This study provides important information of the differences in cause-specific YLL by age, race, and sex. Changes since 1990 indicate progress in YLL among black males and females. While YLL rates among blacks are still higher than those found in whites, dramatic improvements have been made. On the contrary, young and middle age white, Hispanic and AI/AN females have had worsening YLL over the last 25 years, and white males have seen no improvement. API males and females have the lowest YLL for all ages. Further evaluations should consider whether any areas in the US have been more successful in improving YLL for race-sex groups or for certain causes of death.