Unequal Cities: Structural Racism and the Death Gap in America's Largest Cities

Across the United States, Black people have shorter life expectancies than white people―reflecting structural racism and deep-rooted drivers of population health. But are some cities more equal than others?
The elimination of racial and ethnic inequities―differences that are avoidable, unnecessary, and unfair―has been one of the overarching health-related goals of the United States for decades. Yet dramatic differences in health outcomes between Black people and white people persist, rooted in structural and social determinants of health. Nationally, a Black baby can expect to live four years less than a white baby. But mortality outcomes and inequities vary widely across cities. In Washington, DC, for example, the average life expectancy for Blacks is twelve years less than that of whites. But in other cities, mortality differences between races are less striking or nonexistent. If health equity can be achieved in some cities, why not all? This is arguably the most important health equity issue of our time.
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