The police killings of Black Americans such as George Floyd, Breonna Taylor, Ahmaud Arbery, and Elijah McClain (among countless others) sparked a renewed reckoning with racial injustice in 2020. Race differences in the risk of being killed by police are striking. According to recent estimates, Black Americans are over three times more likely to be killed by the police than White Americans.
Racial inequities in mortality, however, extend far beyond police killings. Decades of research show that Black Americans live shorter lives and experience higher mortality rates for numerous causes of death beginning in infancy and continuing throughout much of later life. The recent COVID-19 pandemic has underscored such racial disparities in mortality, with one study suggesting that the odds of dying from COVID-19 are 60% higher for Black Americans compared to White Americans.
These patterns of premature mortality mean that Black Americans lose family members more often and earlier in life than White Americans, a traumatic and uniquely stressful experience that only serves to undermine the health of surviving family members even more. Thus, Black families are trapped in a vicious cycle wherein inequity in longevity leads to inequity in experiencing family loss which then exacerbates existing inequities in health. Considering the already high stress burden of living in a world built on systems of racism, researchers and policy-makers alike should consider the additional burden of premature mortality for the health and well-being of Black families.
Our recent research supported by the National Institutes of Health documents the extent of racial inequities in family loss and shows how this unequal burden adds to racial disadvantage in health and well-being. Indeed, throughout life, Black Americans are much more likely to lose a mother, father, sibling, child, and/or spouse than White Americans and to lose them at earlier ages. The differences are striking. By age 10, Black children are three times more likely than White children to lose a mother. Racial disadvantage in spouse and sibling loss follows similar patterns.
Cumulatively, this results in Black Americans being three times more likely than White Americans to experience the death of two or more family members by age 30. By age 60, this disadvantage persists, with Black Americans almost twice as likely to have lost four or more family members compared to White Americans.
Racial inequity in exposure to family loss sends ripple effects through Black families that are left to deal with the grief of losing a loved one. Such grief can have far-reaching implications for health. Research shows that losing a family member is a uniquely traumatic experience that can have lifelong psychological, social, behavioral, and biological consequences, all of which undermine health and well-being.
For example, experiencing the death of a family member increases the risk of depression and anxiety for bereaved family members, even years after the loss. Losing a family member can also result in new caregiving responsibilities as roles within the family shift. Behaviorally, individuals may self-medicate with drugs and alcohol to cope with their grief. The chronic stress triggered by loss can even get under the skin by adding to cumulative wear and tear on physiological systems which can lead to declines in health. Together, these responses to bereavement can have detrimental effects on health, and the unequal burden of bereavement in Black families disproportionately impinges on the health of Black Americans.
Losing a child is arguably one of the most stressful events a parent can experience. Our research suggests that Black parents are about two times more likely to lose a child by age 60 compared to White parents, a disadvantage that only grows as parents age.
The prolonged stress of losing a child can have long-lasting consequences for health. As our studies show, child loss increases dementia and mortality risks in later life for both Black parents and White parents. Dementia prevalence is already two times higher for Black Americans than for White Americans, so the higher rates of child loss for Black parents exacerbate existing racial disparities in dementia risk. Indeed, we find that Black parents who lose a child by age 40 are almost three times more likely to develop dementia over the study period than White parents experiencing the same loss.
Considering mortality risk in later life, we find that Black mothers who lose a child have 35% higher odds of dying compared to Black mothers who do not experience child loss. Likewise, White mothers who lose a child face 25% higher odds of dying than White mothers who do not lose a child. Again, Black Americans already experience higher mortality rates than white Americans, and the unequal burden of child loss adds to that disadvantage.
The health-damaging consequences of family member deaths are not restricted to later life. A forthcoming paper from our research team explores the potential effect of family losses that occur earlier in life on Black Americans’ cardiovascular disease (CVD) risk in early-to-mid adulthood. We measure CVD risk by combining measurements of blood pressure, waist size, blood sugar, and c-reactive protein (a protein related to inflammation). Preliminary findings suggest that Black Americans, but not White Americans, face increased CVD risk in early-to-mid adulthood following the death of a parent in childhood, adolescence, or early adulthood (up to age 27).
These findings show how bereavement can get under the skin to undermine health even at relatively young ages. Research consistently finds that Black Americans die from cardiovascular diseases at a higher rate than White Americans and these disparities are projected to persist (and potentially grow) in the future. Thus, our findings underscore the need to consider how unequal exposure to family member loss contributes to racial inequities in cardiovascular health.
While the grief that follows the death of a family member is not unique to any one group, higher death rates and lower life expectancy for Black Americans (a result of the long and continuing legacy of racism in the United States) means that Black families disproportionately bear this burden. As our research clearly shows, this lifetime burden of bereavement fuels stark inequities in health and well-being across the life course.
Racial inequities in exposure to family member deaths is a public health crisis that we must address. Policies and public health interventions aimed at improving the health of Black Americans could have far-reaching benefits if they recognize the unequal burden of bereavement and its impact on health. More importantly, directly reducing racial inequity in mortality rates would reduce disparities in bereavement burden and shield surviving family members from the adverse consequences of grief.
Michael A. Garcia is a doctoral student in the Department of Sociology, University of Texas at Austin, Population Research Center (PRC) Graduate Research Trainee, and Executive Director of the Council on Contemporary Families. Her research focuses on how social relationships shape health and well-being across the life course. Her recent work has been published in Social Forces, Social Science & Medicine, and Journal of Marriage and Family. You can follow them on Twitter:@magarcia_tx
Rachel Donnelly is Assistant Professor of Sociology at Vanderbilt University. Her research focuses on the social determinants of health across the life course, with an emphasis on stress, work, and family relationships. She also examines how disparate experiences based on gender, sexual orientation, and race/ethnicity shape mental and physical health outcomes.
Debra Umberson is Professor of Sociology and Co-Director of the Texas Aging & Longevity Center at the University of Texas at Austin, where she also holds a courtesy appointment in the Steve Hicks School of Social Work. Her research focuses on the impact of relationships on health across the life course, and gender, sexuality, and racial variation in relationship and health experiences. You can follow them on them on Twitter: @DebUmberson