Cause-Specific Mortality and Racial Differentials in Life Expectancy, Chicago 2018-2019

Abstract

Background: In Chicago in 2018, the average life expectancy (ALE) for NH Blacks was 71.5 years, 9.1 fewer years than for NH Whites (80.6 years). Inasmuch as some causes of death are increasingly recognized products of structural racism, in urban areas, such causes may have potential for reducing racial inequities through public health intervention. Our purpose is to allocate racial inequities in ALE in Chicago to differentials in cause-specific mortality.

Methods: Using multiple decrement processes and decomposition analysis, we examine cause-specific mortality in Chicago to determine the causes of death that contribute to the gap in life expectancy between NH Blacks and NH Whites.

Results: Among females, the racial difference in ALE was 8.21 years; for males, it was 10.53 years. We find that cancer and heart disease mortality account for 3.03 years or 36% of the racial gap in average life expectancy among females. Differences in homicide and heart disease mortality rates comprised over 45% of the disparity among males.

Conclusions: Strategies for improving inequities in life expectancy should account for differences between males and females in cause-specific mortality rates. In urban areas with high levels of segregation, reducing inequities in ALE may be possible by dramatically reducing mortality rates from some causes.

Contribution: This paper illustrates the state of inequities in ALE between NH Blacks and NH Whites in Chicago for the period just prior to the onset of the COVID-19 pandemic, using a well-established method of decomposing mortality differentials for sub-populations.

Keywords: Decomposition analysis; Demography; Health equity; Life expectancy; Mortality.

Fig. 1

Number of years contributed to the life expectancy gap between non-Hispanic White and non-Hispanic Black populations, by cause of death and sex (2018–2019)