An examination of black/white differences in the rate of age-related mortality increase

Abstract

BACKGROUND The rate of mortality increase with age among adults is typically used as a measure of the rate of functional decline associated with aging or senescence. While black and white populations differ in the level of mortality, mortality also rises less rapidly with age for blacks than for whites, leading to the well-known black/white mortality “crossover”. OBJECTIVE This paper investigates black/white differences in the rate of mortality increase with age for major causes of death in order to examine the factors responsible for the black/white crossover. METHODS The analysis considers two explanations for the crossover: selective survival and age misreporting. Mortality is modeled using a Gompertz model for 11 causes of death from ages 50–84 among blacks and whites by sex. RESULTS Mortality increases more rapidly with age for whites than for blacks for nearly all causes of death considered. The all-cause mortality rate of mortality increase is nearly two percentage points higher for whites. The analysis finds evidence for both selective survival and age misreporting, although age misreporting is a more prominent explanation among women. CONCLUSIONS The black/white mortality crossover reflects large differences in the rate of age-related mortality increase. Instead of reflecting the impact of specific causes of death, this pattern exists across many disparate disease conditions, indicating the need for a broad explanation.

Why Lifespans Are More Variable Among Blacks Than Among Whites in the United States

“… 4 Age-specific death rates are higher for blacks than for whites until age 87 (Fenelon 2013). Because the black-white crossover at age 87 might be due in part to age misreporting for blacks (Fenelon 2013), we performed simulations based on downward adjustments of the age at death among older blacks.…”

“…Because the black-white crossover at age 87 might be due in part to age misreporting for blacks (Fenelon 2013), we performed simulations based on downward adjustments of the age at death among older blacks. These adjustments had very little effect on the difference in the black-white variance.…”

Black–White Disparities in Adult Mortality: Implications of Differential Record Linkage for Understanding the Mortality Crossover

“…Women experience a lower risk of mortality relative to men throughout the life course, and the female advantage in life expectancy at birth is larger among blacks relative to whites (Kochanek et al 2016). A number of studies have documented more severe data quality issues in mortality data among women than men (Curb et al 1985; Fenelon 2013; Preston et al 1996). Unlike the public-use NHIS-LMF data, which top-code age at 85 years in recent survey years, the special-request file used for this study does not top-code age and thus allows observation of mortality among the oldest old, at the ages where black and white mortality rates purportedly cross over.…”

Examining resources and their influence on developmental health outcomes in older African Americans

“…Manton, Poss, & Wing, 1979;Wing, et al, 1985). African American men and women have higher rates of mortality in young older ages than White older adults, whereas Whites have higher mortality than Blacks in very late old age (Fenelon, 2013). This Black/White mortality crossover has remained controversial although it has been documented using multiple sources of data and in a variety of diverse study populations (Dupre, Franzese, & Parrado, 2006;Lynch et al, 2003;Masters, 2012;Wing et al, 1985).…”

“…Two theories have been prominent in the mortality crossover discussion, selective survival and age misreporting. Many scholars have speculated that this crossover resulted from the survival of the fittest among African Americans, with those individuals considered the frailest in the population dying first (Fenelon, 2013;Manton, Poss & Wing, 1979;Manton, Stallard & Vaupel, 1986). Age misreporting posits that Black older adults are more likely to misreport their age as older due to formal birth records unavailability or poor quality (Preston, Elo & Stewart, 1999).…”