Progress for African Americans? Yes, and No

Martin Luther King at podium
Dr. Martin Luther King delivering his “I Have a Dream” speech in Washington on August 28, 1963. National Archives and Records Administration, via Wikimedia

All the discussions today of how much racial progress we’ve made since Dr. Martin Luther King was alive reminded me of a disturbing point about the black−white health gap mentioned in recent research, some of which I discussed in an Atlantic essay over the weekend.

According to the Centers for Disease Control, African Americans have been catching up with whites in terms of life expectancy at birth. So things are looking up, right?

Yes, and no. To a sizeable extent, what explains the narrowing of the life-expectancy gap in the last couple decades is not just that things are better for African Americans (though they have improved), but also that things are worse for whites—working-class whites above all.

A New York Times piece over the weekend highlighted this fact. “A once yawning gap between death rates for blacks and whites has shrunk by two-thirds”—but that’s not because both groups are doing better, according to the article. Overall mortality has declined for African Americans of all ages, but it has risen for most whites (specifically, all groups except men and women ages 54-64 and men ages 35-44).

Furthermore, younger whites (ages 25-34) have seen the largest upticks in deaths, largely because of soaring rates of drug overdoses, and those who have little education are dying at the highest rates. The mortality rate has dropped for younger African Americans, a decline apparently driven by lower rates of death from AIDS. Together these trends have cut the demographic distance between the two groups substantially.

For middle-age African Americans, the progress in improving health outcomes implied by the shrinking black−white mortality gap is also less cause for celebration than it might seem at first.

A much-discussed study last year by the economists Anne Case* and Angus Deaton found that huge spikes in deaths by suicide and drug poisonings over the last couple decades have meant that the trend of declining mortality rates we’ve seen for generations actually reversed for whites ages 45-54 between 1999 and 2013. Again, those with little education were hit the hardest.

In my Atlantic piece, I pointed out that the growing social isolation and economic insecurity of the white working class might explain some of these trends. One of the caveats I mentioned is that death and disease rates remain much higher among African Americans and Latinos. (I should have been more precise in the article: although Latinos have higher rates of chronic liver disease, diabetes, obesity, and poorly controlled high blood pressure, they have lower rates of cancer and heart disease, and lower or at least equivalent rates of death).

But it’s not just that the black−white gap persists. Here’s an important passage from Case and Deaton’s paper:

Over the 15-[year] period, midlife all-cause mortality fell by more than 200 per 100,000 for black non-Hispanics, and by more than 60 per 100,000 for Hispanics. By contrast, white non-Hispanic mortality rose by 34 per 100,000. CDC reports have highlighted the narrowing of the black−white gap in life expectancy. However, for ages 45–54, the narrowing of the mortality rate ratio in this period [1999−2013] was largely driven by increased white mortality; if white non-Hispanic mortality had continued to decline at 1.8% per year, the ratio in 2013 would have been 1.97. The role played by changing white mortality rates in the narrowing of the black−white life expectancy gap (2003−2008) has been previously noted. It is far from clear that progress in black longevity should be benchmarked against US whites.

Let me reiterate their point: for Americans ages 45-54, the narrowing in the black−white gap in life expectancy in recent decades was “largely driven” by more deaths among whites.

It’s heartening that overall life expectancy is increasing for many Americans, including African Americans. But it’s also important to remember that, almost a half century after King’s death, people of all races continue to be left out of this country’s progress, and some—whites and nonwhites—may, in fact, be seeing an unprecedented step backward.

* I want to apologize to Dr. Anne Case for mistakenly identifying her as “Susan Case” in the original version of my article in the Atlantic. (The only reason I can think of for why I made that dumb mistake is that a friend of mine is named Susan Caisse.) This brilliant scholar has already suffered the injustice of having her study erroneously called the “Deaton and Case study” rather than the “Case and Deaton study” (for better or worse, first authorship is everything to us academics), and here I’ve added insult to indignity. My sincere apologies.

This post was first published on In The Fray.