To take stock of the human toll resulting from racial inequality in the United States, we estimate the number of excess deaths that accumulated among African Americans over the twentieth century as a result of the enduring racial gap in mortality rates. We assemble a wide array of demographic and vital statistics data for all years since 1900 to calculate the number of Black deaths in each half-decade that occurred in excess of what would be projected if Blacks had experienced the same gender- and age-specific mortality rates as Whites. We estimate that there were almost 7.7 million excess deaths among African Americans from 1900 through 1999. Those deaths comprised over 40% of all African American deaths over the century.

Excess deaths were highest in the early decades (peaking in 1925–1934), but the only period of sustained decline was 1935–1949. Subsequent reductions in excess deaths were relatively modest and unstable, and in the last decade of the century the percentage of Blacks’ deaths that were excess returned to levels as high as in the first decade. That trajectory is less positive than the trajectory for the racial gap in life expectancy over the century.

Excess deaths fell disproportionately among the young in the early twentieth century, but in the succeeding decades they progressively hit harder among older African Americans, many of them in the prime of life when their economic and social pursuits were vital to their families and communities. Excess deaths were also especially heavy among Black women for most of the century.

We conclude by discussing the social and policy implications of the excess deaths. We assess trends in the early twenty-first century as we consider the political challenges involved in tackling the continuing excess death toll.

为了评估美国种族不平等所造成的人员伤亡，我们估算了由于持久的种族差异导致的二十世纪非裔美国人中累积的额外死亡人数。自1900年以来，我们收集了自1900年以来所有年份的各种人口统计和生命统计数据，以计算每个十年中黑人的死亡人数，如果黑人经历相同的性别和特定年龄死亡率，则该数字将超过预期利率为白人。我们估计，从1900年到1999年，非洲裔美国人中有近770万人死于过度死亡。这些死亡人数占本世纪所有非洲裔美国人死亡人数的40％以上。

在过去的几十年中（1925-1934年），过量死亡人数最高，但是持续下降的唯一时期是1935-1949年。随后的超额死亡人数减少相对适度且不稳定，在本世纪的最后十年，黑人的超额死亡人数百分比恢复到与前十年一样高的水平。该轨迹没有一个世纪以来预期寿命种族差距的轨迹那么积极。

在20世纪初期，过度死亡人数在年轻人中下降的比例不成比例，但是在随后的几十年中，他们逐渐在年长的非洲裔美国人中遭受更大的打击，其中许多人处于经济繁荣时期，因为他们的经济和社会追求对其家庭和社区至关重要。在整个世纪的大部分时间里，黑人妇女的死亡人数也特别多。

最后，我们讨论了过度死亡的社会和政策影响。我们在评估二十一世纪初期的趋势时，考虑了应对持续的过高死亡人数所涉及的政治挑战。