Gap in Black-White Life Expectancy Narrows
It's a good sign, but not a victory, one expert says
FRIDAY, March 16, 2007 (HealthDay News) -- The life expectancy gap between U.S. blacks and whites has been shrinking over the past decade, mainly due to lower death rates among blacks for homicide, HIV, unintentional injuries and heart disease, researchers report.
Overall, the life expectancy divide between whites and blacks has closed from 7.1 years in 1993 to 5.3 years in 2003, government data shows. In 2003, the average U.S. black could expect to live 72.7 years, compared to 78 years for whites.
However, despite this progress, the gap remains significant, and more work is needed if the gap is to be further reduced, according to the report in the March 21 issue of the Journal of the American Medical Association.
"From 1983 to 1993, the life-expectancy gap between blacks and whites widened considerably. From 1993 to 2003, that gap has declined by 18 percent for women and 25 percent for men," said study co-author John Lynch, from the Department of Epidemiology, Biostatistics and Occupational Health at McGill University, in Montreal.
The main reasons for the decline are improving death rates for blacks, Lynch said. For black males, death rates shrank, "especially in terms of homicide, HIV and unintentional injuries," he said. "For black women, there have been improvements in cardiovascular disease. These causes of death make up 70 to 80 percent of the decline," he said.
In the study, Lynch and his colleagues used data from the U.S. National Vital Statistics System, maintained by the National Center for Health Statistics, to look at black and white life expectancy from 1983 to 2003.
They found that, for women, heart disease was the largest contributor to the improvement in life expectancy. Other conditions in 2003 that contributed to the gap narrowing for women included diabetes, stroke and infant mortality.
For men, the largest contributor to the gap in 1983 and 1993 was homicide. By 2003, heart disease had become the leading factor behind the divide, followed by homicide, HIV and infant mortality, the researchers found.
However, despite this progress, the current gap in life expectancy between blacks and whites remains substantial, Lynch said. "The difference for men is 6.3 years, and for women 4.5 years," he said.
"The good news is that the gap has declined," Lynch said. "That should give us some confidence that things can change. But the bad news is that it remains large, but we know what we need to work on."
Lynch believes the health-care system needs to work harder to improve access and quality of care for blacks, especially when it comes to preventing and treating heart disease in men. "We need to target our efforts to reduce this gap between blacks and whites," he said.
One expert agreed that narrowing of the gap is good, but more needs to be done.
"Narrowing the gap is an encouraging sign," said Stephen Thomas, director of the Center for Minority Health at the University of Pittsburgh Graduate School of Public Health. "But there is a level of frustration because the gap in health status has been evident, probably since the time we started collecting health statistics," he added.
For many years, this gap was never recognized, Thomas said. "I am glad that we are beginning to acknowledge the gap. Narrowing the gap is encouraging, but it's nothing to write home about yet. No one should take this as any sign of victory."
"The goal is to improve the health of the American people and not to have pockets of our population suffering from premature illness and death, which in some cases is preventable," Thomas said. "Much more needs to be done."
Access to care and other factors play a role in the gap between black and white, Thomas said. "But there is a broader social and environmental context that perpetuates the gap, even though we might make a little progress -- but it is a persistent reflection of our national life."
Thomas also faulted the black community for not focusing more on health. "We still don't own up to our responsibility in making health our agenda," he said.
"The frontline civil rights organizations that are looked to when it comes to issues of social justice do not have health front and center," Thomas said. "Forty plus years after the passage of the Voting Rights Act, a lot of those objective, blatant forms of racism and racial discrimination are not obvious. We need these mainline organizations to put the health of the African-American community front and center on their agenda," he said.
There's more on race, ethnicity and health care at the Kaiser Family Foundation.