米国ではどの種類の米国人かで死亡率が違う

昨年封切りの近未来SF映画「シビル・ウォー」でどの種類の米国人かで生死を分ける場面があったやに聞き及んでいます。それについて、全米経済調査会(NBER)のワーキングペーパー "Racial Disparities in Mortality by Sex, Age, and Cause of Death" がそういった事実があることを実証しています。まず、論文の引用情報については下の通りです。

• Kaestner, Robert, Anuj Gangopadhyaya and Cuiping Schiman (2025) "Racial Disparities in Mortality by Sex, Age, and Cause of Death," NBER Working Paper No.33905, June 2025

続いて、NBERのサイトから論文のAbstractを引用すると下の通りです。

Abstract
Racial differences in mortality are large, persistent and likely caused, at least in part, by racism. While the causal pathways linking racism to mortality are conceptually well defined, empirical evidence to support causal claims related to its effect on health is incomplete. In this study, we provide a unique set of facts about racial disparities in mortality that all theories of racism and health need to confront to be convincing. We measure racial disparities in mortality between ages 40 and 80 for both males and females and for several causes of death and, measure how those disparities change with age. Estimates indicate that racial disparities in mortality grow with age but at a decreasing rate. Estimates also indicate that the source of racial disparities in mortality changes with age, sex and cause of death. For men in their fifties, racial disparities in mortality are primarily caused by disparities in deaths due to external causes. For both sexes, it is racial disparities in death from healthcare amenable causes that are the main cause of racial disparities in mortality between ages 55 and 75. Notably, racial disparities in cancer and other causes of death are relatively small even though these causes of death account for over half of all deaths. Adjusting for economic resources and health largely eliminate racial disparities in mortality at all ages and the mediating effect of these factors grows with age. The pattern of results suggests that, to the extent that racism influences health, it is primarily through racism's effect on investments to treat healthcare amenable diseases that cause racial disparities in mortality.

続いて、論文から Figure 1. All-cause Hazard Rate of Dying by Sex, Race and Age を引用すると下の通りです。

要するに、Abstractの最後のセンテンスにある "to the extent that racism influences health, it is primarily through racism's effect on investments to treat healthcare amenable diseases that cause racial disparities in mortality." ということなのだろうと思います。ですから、レイシズム、というか、人種的な偏見や差別によって医療を受けられない可能性は決して否定できませんが、レイシズムや人種的な偏見・差別が所得格差を生み出し、その所得格差が医療投資の差をもたらしている可能性も否定できません。死亡率という量的指標とともに、死亡原因という質的な面でも人種的な差がある点がこの論文で差の差(DiD)分析により報告されています。フロントドアが何であれ、バックドアの原因が人種的な偏見や差別にあることは明らかであり、それが現在のトランプ政権により増幅されている可能性が憂慮されます。はい、大いに憂慮されます。