U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

NCHS Data Brief ■ No. 218 ■ November 2015

Leading Causes of Death Contributing to Decrease in Life 

Expectancy Gap Between Black and White Populations: 

United States, 1999–2013

Kenneth D. Kochanek, M.A.; Elizabeth Arias, Ph.D.; and Robert N. Anderson, Ph.D.

Key findings

Data from the National 

Vital Statistics System, 

Mortality

● The gap in life expectancy 

between the black and white 

populations decreased 2.3 years 

between 1999 and 2013 (5.9 to 

3.6 years).

● The decrease in the gap was 

due to larger decreases in death 

rates for the black population for 

heart disease, cancer, and HIV 

disease.

● The gap in life expectancy 

between black and white males 

decreased 2.4 years between 

1999 and 2013 (6.8 to 4.4 years).

● The decrease in the gap 

was due to larger decreases 

in death rates for black males 

for HIV disease, cancer, and 

unintentional injuries.

● The gap in life expectancy 

between black and white 

females decreased 2.2 years 

between 1999 and 2013 (5.2 to 

3.0 years).

● The decrease in the gap was 

due to larger decreases in death 

rates for black females for heart 

disease, HIV disease, and cancer.

The trend in U.S. life expectancy since 1900 has been one of gradual 

improvement (1). Nevertheless, differences in life expectancy by race have 

persisted at least since official estimates were recorded. Measuring health 

disparities, including those in life expectancy, is part of the Healthy People 

2020 recommendations (2). In 1999, the difference in life expectancy between 

the white and black populations was 5.9 years. The gap decreased to

3.6 years in 2013. Black and white population differences in causes of death 

are explored to determine how they contribute to the decrease in the gap in life 

expectancy from 1999 through 2013.

Keywords: mortality • disparities • National Vital Statistics System

What are the recent trends in life expectancy?

Life expectancy at birth increased steadily from 77.3 years in 1999 to 

79.1 years in 2013 for the white population (2.3% increase) (Figure 1). For 

Figure 1. Life expectancy, by race and sex: United States, 1999–2013

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SOURCE: CDC/NCHS, National Vital Statistics System, Mortality.
NCHS Data Brief ■ No. 218 ■ November 2015

■  2  ■

white males, the increase was from 74.6 years to 76.7 years (2.8% increase), and for white 

females, from 79.9 years to 81.4 years (1.9% increase). 

Life expectancy at birth for the black population increased steadily from 71.4 years in 1999 to 

75.5 years in 2013 (5.7% increase). For black males, the increase was from 67.8 years to

72.3 years (6.6% increase), and for black females, from 74.7 years to 78.4 years (5.0% increase). 

How did the racial gap in life expectancy change over time?

In 2013, the difference in life expectancy at birth between the black and white populations was 

3.6 years (Figure 2). For black and white males, this difference was 4.4 years, and for black and 

white females, the difference was 3.0 years.

In 1999, the difference in life expectancy between the black and white populations was 5.9 years. 

For black and white males, this difference was 6.8 years, and for black and white females the 

difference was 5.2 years (1).

Between 1999 and 2013, the gap in life expectancy between the black and white populations 

decreased by 2.3 years. For black and white males, the decrease in the gap was 2.4 years, and for 

black and white females, the decrease in the gap was 2.3 years.

Figure 2. Differences in life expectancy between white and black populations, by sex: United States, 1999–2013

SOURCE: CDC/NCHS, National Vital Statistics System, Mortality.

 

 

 

 

 

 

 

 

 

 

 
NCHS Data Brief ■ No. 218 ■ November 2015

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What leading causes of death influenced the decrease in the life 

expectancy gap between the black and white populations from 1999 to 

2013?

● The decrease in the gap in life expectancy between the black and white populations was 

due to larger decreases in death rates for the black population for heart disease, cancer, HIV 

disease, unintentional injuries, and perinatal conditions (Figure 3), which together accounted 

for 59.1% of the 2.3-year decrease in the gap.

● Greater decreases in heart disease mortality for the black population accounted for

0.370 year of the decrease in the gap in life expectancy. 

● The decline in the gap was attenuated somewhat by greater increases in death rates from 

aortic aneurysm, Alzheimer’s disease, and maternal conditions (Figure 3) for the black 

population. The increase in death rates for these causes accounted for 90.6% of the total 

increase in the gap.

Figure 3. Contribution of leading causes of death to decrease in life expectancy gap between black and white populations: 

United States, 1999–2013

 

SOURCE: CDC/NCHS, National Vital Statistics System, Mortality.
NCHS Data Brief ■ No. 218 ■ November 2015

■  4  ■

What leading causes of death influenced the decrease in the gap in life 

expectancy between the black and white male populations from 1999 to 

2013?

● Greater decreases in death rates for black males due to HIV disease, cancer, unintentional 

injuries, heart disease, and perinatal conditions (Figure 4) together accounted for 64.8% of 

the 2.4-year decrease in the gap.

● Greater decreases in HIV disease mortality alone accounted for 0.426 year in the decrease in 

the gap in life expectancy between black and white males.

● Greater increases in death rates for black males due to hypertension, aortic aneurysm, 

diabetes, Alzheimer’s disease, and kidney disease attenuated the decline in the gap between 

black and white males over the period.

Figure 4. Contribution of leading causes of death to decrease in life expectancy gap between black and white males:

United States, 1999–2013

Gap in life expectancy (years)

–0.5 –0.4 –0.3 –0.2 –0.1 0.0 0.1

Hypertension

Aortic aneurysm

Diabetes

Alzheimer's disease

Kidney disease 0.012

0.013

0.016

0.019

0.022

Perinatal conditions

Heart disease

Unintentional 

injuries

Cancer

–0.426 HIV disease

–0.421

–0.384

–0.248

–0.161

Increase in gap

Decrease in gap

SOURCE: CDC/NCHS, National Vital Statistics System, Mortality.
NCHS Data Brief ■ No. 218 ■ November 2015

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What leading causes of death influenced the decrease in the gap in life 

expectancy between the black and white female populations from 1999 to 

2013?

● Greater decreases in death rates for black females due to heart disease, HIV disease, cancer, 

diabetes, and unintentional injuries (Figure 5) together accounted for 54.7% of the 2.2-year 

decrease in the gap.

● Greater decreases in heart disease mortality alone accounted for 0.534 year in the decrease 

in the gap in life expectancy between black and white females.

● Greater increases in death rates for black females due to Alzheimer’s disease, maternal 

conditions, and atherosclerosis attenuated the decline in the gap between black and white 

females over the same period.

Figure 5. Contribution of leading causes of death to decrease in life expectancy gap between black and white females:

United States, 1999–2013

Increase in gap

Decrease in gap

0.004

0.011

0.019

Unintentional

injuries

Diabetes

Cancer

HIV disease

–0.534 Heart disease

–0.193

–0.179

–0.158

–0.169

 Alzheimer's disease

Maternal conditions

Atherosclerosis

Gap in life expectancy (years)

–0.6 –0.5 –0.4 –0.3 –0.2 –0.1 0.0 0.1

SOURCE: CDC/NCHS, National Vital Statistics System, Mortality.
NCHS Data Brief ■ No. 218 ■ November 2015

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Summary

Life expectancy at birth has increased steadily since 1900 to a record 78.8 years in 2013. But 

differences in life expectancy between the white and black populations still exist, despite a 

decrease in the life expectancy gap from 5.9 years in 1999 to 3.6 years in 2013. Differences in 

the change over time in the leading causes of death for the black and white populations have 

contributed to this decrease in the gap in life expectancy.

Between 1999 and 2013, the decrease in the life expectancy gap between the black and white 

populations was mostly due to greater decreases in mortality from heart disease, cancer, HIV 

disease, unintentional injuries, and perinatal conditions among the black population. Similarly, the 

decrease in the gap between black and white male life expectancy was due to greater decreases in 

death rates for HIV disease, cancer, unintentional injuries, heart disease, and perinatal conditions 

in black males. For black females, greater decreases in diabetes death rates, combined with 

decreased rates for heart disease and HIV disease, were the major causes contributing to the 

decrease in the life expectancy gap with white females.

The decrease in the gap in life expectancy between the white and black populations would 

have been larger than 3.6 years if not for increases in death rates for the black population for 

aortic aneurysm, Alzheimer’s disease, and maternal conditions. For black males, the causes that 

showed increases in death rates over white males were hypertension, aortic aneurysm, diabetes, 

Alzheimer’s disease, and kidney disease, while the causes that showed increases in death rates for 

black females were Alzheimer’s disease, maternal conditions, and atherosclerosis.

This NCHS Data Brief is the second in a series of data briefs that explore the causes of death 

contributing to differences in life expectancy between detailed ethnic and racial populations in the 

United States. The first data brief focused on the racial differences in life expectancy for a single 

year, 2010 (3).

Data source and methods

All data are from the 1999 and 2013 mortality files of the National Vital Statistics System. Life 

table methodology is explained in the NCHS reports “Deaths: Final Data for 2013” (1) and 

“United States Life Tables, 2010” (4). A complete description of the Arriaga life table partitioning 

methodology is available elsewhere (5,6).

Definitions

Cause-of-death classification: Medical information—including injury diagnoses and external 

causes of injury—that is entered on death certificates filed in the United States and classified and 

coded in accordance with the International Statistical Classification of Diseases and Related 

Health Problems, Tenth Revision (ICD–10) (7). Corresponding cause-of-death categories and 

ICD–10 codes presented in this report are: 

● Heart disease (Diseases of heart, I00–I09, I11, I13, I20–I51)

● Cancer (Malignant neoplasms, C00–C97)

● Unintentional injuries (Accidents, V01–X59, Y85–Y86)
NCHS Data Brief ■ No. 218 ■ November 2015

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● Alzheimer’s disease (G30)

● Diabetes (Diabetes mellitus, E10–E14)

● Kidney disease (Nephritis, nephrotic syndrome and nephrosis, N00–N07, N17–N19, N25–

N27)

● Hypertension (Essential hypertension and hypertensive renal disease, I10, I12, I15)

● Perinatal conditions (Certain conditions originating in the perinatal period, P00–P96)

● Aortic aneurysm (Aortic aneurysm and dissection, I71)

● HIV disease (Human immunodeficiency virus [HIV] disease, B20–B24)

● Maternal conditions (Pregnancy, childbirth and the puerperium, O00–O99)

● Atherosclerosis (I70)

Life expectancy: The average number of years that a group of infants would live if the group was 

to experience throughout life the age-specific death rates present in the year of birth. Also referred 

to as period, or current life expectancy (1). 

About the authors

Kenneth D. Kochanek, Elizabeth Arias, and Robert N. Anderson are with CDC’s National Center 

for Health Statistics, Division of Vital Statistics, Mortality Statistics Branch.

References

1. Xu JQ, Murphy SL, Kochanek KD. Deaths: Final data for 2013. National vital statistics

reports; vol 64 no 2. Hyattsville, MD: National Center for Health Statistics. 2016 [Forthcoming]. 

2. U.S. Department of Health and Human Services. Developing Healthy People 2020, Phase I

report: Recommendations for the framework and format of Healthy People 2020, Appendix 11: 

Measuring health disparities and health equity. 2008. Available from: http://www.healthypeople.

gov/2010/hp2020/advisory/PhaseI/appendix11.htm.

3. Kochanek KD, Arias E, Anderson RN. How did cause of death contribute to racial differences

in life expectancy in the United States in 2010? NCHS data brief, no 125. Hyattsville, MD: 

National Center for Health Statistics. 2013.

4. Arias E. United States life tables, 2010. National vital statistics reports; vol 63 no 7.

Hyattsville, MD: National Center for Health Statistics. 2014.

5. Arriaga E. Measuring and explaining the change in life expectancies. Demography 21(1):83–

96. 1984.

6. Arriaga EE. Changing trends in mortality decline during the last decades. In: Ruzicka L,

Wunsch G, Kane P, editors. Differential mortality: Methodological issues and biosocial factors. 

Oxford, England: Clarendon Press. 1989. 

7. WHO. International statistical classification of diseases and related health problems, tenth

revision (ICD–10). 2nd edition. Geneva, Switzerland. 2004. 
NCHS Data Brief ■ No. 218 ■ November 2015

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Suggested citation

Kochanek KD, Arias E, Anderson RN. 

Leading causes of death contributing to 

decrease in life expectancy gap between 

black and white populations: United States, 

1999–2013. NCHS data brief, no 218. 

Hyattsville, MD: National Center for Health 

Statistics. 2015.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Charles J. Rothwell, M.S., M.B.A., Director

Nathaniel Schenker, Ph.D., Deputy Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Vital Statistics

Delton Atkinson, M.P.H., M.P.H., P.M.P., 

Director

Hanyu Ni, Ph.D., M.P.H., Associate Director 

for Science

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