Race and life expectancy

人种与预期寿命

Black lives longer

黑人的寿命在增长

The life-expectancy gap between black and white Americans has steadily declined

美国黑人和白人之间的预期寿命差距一直在稳步缩小

BACK IN 1980 when Harlem was still a byword for poverty, criminality and the decline of New York City, black men in the neighbourhood had a worse chance of living to the age of 65 than men in Bangladesh did. At that time Harlem’s residents—almost all of them black, and many of them poor—died of heart disease at double the rate of whites. They died of liver cirrhosis, brought on by alcoholism or hepatitis, at ten times the rate of whites. And they were 14 times likelier to be murdered. Today the prominent corner of Malcolm X Boulevard and West 125th Street houses a Whole Foods, an upmarket grocery chain, and life expectancy is up to 76.2 years. That is still five years behind the rest of the city, but the gap is no longer so egregious.

早在1980年，哈莱姆区还是贫穷、犯罪和纽约市衰落的代名词，当时，该社区的黑人男性比孟加拉国男性活到65岁的机会更低。那时，哈莱姆区的居民——几乎都是黑人，而且很多都很穷——死于心脏病的比率是白人的两倍。他们死于肝硬化，由酒精中毒或肝炎引起，死亡率是白人的十倍。他们被谋杀的可能性是其他人的14倍。如今，马尔科姆·艾克斯大道(Malcolm X Boulevard)和西125街(West 125 Street)的显眼的角落里，坐落着一家高档食品连锁企业全食超市(Whole Foods)，这里人均寿命高达76.2岁。这仍比伦敦金融城其他地区落后5年，但差距已不再那么大。

词汇

Byword/绰号；笑柄

Cirrhosis/  硬化；[内科] 肝硬化

Hepatitis/肝炎

Egregious/惊人的；过分的；恶名昭彰的

The case of Harlem exemplifies a remarkable trend in American public health that is seldom noticed: the persistent gap in life expectancy between whites and blacks has closed substantially, and is now at its narrowest ever. In 1900, the earliest date for which the Centres for Disease Control and Prevention (CDC) publishes statistics, the life expectancy for black boys at birth was 32.5—14.1 years shorter than for white boys. Put another way, the typical black boy had 30% less life to live. Incremental progress, however fitful, was made for the next century, but epidemics of crack, HIV and urban violence threatened to reverse it. By 1993, a peak year for violent crime, the life-expectancy gap between black and white men had widened again by nearly three years, to 8.5 years.

哈莱姆区是美国公共卫生领域人少为关心但却有着的卫生状况显著改善趋势的例证:白人和黑人预期寿命的持续差距已大幅缩小，目前正处于历史上最接近的水平。1900年，美国疾病控制与预防中心(CDC)最早发布统计数据，黑人男孩出生时的预期寿命比白人男孩短32.5-14.1岁。换句话说，典型的黑人男孩的寿命要少30%。尽管下个世纪取得了断断续续的渐进进展，但【】、艾滋病毒和城市暴力的流行有可能扭转这一趋势。到1993年，暴力犯罪的高发年，黑人和白人男性的预期寿命差距又扩大了近三年，达到8.5岁。

词汇

Persistent/坚持的；持久稳固的

Incremental/增加的，增值的

Fitful/一阵阵的；断断续续的

 

But then it began a sustained, steady fall. In 2011 the black-white gap had narrowed to 4.4 years for men (5.7% less) and just 3.1 years (3.8% less) for women. Though progress then levelled off until 2016, the most recent year available from the CDC, the trend is stable and not reversing.

但随后年龄差开始了持续稳定的缩小。2011年，黑人和白人的年龄差距缩小到男性4.4岁(减少5.7%)，女性3.1岁(减少3.8%)。尽管直到2016年(疾控中心可提供的最近一年)，年龄差才缩小趋于平稳，而且这一趋势是稳定的，不会逆转。

 

The downward trajectory can be explained by several simultaneous phenomena, not all of them cheerful. Among the elderly, more of whom die after all than the rest, the narrowing is due to mortality from heart disease and cancer declining faster for blacks than for whites. But for premature deaths, racial gaps—especially between black and white men—have also narrowed because of substantially reduced mortality from homicide, the result of the great crime decline, and HIV, the result of improved medical therapies. Yet the emergence of the opioid epidemic, which kills whites at higher rates than other races, has also hastened the racial convergence.

下降趋势可以用几个同时出现的现象来解释，但并非所有现象都是值得鼓舞的。在老年人中，死于心脏病和癌症的黑人死亡率比白人下降得更快。但就过早死亡而言，种族差距——尤其是黑人和白人男性之间的差距——也在缩小，因为他杀导致的死亡率大幅下降，这是犯罪率大幅下降的结果，而艾滋病病毒(HIV)则是医疗疗法改善的结果。然而，【】类药物的流行也加快缩短了人种寿命的差距——与其他种族相比，白人的死亡率更高（这里指有钱的白人，花钱买【】类药物，滥嗑药，然后死的快）。

词汇

Trajectory/  轨道，轨线

Mortality/死亡数，死亡率

Homicide/过失杀人；杀人犯

Convergence/收敛；会聚

Criminologists still do not know why violent crime and homicides began to decline in the mid-1990s. A wide array of theories have been proposed: the eroding appeal of crack cocaine, mass incarceration actually working as intended, legalisation of abortion, less lead poisoning of children and the improving economy. But the public-health consequences are abundantly clear, particularly for black men who were and remain the most frequent victims of murder. Patrick Sharkey and Michael Friedson, two sociologists, conducted a thought experiment showing that life expectancy for black men would have been 0.8 years lower if homicide rates had persisted at their levels in 1991. That is a remarkably large health effect—on the order of entirely eliminating obesity among black men. The authors calculate that 17% of the narrowing of the life-expectancy gap for black and white men between 1991 and 2014 could be explained by the unexpected halving of the murder rate over that period.

犯罪学家仍然不知道为什么暴力犯罪和凶杀案在20世纪90年代中期开始下降。人们提出了一系列广泛的理论:高纯度【】吸引力的下降、大规模监禁实际上起到了预期的效果、【】合法化、儿童铅中毒减少以及经济状况的改善。但是公共健康改善的结果是显著的，尤其是对黑人男性来说，他们过去是，现在仍然是最频繁的谋杀受害者。帕特里克·夏基(Patrick Sharkey)和迈克尔·弗里德森(Michael Friedson)是两位社会学家，他们进行了一项思想实验，结果表明，如果谋杀率维持在1991年的水平，黑人男性的预期寿命会低0.8年。这对完全消除黑人男性肥胖的进程有着显著的健康方面影响（我这真的不懂为啥要扯上肥胖率）。作者计算，1991年至2014年间，黑人和白人男性预期寿命差距的缩小有17%可以用这段时间谋杀率出人意料地减半来解释。

Considerable improvement in the treatment of HIV has also decreased premature deaths for black men, who were hammered by the epidemic. An estimated 42% of the 1.1m Americans living with HIV today are black, triple their share of the population. At the peak of the epidemic, around 1994, the virus was killing blacks at an age-adjusted rate of nearly 60 per 100,000—or three times the rate at which opioid overdoses killed whites in 2017. Though blacks still make up a majority of Americans killed by HIV, the overall rates of death have plummeted to around 10 per 100,000.

艾滋病毒治疗的显著改善也减少了黑人男性的过早死亡，他们曾经深受艾滋病的打击。据估计，目前美国110万艾滋病毒携带者中有42%是黑人，是其人口比例的三倍。在1994年左右的疫情高峰期，该病毒以每10万人中近60人的年龄调整率杀死黑人，是2017年【】类药物过量杀死白人的三倍。尽管黑人仍然占死于艾滋病毒的美国人的大多数，但总体死亡率已降至每10万人中有10人左右。

词汇

age-adjusted rate/标化率（age-adjusted mortality rate /年龄调整死亡率）

 

At the same time as lifespans have been increasing for blacks, prospects for whites, especially the non-elderly, have sagged. This is mainly because of the rapid increase in deaths from drug overdoses, opioids chief among them. Death rates for whites caused by all drugs more than quadrupled from 1999 to 2017, and are now 32% higher than for blacks. Historically drug epidemics have disproportionately hit non-white Americans. But of the 47,600 people killed by opioids in 2017, 37,100 were white. Opioid addiction, suicide and overdose-related deaths all affect whites at much higher rates than blacks. Some of the reason for this may, ironically enough, lie in racial discrimination.

与此同时，随着黑人的寿命不断延长，而白人，尤其是非老年人的预期寿命在下降。这主要是由于药物过量导致的死亡人数迅速增加，【】类药物是其中的主要原因。从1999年到2017年，所有【】导致的白人死亡率翻了两番多，现在比黑人高32%。从历史上看，【】流行对非白人美国人的打击是不成比例的。但在2017年死于【】类药物的47600人中，有37100人是白人。【】类药物成瘾、自杀和过量相关死亡对白人的影响都比黑人高得多。具有讽刺意味的是，其中一些原因可能在于种族歧视。

词汇

Sag./ 下垂，下降

Quadrupled/翻了两番；变成四倍的

 

A life-saving bias

偏见，却是在拯救生命

About three in four heroin addictions began with a legitimate prescription. The hotspots of the opioid crisis—the tri-state meeting of Ohio, Kentucky and West Virginia as well as rural New England—where blizzards of pills were later followed by a rise in overdose deaths, are much whiter than the rest of the country. “It is consistent with pretty different rates of prescribing opioids. We supplied it very differently to whites versus blacks in these areas,” says Ellen Meara, a health economist at Dartmouth College. “But we also know that there’s a lot of racial discrimination in our health-care system.”

大约四分之三的【】成瘾者都是从合法处方开始的。【】类药物危机的热点地区——俄亥俄州、肯塔基州和西弗吉尼亚州这三个问题点，以及新英格兰的农村地区——在那里，暴风雪似的药物泛滥过后，药物过量服用的死亡率上升，比国家其他地方更显苍白（可怕）。“这与处方【】类药物的比例相当不同”。达特茅斯学院(Dartmouth College)的健康经济学家艾伦•米拉(Ellen Meara)表示:“在这些地区，我们向B人和H人提供的药方非常不同（给B人提供【】类药物，H人提供其他的，【】类药物贵，但是有很好的止痛效果，但是会成瘾）。”“……”

词汇

Blizzard/暴风雪，大风雪；大打击

Versus/对；与...相对；对抗

Wherever they lived, blacks were less likely to obtain legal opioids in the first place. A study of pain-related visits to emergency departments between 1993 and 2005—a period that overlaps with the run-up to the crisis—shows that whites were substantially more likely to obtain an opioid prescription, even after controlling for the reported severity of pain and other factors. A wealth of studies have found similar effects. Doctors are also much more likely to stop prescribing opioids for blacks after detecting illicit drug use. In the case of opioids, racial bias probably saved lives.

无论他们住在哪里，H人首先获得合法【】类药物的可能性就更小。一项关于1993年至2005年间急诊部门疼痛相关就诊的研究表明，即使在控制了疼痛的严重程度和其他因素后，B人也更有可能获得【】类药物处方。大量的研究也发现了类似的效果。在发现非法使用【】后，医生也更有可能停止给H人开【】类药物的处方。就【】类药物而言，种族偏见可能挽救了生命。

Despite improvements in the racial gap, inequality in life expectancy by class and income still remains. The CDC has begun publishing estimates of life expectancy at the census-tract (or neighbourhood) level. Life expectancy at the 90th percentile is 83.1 years compared with 73.1 years at the 10th. In Chicago, census tracts a few miles apart can differ in average life expectancies by two decades. The estimates are quite closely related to measures of income and poverty: a simple regression shows that a five-percentage-point increase in the poverty rate is associated with a one-year decline in life expectancy.

尽管种族差距有所改善，但按阶级和收入划分的预期寿命不平等仍然存在。美国疾病控制与预防中心(CDC)已开始发布人口普查(或邻近地区)水平的预期寿命估计值。有90%左右的人群的预期寿命为83.1岁，而剩下10%的预期寿命为73.1岁。在芝加哥，相隔几英里的人口普查区域平均预期寿命可能相差20年。这些估计数字与收入和贫困的衡量指标密切相关:简单的回归统计显示，贫困率上升5个百分点与预期寿命下降1年有关。

词汇

Census/人口普查，人口调查

Research by Raj Chetty, an economist, and his colleagues shows that the income gap in life expectancy has been growing even as the racial one has been declining. So has the education gap. Although people have long assumed that higher socioeconomic status bought better health, that was not as true for blacks as it was for whites, says Arline Geronimus, a public-health professor at the University of Michigan. Now that is changing. “The convergence is due to more affluent, educated blacks living longer while less-affluent, less-educated whites are not living as long. It shouldn’t be interpreted as though we’ve made great strides,” she says. Even so, the improvements for black men run counter to the drumbeat of pessimism about race in America. Black lives are longer.

经济学家Raj Chetty和他的同事们的研究表明，尽管种族差异一直在下降，预期寿命影响成分之一——收入差距却一直在扩大。教育差距也是如此。密歇根大学公共卫生教授Arline Geronimus说，尽管人们长期以来一直认为社会经济地位越高，健康状况就越好，但事实并非如此。现在这种情况正在改变。“这种趋同是因为更富裕、受教育程度更高的H人寿命更长，而不那么富裕、受教育程度较低的B人寿命则没有那么长。这不应该被理解为我们已经取得了巨大的进步，”她说。尽管如此，H人男性的进步与美国狭隘悲观的种族偏见背道而驰。黑人的寿命更长。

词汇

run counter/违背