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Jim Crow and Premature Mortality Among the US Black and White Population, 1960–2009: An Age–Period–Cohort Analysis
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BACKGROUND: Scant research has analyzed the health impact of abolition of Jim Crow (ie, legal racial discrimination overturned by the US 1964 Civil Rights Act). METHODS: We used hierarchical age-period-cohort models to analyze US national black and white premature mortality rates (death before 65 years of age) in 1960-2009. RESULTS: Within a context of declining US black and white premature mortality rates and a persistent 2-fold excess black risk of premature mortality in both the Jim Crow and non-Jim Crow states, analyses including random period, cohort, state, and county effects and fixed county income effects found that, within the black population, the largest Jim Crow-by-period interaction occurred in 1960-1964 (mortality rate ratio [MRR] = 1.15 [95% confidence interval = 1.09-1.22), yielding the largest overall period-specific Jim Crow effect MRR of 1.27, with no such interactions subsequently observed. Furthermore, the most elevated Jim Crow-by-cohort effects occurred for birth cohorts from 1901 through 1945 (MRR range = 1.05-1.11), translating to the largest overall cohort-specific Jim Crow effect MRRs for the 1921-1945 birth cohorts (MRR ~ 1.2), with no such interactions subsequently observed. No such interactions between Jim Crow and either period or cohort occurred among the white population. CONCLUSION: Together, the study results offer compelling evidence of the enduring impact of both Jim Crow and its abolition on premature mortality among the US black population, although insufficient to eliminate the persistent 2-fold black excess risk evident in both the Jim Crow and non-Jim Crow states from 1960 to 2009.
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“Further, the intellectual contributions to advancing the science of structural racism have often been led by researchers from racially and ethnically minoritized backgrounds, whose inclusion have been limited by the racist academic enterprise itself [46].”
From Structural Racism Conceptualization and Operationalization for Research for the U.S. HIV Epidemic: Findings from a Scoping Review and Implications for Advancing Research for Structural Interventions (2024) · cites this paper as [46]
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Metadata
- Authors
- Krieger, N., Chen, J. T., Coull, B. A., Beckfield, J., Kiang, M. V., & Waterman, P. D.
- Affiliations
- Harvard University (US)
- Corresponding author
- Krieger, Nancy
- ORCID
- Venue
- Epidemiology
- Published
- 2014-07
- Volume
- 25
- Issue
- 4
- Pages
- 494-504
- ISSN
- 1044-3983 (ISSN-L)
- PMC
- PMC4710482
- OpenAlex
- W2317302092
- Cited by
- 111
- References
- 19
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 19 · 2023: 18 · 2022: 10 · 2021: 9 · 2020: 10 · 2019: 5 · 2018: 5 · 2017: 9 · 2016: 7 · 2015: 3 · 2014: 1
- FWCI
- 8.52
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (R21CA168470)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
- Social Sciences › Sociology and Political Science › Race, History, and American Society
- Keywords
- Jim Crow, racial discrimination, premature mortality, racial disparities in health, Black-White health disparities, Civil Rights Act of 1964, racial segregation, birth cohort, age-period-cohort analysis
- MeSH terms
- Aged, Black or African American, Humans, Middle Aged, United States, Cohort Studies, White People, History, 20th Century, History, 21st Century, Mortality, Premature, Racism
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