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. 2014 Dec;51(6):2047-73.
doi: 10.1007/s13524-014-0343-4.

Long-term trends in adult mortality for U.S. Blacks and Whites: an examination of period- and cohort-based changes

Ryan K Masters  1 , Robert A Hummer, Daniel A Powers, Audrey Beck, Shih-Fan Lin, Brian Karl Finch
Affiliations

Long-term trends in adult mortality for U.S. Blacks and Whites: an examination of period- and cohort-based changes

Ryan K Masters et al. Demography. 2014 Dec.

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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Figures

Fig. 1
Fig. 1
Age, period, cohort patterns in U.S. adult all-cause mortality rates, 1959–2009. Age patterns are estimated at cohort 1920–1930 and period 1975–1979. Period patterns are estimated at age 60–64 and cohort 1920–1930. Cohort patterns are estimated at age 60–64 and period 1975–1979
Fig. 2
Fig. 2
Relative rate ratios between black and white birth cohorts’ adult all-cause mortality rates, 1959–2009. Estimated at age 60–64 and period 1975–1979
Fig. 3a
Fig. 3a
Period and cohort trends in U.S. women's chronic disease mortality rates, 1959–2009. Cohort patterns are estimated at age 60–64 and period 1975–1979. Period patterns are estimated at age 60–64 and cohort 1915–1925
Fig. 3b
Fig. 3b
Period and cohort trends in U.S. women's chronic disease mortality rates, 1959–2009. Cohort patterns are estimated at age 60–64 and period 1975–1979. Period patterns are estimated at age 60–64 and cohort 1915–1925
Fig. 4a
Fig. 4a
Period and cohort trends in U.S. men's chronic disease mortality, 1959–2009. Cohort patterns are estimated at age 55–59 and period 1975–1979. Period patterns are estimated at age 55–59 and cohort 1915–1925
Fig. 4b
Fig. 4b
Period and Cohort Trends in U.S. Men's Chronic Disease Mortality, 1959–2009. Cohort patterns estimated at age 55–59 and period 1975–1979. Period patterns estimated at age 55–59 and cohort 1915–1925
Fig. 5
Fig. 5
Period and cohort trends in U.S. young women's mortality from infectious disease and external causes, 1959–2009. Infectious disease patterns are estimated at age 30–34, period 1985–1989, and cohort 1960–1970. Homicide patterns are estimated at age 20–24, period 2000–2004, and cohort 1960–1970. Accident patterns are estimated at age 20–24, period 1985–1989, and cohort 1960–1970
Fig. 6
Fig. 6
Period and cohort Trends in U.S. young men's mortality from infectious disease and external causes,1959–2009. Infectious disease patterns are estimated at age 30–34, period 1985–1989, and cohort 1960–1970. Homicide patterns are estimated at age 20–24, period 2000–2004, and cohort 1960–1970. Accident patterns are estimated at age 20–24, period 1985–1989, and cohort 1960–1970
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