Ewbank D C
School of Arts and Sciences, University of Pennsylvania, Philadelphia 19104-6298.
Milbank Q. 1987;65 Suppl 1:100-28.
This article documents the history of black mortality between 1850 and 1940 and begins the process of placing that history into the context of the more general history of mortality decline in the United States. One aspect of this process has been to discuss the trends in mortality among blacks and whites living in the same general geographic areas--for example, comparing southern rural blacks with southern rural whites. A second part has been to relate black mortality to many of the factors that have been discussed as determinants of general mortality trends--such as water and sanitation, the urban disadvantage in mortality, and child care and feeding practices. During the second half of the nineteenth century, black mortality declined only slightly or not at all. Between 1850 and 1880 there may have been some decline in child mortality, but the trends in adult mortality are indeterminate. Between 1880 and 1900 both child and adult mortality rates were constant. Sometime between 1900 and 1910 mortality rates among blacks began to decline at all ages, especially in urban areas. During the first four decades of this century mortality rates among American blacks declined substantially. Expectation of life at birth increased from about 35 years to about 54 years, which represents a significant improvement in health and living standards. The life expectancy among blacks in 1940, however, was still two years below the value for whites in the death registration area in 1920. (This may exaggerate the difference slightly since the mortality rates for 1919 and 1920 were artificially low following the pandemic of influenza in 1918. In addition, the mortality rates in the DRA may not have been representative of the whole white population.) Throughout the period studied, blacks had substantially higher mortality rates than whites living in the same area. Although the amount of excessive mortality among blacks differed from place to place and period to period, we did not find a single area or time when black mortality rates were close to those of whites. The examination of causes of death among whites and blacks in 1920 showed that racial differences in the amount of tuberculosis explained a substantial part of the mortality differences in New York and North Carolina, but blacks probably had excessive mortality due to all causes.(ABSTRACT TRUNCATED AT 400 WORDS)
本文记录了1850年至1940年间黑人的死亡率历史，并开始将这段历史置于美国死亡率下降的更广泛历史背景中。这一过程的一个方面是讨论生活在同一大致地理区域的黑人和白人的死亡率趋势——例如，比较南部农村的黑人和白人。第二个方面是将黑人死亡率与许多被讨论为总体死亡率趋势决定因素的因素联系起来——如水和卫生设施、城市在死亡率方面的劣势以及儿童保育和喂养方式。在19世纪下半叶，黑人死亡率仅略有下降或根本没有下降。1850年至1880年间，儿童死亡率可能有所下降，但成人死亡率趋势不明。1880年至1900年间，儿童和成人死亡率均保持稳定。1900年至1910年间的某个时候，黑人各年龄段的死亡率开始下降，尤其是在城市地区。在本世纪的前四十年里，美国黑人的死亡率大幅下降。出生时的预期寿命从约35岁增加到约54岁，这代表着健康和生活水平的显著提高。然而，1940年黑人的预期寿命仍比1920年死亡登记地区白人的预期寿命低两年。（这可能略微夸大了差异，因为1918年流感大流行后，1919年和1920年的死亡率人为地较低。此外，死亡登记地区的死亡率可能并不代表整个白人人口。）在整个研究期间，黑人的死亡率大大高于生活在同一地区的白人。尽管黑人中过高死亡率的数量因地点和时期而异，但我们没有发现任何一个地区或时期黑人死亡率接近白人死亡率。1920年对白人和黑人死因的调查表明，纽约和北卡罗来纳州结核病数量的种族差异解释了死亡率差异的很大一部分，但黑人可能因所有原因都有过高的死亡率。（摘要截取自400字）
