From one death to another: The relationship between familial deaths and one’s own mortality risk among an urban Black American cohort

Black Americans continue to be 1.5 times more likely to experience premature death with life expectancy up to six years shorter than their white American counterparts. These racial disparities in mortality translate into Black Americans being much more likely to experience the deaths of family members at younger ages in the life course. This study examines the impact of experiencing familial death on the survivor's mortality risk among a cohort of Black men and women. Data collected from a community cohort first assessed in 1966 (at age 6) and followed at three additional time points (ages 16, 32, and 42) are supplemented with mortality data, retrieved from the National Death Index, that include deaths through 2021 (modal age 61). Among the 941 participants who survived to age 32 and had information on familial deaths, 38.9% experienced the death of a parent, child, or sibling by age 32, and close to one-fifth (18.2%) died between ages 33 and 61. Cox regression models that adjust for early life covariates revealed a 48% higher mortality risk among those who experienced at least one familial death by age 32; separate models provide evidence that the accumulation of familial deaths is related to midlife mortality risk. Models of relationship type indicate that death of a mother or sibling is associated with a 74% and 77% increase in mortality risk, respectively. Results highlight the heavy burden of premature familial mortality on Black Americans and its adverse impact on one's own life expectancy.