In many societies, racial minorities suffer from disproportionately high rates of disease and mortality. Life expectancy for Australia’s aboriginal people is about 10 years shorter compared to the country’s non-indigenous population. In New Zealand, life expectancy for Maoris is about eight years shorter compared to non-Maori New Zealanders. In the United States, Native Americans are expected to live two years less than whites, and African-Americans are expected to live four years less.

Historically, the dominant explanation for racial health disparities held that minorities experienced greater genetic susceptibility to disease. However, decades of evidence from the field of epidemiology have challenged this explanation. Studies have found that social factors, such as low levels of socioeconomic status and experiences of discrimination, can explain many of the observed racial inequalities in health outcomes.

Despite the growing body of research on social factors that drive racial health disparities, few U.S. studies have assessed the role of specific policies or looked back in history to the pre-Civil Rights era. Understanding more precisely the persistent effects of racial discrimination in the near-past is important, as it is germane to issues ranging from school desegregation and employment-related policies to issues of income mobility and possibly even the rekindled debate over reparations.

A 2014 study published in Epidemiology, “Jim Crow and Premature Mortality Among the U.S. Black and White Population, 1960-2009,” helps fill gaps in the research literature by examining the health effects of the state- and county-level racial segregation laws known as Jim Crow. Harvard University researchers Nancy Krieger, Jarvis T. Chen, Brent A. Coull, Jason Beckfield, Mathew V. Kiang and Pamela D. Waterman obtained mortality and population data for all U.S. counties covering the period 1960-2009. The people in their study were born between 1901 and 2009. The authors assessed racial gaps in premature mortality, which they defined as death before age 65.

The study’s findings include:

• In 1960, 36% of the total U.S. population lived in a jurisdiction with Jim Crow laws, and 63% of African-Americans lived under Jim Crow (these laws were abolished with the enactment of the 1964 Civil Rights Act).
• Black people born between 1921 and 1945 experienced the largest Jim Crow-related effects on premature mortality — those residing in Jim Crow jurisdictions were 20% more likely to die prematurely compared to those living outside Jim Crow jurisdictions.
• In both Jim Crow and non-Jim Crow jurisdictions, black people were about twice as likely to experience premature death compared to whites over the entire study period. Jim Crow laws do not fully account for the difference in premature mortality rates.
• The highest Jim Crow-related risks for premature mortality occurred among blacks born between 1901 and 1945. There was no clear pattern of Jim Crow-related risks over time for whites.

The authors conclude that the study “provides novel and compelling evidence of the enduring impact of Jim Crow and its abolition on the risk of premature mortality among the U.S. black population, as reflected in both period and cohort effects. Even so, abolition of Jim Crow has been insufficient to eliminate the persistent 2-fold black excess risk of premature mortality evident, both in states that did and did not have Jim Crow laws, over the 50 years (1960–2009) encompassed by our study.”

Related research: Research published in 2011 in the DuBois Review, “Racial Disparities in Health: How Much Does Stress Really Matter?” looks at the role that stress plays in health disparities between black, Latino, and white participants in a Chicago-based study.

 

Keywords: African-American, discrimination