Trends in the black-white life expectancy gap among US states, 1990-2009.

Nationwide differences in US life expectancy trends for blacks and whites may mask considerable differences by state that are relevant to policies aimed at reducing health inequalities. We calculated annual state-specific life expectancies for blacks and whites from 1990 to 2009 using age-specific mortality counts and census-based denominators. Nationally, the black-white difference in life expectancy at birth shrank during the period by 2.7 years for males (from 8.1 to 5.4 years) and by 1.7 years for females (from 5.5 to 3.8 years). We found considerable variation across states in both the magnitude of the life expectancy gap (approximately fifteen years) and the change during the past two decades (about six years). Decomposition analysis showed that New York made the most profound contribution to reducing the gap, but less favorable trends in a number of states, notably California and Texas, kept the gap from shrinking further. Large state variations in the pace of change in the racial gap in life expectancy suggest that state-specific determinants merit further investigation. Project HOPE—The People-to-People Health Foundation, Inc.