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David Satcher, George E. Fryer, Jr., Jessica McCann, Adewale Troutman, Steven H. Woolf, and George Rust What If We Were Equal? A Comparison Of The Black-White Mortality Gap In 1960 And 2000 Health Affairs, March/April 2005; 24(2): 459-464. [Abstract] [Full Text] [Figures Only] [PDF] [Reprints & Permissions]

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Appraising the Size of Racial Disparities in Mortality

James P. Scanlan, None   ( 23 August 2005 )

Appraising the Size of Racial Disparities in Mortality 23 August 2005
James P. Scanlan, Attorney None, None Send comment to journal: Re: Appraising the Size of Racial Disparities in Mortality jps{at}jpscanlan.com James P. Scanlan, et al.	The effort by Satcher et al. to appraise changes in racial disparities in mortality over time reflects the common failure to appreciate the tendency for demographic disparities in an outcome almost invariably to increase as the outcome declines. The tendency is a consequence of the fact that disadvantaged groups comprise larger proportions of the part of the population that is very susceptible to some adverse outcome than they comprise of the part of the population that is only somewhat susceptible to the outcome. This pattern can be observed in almost every data set that allows one to examine the demographic makeup of the population falling below various points in a continuum. Published income data provide a ready illustration.[1] The black poverty rate (24.3 percent) is 2.3 times the white poverty rate (10.6 percent); but the black rate of falling below 50 percent of the poverty line (11.7 percent) is 2.8 times the white rate (4.2 percent). Suppose, then, that a program to reduce poverty enabled everyone with incomes between the poverty line and 50 percent of the poverty line to escape poverty. The ratio of the black poverty rate to the white poverty rate would increase. For that matter, the ratio would increase even where, say, all blacks between the two points escaped poverty but only 90 percent of whites did. Even if the tendency is not found in every setting, the recognition of the typicality of the pattern is crucial to any effort to appraise the relative size of disparities at different points in time.[2] [1] U.S. Census Bureau, Current Population Survey, 2004 Annual Social and Economic Supplement, Table POV01: “Age and Sex of All People, Family Members and Unrelated Individuals Iterated by Income-to-Poverty Ratio Below 100% of Poverty – White Alone or in Combination (A.O.I.C.),” July 9, 2004, http://pubdb3.census.giv/macro/032004/pov/new01_100_02.htm [2] J.P. Scanlan, “Race and Mortality,” Society 37, no. 2:29-35. 2000.