Racial/Ethnic Differences in Early-Life Mortality in the United States

Abstract

U.S. early life (ages 1–24) deaths are tragic, far too common, and largely preventable. Yet demographers have focused scant attention on U.S. early life mortality patterns, particularly as they vary across racial and ethnic groups. We employ the restricted-use 1999–2011 National Health Interview Survey-Linked Mortality Files and hazard models to examine racial/ethnic differences in early life mortality. Our results reveal that these disparities are large, strongly related to differences in parental socioeconomic status, and expressed through different causes of death. Compared to non-Hispanic whites, non-Hispanic blacks experience 60%, and Mexican Americans 32% higher risk of death over the follow-up period, with demographic controls. Our finding that Mexican Americans experience higher early life mortality risk than non-Hispanic whites differs from much of the literature on adult mortality. We also show that these racial/ethnic differences attenuate with controls for family structure and especially with measures of socioeconomic status. For example, higher mortality risk among Mexican-Americans relative to non-Hispanic whites is no longer significant once we control for mother’s education or family income. Our results strongly suggest that eliminating socioeconomic gaps across groups is the key to enhanced survival for children and adolescents in racial/ethnic minority groups.

The persistent southern disadvantage in US early life mortality, 1965‒2014

“…To begin, children, adolescents and young adults in the 1 to 24 age group, with a population of approximately 100.8 million, make up 31.2% of the entire US population. 7 Although this age group is generally healthy, considerable evidence suggests that many of the same social disparities and patterns in health observed among older adults are already observable at these younger ages (Mehta, Lee, and Ylitalo 2013;Mulye et al 2009;Park et al 2014;Rogers et al 2017). In addition, the majority of deaths in this age group are from external causes such as motor vehicle accidents, suicides, homicides, and drug overdoses, which are considered largely preventable and avoidable (Cunningham, Walton, and Carter 2018;Singh et al 2013).…”

Family Structure and Early Life Mortality in the United States

“…In a more recent study, Rogers, Lawrence, Hummer, and Tilstra () used the 1999–2011 National Health Interview Survey‐Linked Mortality Files (NHIS‐LMFs) to find that compared to children living with two parents, children living in other family structures at the time of the survey experienced higher overall early life mortality (hazard ratio [HR] = 1.31) with demographic controls (sex, race/ethnicity, nativity, and region), but this association was no longer statistically significant with full controls for demographic factors and SES. In contrast, compared to children living with two parents, children in other family structures experienced higher risks of external causes of death (HR = 1.27), including homicides (HR = 1.56) and suicides (HR = 1.97), net of demographic and socioeconomic factors.…”

“…Consistent with most studies on this and related topics, both studies used broad categories of household structure. Hussey () examined married‐couple households, single mother households, and other structures, whereas Rogers et al () compared children living with two‐parent families to those living in other family structures.…”

“…Prior research has demonstrated that the association between family structure and child well‐being is primarily due to socioeconomic resources (Braudt, Lawrence, Tilstra, Rogers, & Hummer, ; Hussey, ; Rogers et al, ; Thomson, Hanson, & McLanahan, ). Thus, it is important to control for SES, which may confound the family structure–mortality relationship.…”

“…For example, the percentage of children living in single‐parent families in 2017 was 24% for non‐Hispanic whites, 41% for Hispanics, and 65% for African Americans (Annie E. Casey Foundation, ). Moreover, African American and Hispanic children exhibit considerably higher early life mortality risks than non‐Hispanic white children (Rogers et al, ). Children living in the South experience higher mortality rates than children living in other regions of the country (Dollar et al, ).…”