Why did black life expectancy decline from 1984 through 1989 in the United States?

Abstract

OBJECTIVES. The objective of this study was to partition the change in US life expectancy into those major causes of death and age groups that contributed most to the decline in life expectancy for Black males and females and to the increase in life expectancy for White males and females in the period from 1984 through 1989. METHODS. By means of a life table partitioning technique, the positive and negative contributions of age and cause of death to changes in life expectancy were estimated. RESULTS. Causes contributing most to the decrease in life expectancy for Black males included human immunodeficiency virus (HIV) infection (< 5 and 20-69 years of age) and homicide (1-4 and 10-34 years of age); for Black females the causes included HIV infection (< 5 and 20-59 years of age) and cancer (65-79 and > or = 85 years of age). CONCLUSIONS. Mortality trends between the two major race groups in the United States diverged sharply, and without precedent, during the late 1980s. A description of these trends in terms of contributions to change in life expectancy may help us better analyze and interpret changes in the health of these groups and may contribute to a better allocation of resources for research, education, and public health programs.