Long-term trends in the contribution of major causes of death to the black-white life expectancy gap by US state

States have fared differently in their progress towards eliminating the black-white life expectancy gap. Our objective is to describe the pattern of contributions of each of six major causes of deaths to the sex-specific black-white life expectancy gap across states over the last half-century, and identify divergent states. Using vital statistics and census data, we extracted the number of deaths and population sizes for the years 1969 to 2013, by state, gender, race, 19 age groups, and six major causes of death. Although mortality from cardiovascular disease has decreased dramatically, its contribution to the life expectancy gap increased over time for men (from 0.9 to 1.2 years), but decreased for women (from 2.4 to 1 years). The contribution of noncommunicable diseases to the gap was stable over time for men (approximately 0.4 years) but decreased for women (from 0.7 to 0.2 years), while cancers exhibited an inverted-U trend for men (peaking at 1.1 years in 1988) and a stable contribution for women (approximately 0.5 years). Both genders exhibited a decreased contribution from injuries (men: 2.2 to 0.4 years), that became negative for women (women: 0.5 to -0.1 years). Several states diverged from these general trends. Life expectancy for both races has improved substantially in the US. For men, much of this improvement was due to narrowing differences in injury-related mortality, but these contributions were rivaled by an increasing gap in CVD-related mortality. In women, a crossover in injury-related mortality led to a narrower gap, realized partially by increasing mortality among whites. . CC-BY-NC 4.0 International license peer-reviewed) is the author/funder. It is made available under a The copyright holder for this preprint (which was not . http://dx.doi.org/10.1101/140152 doi: bioRxiv preprint first posted online May. 25, 2017;