SYNOPSISObjectives. Optimistic predictions for the Healthy People 2010 goals of eliminating racial/ethnic disparities in health have been made based on absolute improvements in life expectancy and mortality. This study sought to determine whether there is evidence of relative improvement (a more valid measure of inequality) in life expectancy and mortality, and whether such improvement, if demonstrated, predicts future success in eliminating disparities.Methods. Historical data from the National Center for Health Statistics and the Census Bureau were used to predict future trends in relative mortality and life expectancy, employing an Autoregressive Integrated Moving Average (ARIMA) model. Excess mortality and time lags in mortality and life expectancy for blacks relative to whites were also estimated.Results. Based on data for 1945 to 1999, forecasts for relative black:white ageadjusted, all-cause mortality and white:black life expectancy at birth showed trends toward increasing disparities. From 1979, when the Healthy People initiative began, to 1998, the black:white ratio of age-adjusted, gender-specific mortality increased for all but one of nine causes of death that accounted for 83.4% of all US mortality in 1998. From 1980 to 1998, average numbers of

Social development and stress process theories suggest that participation in one's community can function as a protective factor for mental health, especially for youth from socioeconomically disadvantaged areas. However, the effects of community involvement on adolescent mental health could vary across racial/ethnic groups and levels of neighborhood disadvantage. The objectives of this paper are to: (1) examine the effects of various types of community involvement on adolescent mental health, and (2) assess the extent to which race/ethnicity and neighborhood disadvantage moderate the effects of community involvement on adolescent mental health. Using data from two waves (1994/95 and 1996) of the National Longitudinal Study of Adolescent Health (“Add Health,” N=7,863), multilevel (hierarchical) linear models were estimated that tested for interaction effects of race/ethnicity and neighborhood disadvantage. The types of community participation that impacted adolescent mental health varied across racial/ethnic groups. Neighborhood interaction and religious participation were salient for both White and Hispanic teens, but the impact of religious participation for Whites was moderated by neighborhood disadvantage. Non‐sport extracurricular activities and employment were the salient factors for Black teens, both of which were moderated by neighborhood disadvantage. The findings from this study have implications for community‐level and clinical interventions to prevent and/or treat mental health problems among adolescents. Social integration interventions should take into account adolescents' cultural backgrounds and socioeconomic contexts in order to be effective. © 2008 Wiley Periodicals, Inc.

Evidence was mixed for all outcomes. Results should be interpreted cautiously given the high variability in study designs and interventions. Further research needs long-term follow-up, multistrategy interventions that include changes in the nutrition and physical activity environment, reporting of cost data, and consideration of sustainability.

The rationale that underlies the optimistic Healthy People 2010 forecasts, that future success can be built on a foundation of past success, is not supported when relative measures of inequality are used. There has been no sustained decrease in black-white inequalities in age-adjusted mortality or life expectancy at birth at the national level since 1945. Without fundamental changes, most probably related to the ways medical and public health practitioners are trained, evaluated, and compensated for prevention-related activities, as well as further research on translating the findings of prevention studies into clinical practice, it is likely that simply reducing disparities in access to care and/or medical treatment will be insufficient. Millions of premature deaths will continue to occur among African Americans.