In the first half of the twentieth century, deaths from infectious disease, especially among the very young, fell dramatically in American cities. However, as infant mortality fell and life expectancy rose, racial inequality in urban infectious disease mortality grew. In this paper, we show that the fall in mortality and the rise in racial inequality in mortality reflected two countervailing processes. The dramatic decline in infant mortality from waterborne diseases drastically reduced the total urban infectious disease mortality rate of both Black and white Americans while having a comparatively small effect on the total racial disparity in urban infectious disease mortality. In contrast, the unequal fall in tuberculosis mortality, particularly in the prime of life, widened racial inequality in infectious disease mortality in US cities.

二十世纪上半叶，美国城市因传染病死亡的人数，尤其是幼儿的死亡人数急剧下降。然而，随着婴儿死亡率下降和预期寿命延长，城市传染病死亡率的种族不平等加剧。在本文中，我们表明死亡率的下降和死亡率种族不平等的上升反映了两个相互抵消的过程。水传播疾病婴儿死亡率的急剧下降大大降低了美国黑人和白人的城市传染病总死亡率，而对城市传染病死亡率总种族差异的影响相对较小。相比之下，结核病死亡率下降的不平等，尤其是在壮年时期，扩大了美国城市传染病死亡率的种族不平等。