Survival in Adversity: Trends in Mortality Among Blacks in the United States, 1900–2010

The goal of this study was to analyze trends in black age-adjusted mortality rates (AADR) from 1900 through 2010 and to propose explanations. Analyses included a descriptive study of trends in AADR from major causes for blacks and age-specific all-cause mortality at each decade. In 1900, all-cause AADRs were higher for blacks than whites. Over the century, differences decreased substantially. Reductions mortality were greatest among young people, lowest among older adults. Deaths from infectious diseases showed the greatest decrease. Heart disease mortality among blacks increased from 1920 to 1950, then decreased by 2010. For men and women, AADRs for cancer rose to a peak in 1990, then declined. Stroke mortality decreased steadily for males and females. AADRs from unintentional injuries (not including motor vehicle injury) decreased gradually. Despite widespread societal resistance, blacks have made substantial gains in a wide range of social determinants of health, such as civil rights, education, employment, income, and housing. Substantial gains remain to be made.