PRB

As the novel coronavirus has spread across the United States, Black Americans have been disproportionately affected by infections and deaths. Among Black Americans ages 65 and older, death rates from COVID-19, the disease caused by the coronavirus, appear to be three times that of their white peers.¹

The pandemic has shone a spotlight on well-documented and long-standing health disparities between Black and white Americans. Compared with their white counterparts, Black men and women have lower life expectancies and a higher prevalence of health conditions such as hypertension, diabetes, dementia, stroke, and cancer.

Growing evidence suggests that a variety of social factors, not genetics, drive this health inequality—including lower levels of education and income, less access to and lower quality health care, and the toll that racism-related stress takes on the body’s defenses. These factors combine with a higher risk of exposure at work and in multigenerational households to help explain why older Black adults have been especially vulnerable to COVID-19 (download the full issue in the left sidebar, or see more content from this issue under “In Six Parts” below. )

This brief summarizes what we know about Black-white health inequality at older ages, focusing on the recent work of researchers supported by the National Institute on Aging. It explores trends and examines the underlying structural forces shaping racial health disparities. These findings can help lawmakers design policies to address these inequalities and help improve health and prevent early death among Black Americans.

Racial Health Disparities Have Policy Implications

The COVID-19 pandemic laid bare long-standing racial health disparities woven deeply into U.S. social structures. Older Black adults have been disproportionately burdened by the pandemic—reflecting more limited health care access, greater job and household exposure to the coronavirus, and higher rates of underlying health conditions, all of which increase vulnerability to severe illness and death.

Trends summarized in this report show that Black-white health disparities related to cardiovascular disease narrowed somewhat related to improvements in diabetes and blood pressure control. Better prevention and treatment of chronic disease and obesity could help shrink the racial gaps in life expectancy and chronic disease.

But socioeconomic inequality and racism-related stress are at the root of Black-white health disparities, requiring policies and interventions targeting both economic inequality and exposure to high levels of stress. Comprehensive action is needed to close health gaps, including criminal justice reform, expanded health care access, job guarantees and desegregation of schools, jobs, and neighborhoods. There is no magic bullet to eliminate long-standing Black-white disparities in health and mortality, but understanding these gaps and their causes is an important first step toward achieving equity.