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Jan H. Richardus, MD, PhD and Anton E. Kunst, PhD

The authors are with the Department of Public Health, Erasmus University Rotterdam, Rotterdam, the Netherlands.

Correspondence: Requests for reprints should be sent to Jan H. Richardus, MD, PhD, Department of Public Health, Erasmus University Rotterdam, Postbox 1738, 3000 DR Rotterdam, The Netherlands (e-mail: richardus{at}mgz.fgg.eur.nl).

Objectives. This study determined the degree to which Black–White differences in infectious disease mortality are explained by income and education and the extent to which infectious diseases contribute to Black–White differences in all-cause mortality.

Methods. A sample population of the National Longitudinal Mortality Study from 1979 through 1981 was analyzed and followed up through 1989.

Results. Infectious disease mortality among Blacks was higher than among Whites, with a relative risk of 1.53 after adjustment for age and sex and 1.34 after further adjustment for income and education. Death from infectious diseases contributed to 9.3% of the difference in all-cause mortality.

Conclusions. In the United States, infectious diseases account for nearly 10% of the excess all-cause mortality rates in Blacks compared with Whites.

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