Although homicide is the cause of less than 1 percent of deaths nationwide, it is responsible for 10 percent of the difference in life expectancy between whites and blacks, the study says. Health-care professionals, police officials and educators need to target violence if they are going to correct the imbalance, the researchers say.
Deaths from heart disease and cancer are the two leading causes of the difference between black and white mortality statistics, researchers say. But homicide, which ranks 13th in the general population. ranks third among African-Americans, the report says."There has been a renewed effort in this country to eliminate the disparities in health between minorities and the general population," says study author Dr. LaMar Hasbrouck, medical epidemiologist in the Division of Violence Prevention at the National Center for Injury Prevention and Control. "This study comes on the tail of that effort to quantify the role of homicide in those health disparities."
To get a handle on the causes of the difference in life expectancy between blacks and whites, Hasbrouck and his colleagues looked at death certificates collected by the National Center for Health Statistics for 1998, the most recent year for which data were available. "The study then looked at the various causes of death and measured their contribution to the gap," Hasbrouck says.
"The life expectancy gap between blacks and whites is about six years, and that has not changed since 1980. Overall, heart disease contributed almost two years to that six-year difference; cancer contributed a little over one year, and the third contributor was homicide, and that was about a half a year," Hasbrouck reports.
For people ages 15 to 34, homicide is the number one cause of death among blacks, Hasbrouck says.
The findings appear in the Sept. 14 issue of Morbidity and Mortality Weekly Report, a publication of the Centers for Disease Control and Prevention (CDC).
More than 750,000 Americans died in 1998 from heart disease and nearly 540,000 died from cancer, the top two causes of death in the country, reports the National Center for Health Statistics. The U.S. Department of Justice says 14,000 people were murdered in the United States in 1998, about evenly divided between blacks and whites. But there are more than 211 million whites in the United States compared with less than 35 million blacks.
"If we are going to be serious about eliminating the health gap between whites and minorities in this country, we need to prioritize those health conditions that are most important in that gap. And so the implication of our study, in addition to heart disease and cancer, officials need to target homicide as well," Hasbrouck says.
"That initiative needs to come from the U.S. Department of Health and Human Services, as well as the general public-health community. The effort needs to involve educators and law enforcement. Those are the folks who are the major players in dealing with violence," he says.
"There's no real surprise in these numbers," says Nancy Hwa, a spokeswoman for the Brady Center to Prevent Gun Violence in Washington D.C. "From our perspective, because we look at firearm deaths, we have long known that the African-American community is disproportionately impacted by gun homicides, and, as we all know, most homicides are committed by firearms."
Hwa says a coalition is necessary if the country is to deal with violence and homicide as a health issue. "It does require a multi-pronged approach. We are talking about approaching this problem not only as a legislative issue, but as a public health issue -- as a community issue," she says.
"What we need to do is to get guns out of the wrong hands, making it more difficult for criminals and juveniles to get a hold of guns. We also need to educate the public on the real risk of keeping guns for self-protection. Unfortunately, the gun lobby has been very successful at promoting the myth that a gun in the home is a good way to protect yourself," Hwa says.