Possibility of eliminating racial disparity in premature mortality in the United States by 2010

Introduction: The second goal in Healthy People 2010, eliminating health disparities, is a noble and daunting challenge. Measuring racial health disparities in premature mortality is a simple way of assessing progress that addresses this goal as well as the first goal, increasing length of life. We use premature mortality rates over both 35 years and a more recent 10 year period to assess the probability of achieving these important goals. Methods: Calculate age-adjusted premature mortality rates, measured as years of life lost before age 75 by race, plot long term (1968-2003) and more current (1994-2003) trends, then project linear trends on each data series to 2010. Examine the association of federal policy changes with progress toward elimination of the racial disparity. Results: Premature mortality for Non-Whites was 129% greater than Whites in 1968 but decreased at a greater rate (58% versus 44%) over 35 years. Projection to 2010, based on the previous 35 year trend, predicts that the Non-White-to-White rate will be reduced to a 44% disparity. Using the most recent 10-year trend for projection suggests that this racial disparity may actually be eliminated by 2010. Federal initiatives and expenditures associated with 6 presidential administrations show small relationship to this progress. Conclusions: Substantial progress is being made toward elimination of racial disparity using this measure and trends should be tracked closely to inform goal setting for HP2020. More sophisticated models and methods are needed to correlate progress toward Healthy People goals with policy and program expenditures.