Public Policy Institute of California California Counts population trends and profiles Death in the Golden State

A black man in California can expect to live 68.6 years on average, which is far below the life expectancy of the average California white male, who can expect to live 75.5 years. Despite the impressive gains in American longevity over the past century, significant disparities in life expectancies such as this one persist across racial and ethnic groups in California. These racial and ethnic disparities reflect underlying differences in specific causes of death, which is the focus of this issue of California Counts. Understanding the causes of death that contribute to racial and ethnic differences in life expectancies can shed light on the underlying factors that drive inequalities in health and can inform state health officials trying to identify more effective avenues of prevention. In our analysis, we find that black men and women have higher levels of mortality (from all causes combined) than whites. In contrast, Hispanics and Asians appear to have a slight life expectancy advantage over whites. We further find that death rates for blacks for almost all chronic diseases and injuries exceed those of whites and sometimes markedly so. Hispanics and Asians have lower death rates for most chronic conditions and injuries than whites, with a few exceptions. In addition, we illustrate how differences in socioeconomic status, measured in terms of educational attainment, contribute to observed mortality disparities. Across all racial/ethnic groups, more educated Californians have better mortality outcomes than less educated Cali-fornians, although black-white disparities persist among individuals with similar levels of educational attainment. In this issue, we also break down the overall life expectancy gaps among racial/ethnic minority groups and whites to identify the causes of death that most definitively account for Summary Hans P. Johnson, editor California Counts Death in the Golden State Public Policy Institute of California 2 racial/ethnic disparities. Heart disease drives much of the mortality disadvantage for adult black men, followed by homicide. Eliminating these two causes of death would reduce the black-white disparity in life expectancy among men by more than 40 percent. Higher mortality rates from heart disease, cancers (especially lung cancer), and chronic lower respiratory diseases are the causes that mainly drive the lower life expectancy seen among white men relative to Hispanic men. However, the Hispanic mortality advantage over whites would be almost 30 percent higher were it not for Hispanic men's higher death rates attributed to diabetes and liver disease. For women, heart disease …