An institution that existed more than 150 years ago is still impacting who lives and dies today.
A new study co-authored by UC Berkeley Psychology Professor Manuel Galvan found that modern-day Black Americans have higher mortality rates in counties that had greater proportions of enslaved people in the 19th century.
The opposite was true for White Americans: counties with a greater historical reliance on slavery had lower mortality rates among White residents.
The study, “Historical slavery predicts contemporary disparities in mortality between Black and White Americans,” was published in Proceedings of the National Academy of Sciences of the United States of America(PNAS). It estimated that for every 10% increase in a county’s enslaved population in 1860, there were about 22 additional deaths per 100,000 among Black Americans relative to White Americans from 2010 to 2020.
These results show how racial inequality is deeply embedded in the social and economic conditions that shape health, according to the researchers.
“Historical systems such as slavery created unequal institutions, policies and distributions of resources,” said Keith Payne, a psychology and neuroscience professor at University of North Carolina Chapel Hill and one of the study’s co-authors. “They left Black Americans more likely to experience poverty, fewer educational opportunities, unsafe neighborhoods and other conditions that increase health risks. At the same time, they gave White Americans greater access to the resources that protect health.”
The findings also highlight how the environmental conditions people live in can shape their health beyond individual choices, the researchers said.
“There’s a pretty pervasive belief in the U.S. that health outcomes are fundamentally due to individual choices,” Galvan said. He referenced a 2022 study that showed more than 70% of Americans in the study sample found personal choices to be more important to health and well-being than external factors.
But many people, Galvan said, overlook how those choices can be constrained by the environments they live in. For example, someone living in an impoverished community may have less access to high-quality grocery stores, making it harder for them to eat a healthy diet.
“People don’t choose what their skin color is, or how much their community relied on slavery in 1860,” Galvan said. “Our analysis shows that those conditions play a significant role in who lives in a segregated community, who struggles with poverty, who attains a college education, and consequently, who lives and who dies.”
He added that Black-White disparities in wealth, income, housing, education and health all began in the slavery era.
“There’s this kind of unbroken chain of events that connects what happened in that past to what we see today,” Galvan said.
Going forward, the researchers argue that reducing health disparities will require addressing inequality — and recognizing that slavery is not simply a thing of the distant past.
“There hasn’t been a really strongly sustained policy effort to address the legacy of slavery,” Galvan said. “We have not seen America really grapple with the history of slavery and really try to reverse what we find, which is why the inequalities we saw back then never truly went away.”
Payne emphasized that the mortality gaps identified in this paper go beyond problems that can be fixed with medical solutions.
“These mortality gaps reflect policy choices that were intentionally made in the past and that continue to divide us as a country today,” he said. “Reducing them will require policies that reduce poverty, raise incomes, improve schools and make college more accessible.”