In their evocative thought experiment, Woolf et al. demonstrate that reducing racial disparities might result in greater gains in life expectancy than investments in medical technology.1 In calculating reductions in mortality attributable to medical technology, the authors conservatively assumed that medical technology was responsible for 100% of the observed reduction in mortality over the study period. Unfortunately, there is a catch to this assumption that renders it less conservative. Over the 1991–2000 study frame the authors used, increases in the Gini coefficient occurred.2 This suggests that socioeconomic disparities for the overall population (not just African Americans) worsened. If disparities are causing declines in health, they will hide a portion of the observed gains in life expectancy owing to medical technology
