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Purpose Despite efforts to reduce health disparities, Black Americans still face higher mortality rates than Whites. Racism has been recognized as a significant social determinant of health. Using social media data, human-being qualitative coding, and AI, we created a county-level racial discrimination index, exploring its association with years of potential life lost (YPLL) rates. Methods Through human-AI collaborative approaches using X/Twitter data, we calculated yearly county-level racial discrimination index (RDI)—number of racial discrimination posts per 100,000 in-county non-duplicated posts and examined the relationship between RDI terciles and YPLL per 100,000 non-Hispanic Black individuals. Annual data for the covariates were derived from 2018–2022 County Health Rankings and American Community Surveys across all South Carolina (SC) counties. Results RDI increased from 2018 (mean [SD], 1.443 [1.991]) to 2022 (3.439 [5.761]). Adjusting for county sociodemographic factors and historical trends, RDI was associated with the YPLL rate (marginal effects, highest vs. lowest tercile, 421.3; 95% confidence interval, 134.7–709.8; p = 0.006). Conclusions Digital racial discrimination was highly associated with Black YPLL rates, confirming the importance of racial discrimination in health disparity, especially premature deaths. Addressing explicit and implicit racism in highly affected counties is crucial for reducing persistent health inequities and promoting equity in communities.

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