Eddy van Doorslaer, Josselin Thuilliez, Ana Rodríguez-González, Bram Wouterse, Stefano Lombardi, René Karadakic, Paola Bertoli, Libertad Gonzalez, Janet Currie, Joachim Winter, Kjell G. Salvanes, Kristiina Huttunen, Sarah Cattan, Amelie Wuppermann, Peter Redler, Marlies Bär, Cláudia Costa, Veronica Grembi, Hannes Schwandt, Aline Bütikofer, Carlos Riumallo-Herl, Lucy Kraftman, James Banks, Paula Santana, Beatrice Zong-Ying Chao, Tom Van Ourti, Sonya Krutikova, Northwestern University [Evanston], National Bureau of Economic Research [New York] (NBER), The National Bureau of Economic Research (NBER), Center for Health and Wellbeing, Princeton University, Princeton University, Erasmus School of Health Policy and Management |Rotterdam], University of Manchester [Manchester], Institute for Fiscal Studies, Department of Economics and SAFE Center, University of Verona, University of Verona (UNIVR), Norwegian School of Economics and Business Administration, Department of Economics (NHH), Norwegian School of Economics and Business Administration, The Institute for Fiscal Studies (IFS), The Institute for Fiscal Studies, University of Coimbra [Portugal] (UC), Universitat Pompeu Fabra [Barcelona] (UPF), Department of Statistics and Quantitative Methods University of Milano-Bicocca, Università degli Studi di Milano-Bicocca [Milano] (UNIMIB), Aalto University, Government Institute for Economic Research, Helsinki (VATT), VATT, University of Munich (LMU Munich), Department of Economics, Faculty of Economics, Erasmus University Rotterdam, Erasmus university, Lund University [Lund], Centre d'économie de la Sorbonne (CES), Université Paris 1 Panthéon-Sorbonne (UP1)-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS), Erasmus University Rotterdam, Martin-Luther-University Halle-Wittenberg, Claudia Costa received support from the Science and Technology Foundation (FCT), the European Social Fund, and the Centro Operational Programme (SFRH/BD/132218/2017). Paula Santana received support from the Centre of Studies in Geography and Spatial Planning (UIDB/04084/2020), through an FCT fund. Aline Bütikofer, René Karadakic, and Kjell Salvanes received support from the Research Council of Norway through project No. 275800 and through its Centres of Excellence Scheme, FAIR project No. 262675 and by the NORFACE DIAL grant 462-16-050. Peter Redler received support from the Elite Network of Bavaria within the Evidence-Based Economics programme., Northwestern University, University of Verona, Norwegian School of Economics, Universidade de Coimbra, Universitat Pompeu Fabra, University of Milano, Department of Economics, VATT Institute for Economic Research, Ludwig Maximilian University of Munich, Lund University, Université Paris 1 Panthéon-Sorbonne, Martin Luther University Halle-Wittenberg, and Aalto-yliopisto
Significance From 1990 to 2018, the Black–White American life expectancy gap fell 48.9% and mortality inequality decreased, although progress stalled after 2012 as life expectancy plateaued. Had improvements continued at the 1990 to 2012 rate, the racial gap in life expectancy would have closed by 2036. Despite decreasing mortality inequality, income-based life expectancy gaps remain starker in the United States than in European countries. At the same time, European mortality improved strongly and even those U.S. populations with the longest life spans–White Americans living in the highest-income areas–experience higher mortality at all ages than Europeans in high-income areas in 2018. Hence, mortality rates of both Black and White Americans could fall much further in both high-income and low-income areas., Although there is a large gap between Black and White American life expectancies, the gap fell 48.9% between 1990 and 2018, mainly due to mortality declines among Black Americans. We examine age-specific mortality trends and racial gaps in life expectancy in high- and low-income US areas and with reference to six European countries. Inequalities in life expectancy are starker in the United States than in Europe. In 1990, White Americans and Europeans in high-income areas had similar overall life expectancy, while life expectancy for White Americans in low-income areas was lower. However, since then, even high-income White Americans have lost ground relative to Europeans. Meanwhile, the gap in life expectancy between Black Americans and Europeans decreased by 8.3%. Black American life expectancy increased more than White American life expectancy in all US areas, but improvements in lower-income areas had the greatest impact on the racial life expectancy gap. The causes that contributed the most to Black Americans’ mortality reductions included cancer, homicide, HIV, and causes originating in the fetal or infant period. Life expectancy for both Black and White Americans plateaued or slightly declined after 2012, but this stalling was most evident among Black Americans even prior to the COVID-19 pandemic. If improvements had continued at the 1990 to 2012 rate, the racial gap in life expectancy would have closed by 2036. European life expectancy also stalled after 2014. Still, the comparison with Europe suggests that mortality rates of both Black and White Americans could fall much further across all ages and in both high-income and low-income areas.