When researchers at the University of Pittsburgh Graduate School of Public Health crunched 25 years of data involving 60 million U.S. death records they were surprised at what they found — a dramatic decline in premature deaths for middle-aged African Americans.
"We were glad to see this," said Donald S. Burke, the school's dean and senior author of the paper, published recently in PLOS ONE. "Racial disparity in many aspects of health has been a difficult problem in society and to see we are making substantial improvements is very good news."
The researchers looked at death reports by age group, sex, race, and cause of death from 1990 to 2014 and found a decline in heart disease, HIV, and cancer death rates among blacks. At the same time, they found some disturbing increases in premature deaths in whites, due in part to drug overdoses.
Net effect: The historic racial disparity gap for premature deaths appears to be narrowing.
Burke and his colleagues measured "years of life lost," an estimate of how long an individual would have lived had they not died of preventable causes. The study was funded by the Robert Wood Johnson Foundation.
"Every year of life is precious," said Burke. "Asking how much premature or avoidable death there was, is a way of comparing how much life was left on the table and how much we are improving."
Historically, American blacks have experienced shorter life spans than whites. In 2015, the U.S. Census listed the life expectancy for a black man at 72.2 years and 78.5 years for a black woman. A white man could be expected to live 76.6 years and a white woman, 81.3 years.
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For all Americans, life expectancy improved by 10 percent in that same time period but with some notable exceptions, researchers found.
For white adults, the data showed a 6 percent increase in years of life lost.
While white males experienced a slow increase in life expectancy, white women have seen an 18 percent increase in years of life lost, primarily due to drug overdoses.
Asians had a lower rate of years lost for all causes of death for every age group studied. Hispanic males ages 25 to 35 saw a drop in life expectancy with a 16 percent increase in years lost due to overdose and suicides, the researchers found.
In a positive development, the homicide rate for black men ages 20 to 64 has leveled off, according to the study.
Edith Mitchell, an oncologist and director at The Center to Eliminate Health Disparities in the Sidney Kimmel Cancer Center at Jefferson Health, said the improvements likely are due to advanced health screening and earlier diagnosis, more health insurance, access to clinical trials, reductions in smoking and other pollutants, and higher incomes for some African Americans.
While there has been significant improvement, there is still a long way to go to improve the general health of all Americans, she said. For one thing, the study illustrates that physicians need to focus on the specific health issues related to each demographic group, and tailor their approachs, she said.
"We don't use a one-shoe-fits-all theory," Mitchell said. For example, a patient who lives in a neighborhood that lacks proper grocery stores can't be told simply to eat more fruits and vegetables. Instead, that person might need specific assistance to find healthier foods.
"All the factors that are social determinants of health have to be addressed," Mitchell said.
Andrea Curtis, president of the Urban League of Philadelphia, said more education is needed for patients of color especially when it comes to kidney disease. Blacks and Hispanics suffer kidney failure at significantly higher rates than whites as a result of higher rates of diabetes, high blood pressure, and heart disease, she said.
On Saturday from 10 a.m. to 3 p.m. the North Philadelphia Health Fair will offer health screenings including a risk survey, body mass index, blood pressure, and blood sugar checks and urine analysis, she said. And there also will be bounce castles, Zumba and kickboxing demos, and music to involve all members of the family.
"We are going to have fun," Curtis said.