Lawrence Jourdyn A, Jahn Jaquelyn L, Shi Joy, Himmelstein Kathryn E W, Feldman Justin M, Linos Natalia, Bassett Mary T
Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, United States.
The Ubuntu Center on Racism, Global Movements, and Population Health Equity, Drexel University, Philadelphia, Pennsylvania, United States.
Am J Epidemiol. 2024 Nov 29. doi: 10.1093/aje/kwae444.
Activists, policymakers, and scholars increasingly have advocated for reparations payments to Black Americans to redress the harms of enslavement and discriminatory practices that followed. This study examined the effects of a hypothetical monetary reparations intervention on all-cause premature and overall mortality among Black adults in the U.S. We used the Black-white wealth gap to calculate monetary costs, modeling the effects of wealth influxes of $905,426.10 (in 2019 USD) to each Black household (the amount necessary to eliminate the mean Black-white wealth gap), distributed over 10 years. We applied a target trial emulation framework to data in the Panel Study on Income Dynamics (n=16,010). Each Black household head or spouse/partner was followed from baseline until death, incomplete follow-up, 18 years after baseline, or the end of follow-up in 2019, whichever occurred first. Using the g-formula to account for time-fixed and time-varying confounders, we found a 29% reduction in premature mortality and a 25.6% reduction in overall mortality among Black adults under the reparations intervention. Our findings provide evidence that reparations are a lifesaving and justice-promoting social policy that could significantly contribute to efforts to eliminate health inequities.
活动人士、政策制定者和学者越来越多地主张向美国黑人支付赔偿金，以弥补奴隶制及随后的歧视性做法所造成的伤害。本研究调查了一项假设的货币赔偿干预措施对美国成年黑人全因过早死亡率和总体死亡率的影响。我们利用黑人和白人之间的财富差距来计算货币成本，模拟了向每个黑人家庭（消除黑人和白人平均财富差距所需的金额）流入905,426.10美元（2019年美元价值）的财富在10年内的影响。我们将目标试验模拟框架应用于收入动态面板研究（n = 16,010）中的数据。从基线开始跟踪每个黑人户主或配偶/伴侣，直至死亡、随访不完整、基线后18年或2019年随访结束，以先发生者为准。使用g公式来考虑固定时间和随时间变化的混杂因素，我们发现在赔偿干预措施下，成年黑人的过早死亡率降低了29%，总体死亡率降低了25.6%。我们的研究结果提供了证据，表明赔偿是一项挽救生命和促进正义的社会政策，可显著推动消除健康不平等的努力。
