In health and social policy we often focus on problems that are bad and getting worse (think obesity or autism among children). Some problems are bad but getting better, and we can learn quite a lot from studying those problems too. For example, as I blogged before, United States has made steady progress in reducing teenage pregnancy.
Here are two charts on injury fatalities over time between non-Hispanic white adolescent males and adolescent males in four major racial/ethnic minority groups. The first chart shows annual motor vehicle fatalities per 100,000, the second shows annual homicide fatalities per 100,000 (the data file can be found here).
In their own way, each set of numbers is really staggering. Take disparities in motor vehicle fatalities: there has consistently been an almost threefold difference between the group with the highest mortality (Native Americans) and the lowest mortality rate (Asian Americans). Some of these differences are easily accounted for. For instance, Native American youth spend more time in motor vehicles because they tend to live in more rural areas with more dangerous roads.
How should we explain the spectacular decline across groups? I would be interested to see any relevant literature on this topic. My hunch is that it is a combination of factors: declining rates of drunk driving among teenagers, safer cars, safer roads, and better emergency medicine that keeps youth alive after car accidents. Still, we can do much better. Consider that Native American youth in 2007 still died at rates higher than blacks and Asian Americans from twenty years prior.
How about homicides? If you were a researcher or journalist in the early 1990s, it would have been reasonable to extrapolate that black males would continue to kill each in a situation that resembles today’s northern Mexico. Not surprisingly, homicide rose to the number one cause of preventable years of life lost in the late 1980s among black youth, eclipsing the AIDs epidemic. The increase among Hispanics in the early 1990s was also staggering in relative terms.
Things changed in the late 1990s. We know part of what changed: the crack epidemic subsided, the economy improved, policing strategies changed, and community leaders began to organize and mobilize against urban violence. The world is safer for black adolescent males than it was in the early 1990s, but the data are still very sobering. Even in 2007, the black adolescent male homicide mortality rate eclipses the Hispanic rates from the height of the homicide epidemic.
Some of the solutions to this problem are very easy and very obvious: first, stop the sale of automatic weapons and clamp down on secondary markets for handguns. Period. Some of the change will be harder to realize. We need to deal with persistent unemployment among minority males in urban areas. Still, these data should prompt a discussion about ways to bring about changes like those seen in the late 1990s.