Disparities in Lifetime Risks of Death

An ambulance speeding through traffic at nighttime.

The chance of dying from a firearm injury, drug overdose, or motor vehicle accident (MVA) is much higher in the United States than in other countries. Many of these causes of early death are preventable. Studies have shown that men are more likely than women to die from MVAs. Over the past two decades, MVA deaths have decreased, while drug overdose and firearm deaths have increased. An NIMHD-supported researcher at the Case Western Reserve University Center for Reducing Health Disparities, Ashwini R. Sehgal, M.D., has further shown that race/ethnicity and where someone lives affect their risk of these premature deaths.

National data from the Centers for Disease Control and Prevention included 146,511 deaths related to firearms, drug overdoses, and MVAs, accounting for more than 5% of U.S. deaths in 2018. Dr. Sehgal analyzed reported deaths from birth to age 84 across Asian Americans, Blacks, Hispanics, American Indians/Alaska Natives, and Whites. Among the groups studied, young Black men had the highest death rates from firearms. Drug overdose–related deaths were most common for Black and White male populations. American Indian/Alaska Native male populations had the highest rates of death from MVAs. Asian American, followed by Hispanic, women and girls had the lowest death rates for all of these causes. Among men and boys, these causes of death were also least common for Asian Americans, followed by Hispanics.

Dr. Sehgal also studied the differences in lifetime risks of deaths across states. He found that people who live in West Virginia, Delaware, and the District of Columbia have double the lifetime risk of death from drug overdose compared with the national average. The state with the highest lifetime risks of death from firearms and MVAs was Mississippi. Rhode Island, South Dakota, and New York had the lowest lifetime risks of death from firearms, drug overdoses, and MVAs, respectively.

This study exposes significant disparities in largely preventable deaths by sex, race/ethnicity, and state of residence. The information can help researchers understand the causes of these differences and lead to further studies on how these early deaths might affect families and societies. Dr. Sehgal shares ways that health providers and researchers can help reduce the lifetime risks of these three causes of death. For example, health providers can screen patients for depression and a history of violence and ask whether they have firearms at home. Health providers can also limit prescriptions of drugs associated with overdose and discuss safety practices, such as using seat belts and helmets. Researchers can help inform policymakers about the lifetime risks. Moreover, researchers can suggest how communities might work toward decreasing these chances of death for people in all racial/ethnic groups.

Sehgal, A. R. (2020). Lifetime risk of death from firearm injuries, drug overdoses, and motor vehicle accidents in the United States. American Journal of Medicine, 133, 1162–1167. doi:10.1016/j.amjmed.2020.03.047

Page updated January 14, 2022