US racial inequality may be as deadly as COVID-19

Abstract

The COVID-19 pandemic is causing a catastrophic increase in US mortality. How does the scale of this pandemic compare to another US catastrophe: racial inequality? Using demographic models, I estimate how many excess White deaths would raise US White mortality to the best-ever (lowest) US Black level under alternative, plausible assumptions about the age patterning of excess mortality in 2020. I find that 400,000 excess White deaths would be needed to equal the best mortality ever recorded among Blacks. For White mortality in 2020 to reach levels that Blacks experience outside of pandemics, current COVID-19 mortality levels would need to increase by a factor of nearly 6. Moreover, White life expectancy in 2020 will remain higher than Black life expectancy has ever been unless nearly 700,000 excess White deaths occur. Even amid COVID-19, US White mortality is likely to be less than what US Blacks have experienced every year. I argue that, if Black disadvantage operates every year on the scale of Whites' experience of COVID-19, then so too should the tools we deploy to fight it. Our imagination should not be limited by how accustomed the United States is to profound racial inequality.

Keywords: COVID-19; mortality; racial inequality.

Fig. 1.

US Black and White (A) logged deaths per 100,000 and (B) life expectancy, 1900–2017.

Fig. 2.

Hypothetical excess White mortality that would raise White mortality, or lower White life expectancy, to best-ever Black levels. (A) Logged deaths per 100,000 and (B) life expectancy for non-Hispanic Blacks and Whites, 2006 to 2017, representing all years with official US life tables for these populations. The bolded numbers represent the number of excess White deaths in 2020 needed to raise the most recent documented White mortality to the lowest-ever Black mortality, or lower the most recent documented White life expectancy to the highest-ever Black life expectancy, respectively.