 
• Reducing deaths from heart disease and stroke. 
• Reducing maternal deaths.
• Reducing the rate of infant deaths. 
• Reducing the rate of child and adolescent deaths.

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