Background: Life expectancy is a critical measure of population health. In the U.S., Black Americans have historically experienced lower life expectancy than White Americans due to factors such as health insurance inequities, socioeconomic disparities, and systemic barriers. Though the Black-White life expectancy gap narrowed after 1990, it has fluctuated in recent years, influenced by socioeconomic changes and the COVID-19 pandemic. Objective: This study examines how national-level differences in education and income contributed to the Black-White life expectancy gap in the United States from 2007 to 2018. Methods: Data were analyzed from the National Health and Nutrition Examination Survey (2007 to 2018) and its Linked Mortality File. Using 3 survival models, this study assessed life expectancy at age 20 for Non-Hispanic Black (NHB) and Non-Hispanic White (NHW) populations. Covariates included education and income. Results: The unadjusted life expectancy gap at age 20 between NHB and NHW individuals averaged 3 years. Adjusting for education using a flexible parametric survival model reduced the gap by 50%, while adjusting for income reduced the gap by 75%. When both factors were adjusted simultaneously, two survival models indicated that NHB life expectancy slightly exceeded NHW life expectancy. Income disparities persisted across educational levels, signifying unequal economic returns to education. Conclusions: Addressing income disparities is essential for reducing racial inequities in life expectancy. Policies promoting both equitable education access and income equivalence are critical for achieving health equity and improving population health.

The authors have declared no competing interest.

This study did not receive any funding.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Source data were openly available before the initiation of the study. They can be obtained at: https://www.cdc.gov/nchs/nhanes/?CDC_AAref_Val=https://www.cdc.gov/nchs/nhanes/index.htm

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

All data produced are available online at: https://www.cdc.gov/nchs/nhanes/?CDC_AAref_Val=https://www.cdc.gov/nchs/nhanes/index.htm