March 03, 2023 | Press Release

US Mortality: New Measure Reveals Large Mortality Inequality

Researchers at the MPIDR and University of Wisconsin-Madison developed a new measure called GAP to assess contemporary mortality inequality in the US across racial-ethnic groups. They find that current estimates based on standard metrics such as life expectancy underestimate racial-ethnic disparities in mortality.

Racial-ethnic groups in the U.S. have very different population age structure due to differences. For example, Hispanic population is younger than Whites. “Standard approaches measuring mortality inequality take into account only risk of death. Our approach is tailored to capture also the fact that the age structures differ,” says Mikko Myrskylä, Director of the Max Planck Institute for Demographic Research in Rostock, Germany and co-author of the paper recently published in Epidemiology.

Myrskylä, Héctor Pifarré i Arolas, Assistant Professor at the University of Wisconsin- Madison, and co-authors developed a new measure of mortality inequality that accounts for age structure of different groups and called it GAP (a reference to the age gap it is tracking). After assessing mortality inequality related to race-ethnicity in the US, they found that current estimates based on standard metrics such as life expectancy underestimate mortality differences for these populations.

Re-analyzing racial-ethnic mortality inequalities using the GAP

“Existing approaches implicitly or explicitly assume age structures that differ from those of actual populations, and in some cases this practice can result in misleading conclusions,” says Pifarré i Arolas.

The researchers used GAP to re-analyze current racial-ethnic mortality inequalities by comparing Asian Americans, Blacks, Hispanics, and Native Americans/Alaska Natives to Whites. The team used circulatory diseases, the leading cause of death in the US, for normalizing disparities. Based on GAP, Black and Native American mortality disadvantage, compared to Whites, is as deadly or deadlier than circulatory diseases.

More reasonable signal for health policy to allocate resources

In contrast, Asian Americans and Hispanics have a mortality advantage over Whites that is over two times larger than that based on life expectancy.

The demographers used publicly available data from the Human Mortality Database, the National Center for Health Statistics, the Centers for Disease Control and Prevention, and the World Health Organization as inputs for the newly proposed GAP method.

“For health policy, age-structure corrected inequalities which are illuminated by measures such as GAP may provide a more reasonable signal on where to allocate scarce resources,” says Hector Pifarré i Arolas.

Original Publication

Pifarré i Arolas, H., Acosta, E., Dudel, C., Hale, J.M., Myrskylä, M: U.S. Racial/Ethnic Mortality Gap Adjusted for Population Structure. Epidemiology (2022). DOI: 10.1097/EDE.0000000000001595