Excess Mortality and Years of Potential Life Lost Among Black People in the US from 1999 to 2020

Abstract

Background: There is scarce information on recent trends in excess deaths and years of potential life lost among Black populations compared with White populations in the United States. Methods: We used death certificates data from the Centers for Disease Control and Prevention WONDER from 1999-2020 and evaluated trends in excess age-adjusted mortality rate (deaths per 100,000 individuals) and years of potential life lost (YPLL) among Black people compared with White people. We also evaluated these metrics by cause of death and age. Results: From 1999 to 2020, the total number of excess deaths was 658,356 and 1,154,108 among Black females and males, representing 34,938,070 and 47,005,048 excess YPLL among Black females among males, respectively. The excess deaths and YPLL were the greatest in deaths due to heart disease and among infants and non-elderly adults. From 1999, the age-adjusted excess mortality rate among Black people declined at an annual average of -9.0 (95% CI: -10.0, -8.0; P<0.001) among females and -16.3 (95% CI: -20.9, -11.6; P<0.001) among males. It plateaued between 2015-2019 among females and 2012-2019 among males. In 2020, rates increased to 395 and 192 excess deaths per 100,000 males and females, respectively, reaching rates close to those of 1999. The trends in rates of excess YPLL followed a similar pattern. Conclusions: Over a recent 22-year period, Black people in the US lost more than 80 million years of life when compared with White people. After a period of some progress, improvements stalled, and most gains were eliminated in 2020.

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