COVID-19 and Other Risk Factors Widen the Black-White Life Expectancy Gap

Black Americans’ higher rates of chronic conditions and disease such as obesity and diabetes, which are linked to fatal COVID-19 infections, may underlie life expectancy differences.

This article is an excerpt from issue 41 of Today’s Research on Aging.

In 2020, COVID-19 deaths appear to have eliminated many of the gains made since 2006 in closing the Black-white life expectancy gap.1 Theresa Andrasfay and Noreen Goldman projected the gap in life expectancy at birth between Black and white Americans would widen by nearly 40% in 2020—from 3.6 years to more than 5 years—reflecting how the pandemic has “laid bare the risks associated with social and economic disadvantage.” They estimated COVID-19 deaths would reduce average years remaining at age 65 by 1.7 years for Black people and 0.6 years for white people. As Andrasfay and Goldman point out, Black Americans’ higher rates of chronic conditions and disease such as obesity and diabetes may underlie these life expectancy differences as these factors are linked to fatal COVID-19 infections.

Differences in obesity, smoking, and education levels help explain the Black-white disparity in premature death.2 Using data on Americans ages 40 to 79 from the National Health and Nutrition Examination Survey, Irma T. Elo, Neil Mehta, and Samuel Preston explore what would happen to the Black-white mortality gap if Black Americans had the same obesity rate, smoking prevalence, and educational distribution as their white peers.

Elo, Mehta, and Preston find that key risk factors for premature death are obesity among Black women and smoking among Black men (see table). Lower educational attainment among both Black men and women also contributes to the Black-white mortality gap. Low educational attainment is associated not only with smoking and obesity but also with lifelong economic hardship, inferior access to health care, and a range of other factors pertinent to health, the researchers report. Smoking may be a way of coping with stressful life conditions, they suggest.

TABLE. Smoking, Obesity, and Education Levels Explain a Large Share of Black-White Differences in Premature Death

Key Risk Factors Contributing to Black-White Differences in Mortality Among Men and Women Ages 40-79 (in Percentages)

Risk Factors Men Women
Smoking 17% 6%
Obesity 1% 30%
Educational Attainment 19% 25%

Source: Irma T. Elo, Neil Mehta, and Samuel Preston, “The Contribution of Weight Status to Black-White Differences in Mortality,” Biodemography and Social Biology 63, no. 3 (2017): 206-20, https://doi.org/10.1080/19485565.2017.1300519.


In 2010, diabetes was responsible for reducing life expectancy by slightly more than one year among Black women at age 30 and by an average of about 10 months among all Americans, Preston and colleagues show in another study.3 Given that life expectancy grew by only 0.1 years between 2011 and 2015, they argue that diabetes plays a major role in reducing U.S. longevity, particularly among Black women.

By age 50, Black parents are up to twice as likely as white parents to have experienced the stressful and traumatic death of a child, Rachel Donnelly and colleagues report.4 Using data from the nationally representative Health and Retirement Study, they show that losing a child is related to heightened mortality risk among both aging Black and white parents.

“Black Americans already face higher mortality rates compared to white Americans, and the unequal burden of child death adds to their mortality risk,” the research team writes. To reduce racial disparities in health and mortality, they argue for policies and programs designed to address “the unequal burden of family loss experienced in black communities.”



  1. Theresa Andrasfay and Noreen Goldman, “Reductions in 2020 U.S. Life Expectancy Due to COVID-19 and the Disproportionate Impact on the Black and Latino Populations,” Proceedings of the National Academy of Sciences 118, no. 5 (2021): e2014746118, https://doi.org/10.1073/pnas.2014746118.
  2. Irma T. Elo, Neil Mehta, and Samuel Preston, “The Contribution of Weight Status to Black-White Differences in Mortality,” Biodemography and Social Biology 63, no. 3 (2017): 206-20, https://doi.org/10.1080/19485565.2017.1300519.
  3. Samuel H. Preston et al., “Effect of Diabetes on Life Expectancy in the United States by Race and Ethnicity,” Biodemography and Social Biology 64, no. 2 (2018): 139-51, https://doi.org/10.1080/19485565.2018.1542291.
  4. Rachel Donnelly et al., “Race, Death of a Child, and Mortality Risk Among Aging Parents in the United States,” Social Science & Medicine 249 (2020), https://doi.org/10.1016/j.socscimed.2020.112853.