MORTALITY

Historical Trends

The long-term trend of substantial increase of life expectancy at birth, which began in the late 1800's with the public health movement, continued well into the 20th century. In the early 1900's, the expectation of life for the Black population was about 16 years less than that of the White population.1 (In the 1900-02 period, expectation of life at birth for Black males and females was about 33 and 35 years, respectively.) Greater relative gains in life expectancy on the part of the Black population during the 20th century have greatly reduced this differential. Nevertheless, as of 1974, Black males and females had a life expectancy at birth of 63 and 71 years respectively, which was still about 6 years less than their White counterparts (table 84).

Three phases in a mortality transition for the Black population in the 20th century were roughly delineated by the two World Wars.2 During the first two decades of this century when the Black population resided principally in the rural South, expectation of life at birth was around 35 years; the White population had a life expectancy of about 50 years. The decade between 1909-11 and 1919-21 was characterized by tremendous gains in life expectancy (13 years for Black males and over 9 years for Black females). Steady improvements were made in the expectation of life during the 1920's and 1930's culminating in another large increase after World War II when the Black-White differential was reduced to less than 8 years. The present phase so far has been characterized by a slow improvement in life expectancy for Black men (a 4-year gain between 1949-51 and 1974), but a relatively rapid gain for Black women (8.5 years since 1949-51). For both sexes, Blacks have made relatively greater gains than Whites in life expectancy since World War II (table 84).

There are several reasons for the two peaks in the gain in life expectancy for both the Black and White populations

'In this section, the term "Black" is used in the text although the data may be for "Black and other races." Blacks constitute about 90 percent of this group.

For a detailed analysis of this transition, see S. L.N. Rao, "On Long-Term Mortality Trends in the United States, 1850-1968." Demography, Vol. 10, No. 3 (August 1973), pp. 405-419.

centering around World War I and World War II. Aside from the improved medical techniques and drugs introduced during the war years and the GI benefits derived by spouses of Armed Forces personnel, major changes in the economic structure of the Nation during the war years produced substantial geographic shifts in the Black population to northern and urban areas with better educational institutions and health service delivery systems.

Age Differentials

Since 1940, the most significant gains in life expectancy have occurred at the younger ages although smaller gains have been made at the older ages for both Blacks and Whites. Whereas Black-White differentials in life expectancy at birth have decreased due to relatively greater declines in infant mortality for Blacks, little progress has been made among middle-aged people (tables 85 and 86).

An increasing differential in the number of additional years of life expected emerges, however, between Black males and females at all ages (table 85). For example, in the 1939-41 period, Black men 25 years old expected 35.9 additional years of life while the comparable group of women expected 38.3 additional years, a difference of 2.4 years. By 1974, this gap had widened to 7.3 years. The principal reason for this diverging trend at age 25 was the rapid fall in maternal mortality rates at the childbearing ages (15 to 44 years old) (table 86). High maternal mortality rates among Black women in the early part of this century were substantial enough to raise the overall mortality rate for all Black women in the childbearing ages above the rate for men at the same ages.3

Examining the age-specific death rates for both the Black and White populations show that Blacks have substantially higher death rates than Whites except at the oldest ages (75 years and over). A possible reason for this reversal involves inaccuracies in age reporting for the Black population at the older ages. In recent years, Blacks have had a lower crude death rate than Whites, despite the fact that Whites have had both lower mortality rates at all ages (except the oldest) and

3 Mortimer Spiegelman, Introduction to Demography, rev. ed. (Cambridge: Harvard University Press, 1970), p. 90.

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