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US blacks see gains in life expectancy

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By Sabrina Tavernise

New York Times

WASHINGTON — It is a bitter but basic fact in health research: Black Americans die at higher rates than whites from most causes, including AIDS, heart disease, cancer, and homicide.

But a recent trove of federal data offered some good news on the group's longevity.

The suicide rate for black men declined from 1999 to 2014, making them the only racial group to experience a drop. Infant mortality is down by more than a fifth among blacks since the late 1990s, double the decline for whites. Births to teenage mothers, which tend to have higher infant mortality rates, have dropped by 64 percent among blacks since 1995, faster than for whites.

Blacks are still at a major health disadvantage compared with whites. But evidence of black gains has been building and has helped push up the ultimate measure — life expectancy.

The gap between blacks and whites was seven years in 1990. By 2014, the most recent year on record, it had shrunk to 3.4 years, the smallest in history, with life expectancy at 75.6 years for blacks and 79 years for whites.

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Part of the reason has been bad news for whites, namely the opioid crisis. The crisis, which has dominated headlines — some say unfairly, given racial disparities — has hit harder in white communities, bringing down white life expectancy and narrowing the gap.

But there also has been real progress for blacks. The rate of deaths by homicide for blacks decreased by 40 percent from 1995 to 2013, according to Andrew Fenelon, a researcher with the National Center for Health Statistics, compared with a 28 percent drop for whites. The death rate from cancer fell by 29 percent for blacks over that period, compared with 20 percent for whites.

"Blacks are catching up," said Samuel Preston, a University of Pennsylvania demographer. "The gap is now the narrowest it has been since the beginning of the 20th century, and that's really good news."

The history of health for black Americans has been one of deep inequity. At the start of the 1900s, life expectancy for blacks was nearly 15 years less than for whites, according to federal data.

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This was partly because infant mortality was so much higher for blacks. But it was also because blacks, who were subjected to discrimination and segregation, faced worse living conditions and had almost no access to medical care.

Life expectancy for blacks improved in the 1970s as Medicare and Medicaid increased access to health care and helped integrate hospitals after the abolition of Jim Crow. Smoking had started to decline and new treatments for heart disease, including blood-pressure medications, drastically improved health for everyone.

From 1982 to about 1995, blacks' progress in life expectancy stalled, dragged down by homicides, AIDS, and fallout from the crack epidemic. Since then, blacks have experienced health improvements on a number of fronts.

One profound change has been the decline in violence during the past two decades. The cause is still a matter of intense debate. The decline came after the institution of contentious tough-on-crime policies, but some researchers point out that similar declines happened in Canada, where no such policies were enacted.

Homicides have decreased for everyone since the early 1990s, but have gone down faster for blacks. As a result, the black-white gap in deaths from homicides fell by 40 percent from 1990 to 2010 in the largest metro areas across the country, according to Michael Light, a sociologist at Purdue University.