Black & White: Death & Dying by Race & Ethnicity

Is health black and white?

Before you answer… Did you know that there are differences in death rates based on race? On average, at birth a white person may expect to live 5 years longer than a black person in the United States. This gap grows to a 10 year difference when comparing life expectancy of white women (81 years) to black men (71 years) [1, 2].

Why is this the case?

Well for starters, the leading causes of death differ down both race/ethnicity and gender lines. For instance, homicide makes the list as one of the top five killers of black men, but does not make the list for white men (nor either group of women). Diabetes makes the list as one of the top five killers of black women, but does not make the list for white women (nor either group of men) [3]. However, when comparing death rates between blacks and whites for the same disease, blacks still tend to have worse health outcomes. In fact, according to 2012 data, the U.S. Department of Health and Human Services Office of Minority Heath states “the death rate for African Americans was generally higher than Whites for heart diseases, stroke, cancer, asthma, influenza and pneumonia, diabetes, HIV/AIDS, and homicide” [4].

But really, why is this the case?

It comes down to what researchers refer to as ‘social determinants of health’. This term translates into how where you live, work, and play shapes your health. Moreover, these differences may in part be explained by health inequity, “difference or disparity in health outcomes that is systematic, avoidable, and unjust” [5]. For instance, it is common knowledge that many black people in America are living in poverty. This fact is tied to societal oppression dating back to slavery. Poverty manifests in predominately black neighborhoods, leading to limited access to resources such as healthy food, safe environments for physical activity, and quality health care services. As declared by Dr. Martin Luther King Jr., “of all the forms of inequality, injustice in health care is the most shocking and inhumane.” BUT, poverty does not explain it all. Even when a 2015 study compared breast cancer survival rates between low socioeconomic status white women with high socioeconomic status black women, black women still suffered from worse health outcomes [6]. Thus, factors beyond poverty, such as racial discrimination (e.g. subconscious differences in treatment by health care professionals) must be considered.

What can be done?

First and foremost, health education and health inequity awareness must become common knowledge. Children and adults, men and women, black and white must all understand what constitutes health, so that health is not only seen as the physical absence of a pathogen, but more holistic and inclusive of mental, emotional, environmental, and social health. Professionals and patients must work together to actively address gaps in sociocultural competence/humility through being open and honest with each other. Particularly, physicians have a responsibility to treat “humanity as [their] patients” [7]. Thus, systematic discrimination must be deconstructed for the assurance of ‘justice for all’. While health policy should be at the forefront of the conversation to combat these issues of social justice, communities must also consider their power in determining their destiny. Black communities, as they have done in the past, must begin to gather, organize, and mobilize to persevere.

Now, with all of this in mind… you tell me, how long should health continue to be black and white?

Rhoda Moise is a graduate of Pennsylvania State University with a B.S. in Biobehavioral Health and a passion for health promotion. She has been trained to approach health from an interdisciplinary perspective from proteins to people. Through her doctoral studies as a PhD student at The University of Miami, she intends to combat health disparities by conducting research which provides empirical evidence that demands alteration in standing policy.

References

1 http://www.cdc.gov/nchs/nvss/mortality_tables.htm

2 http://www.cdc.gov/nchs/data/dvs/LEWK3_2009.pdf

3 http://www.cdc.gov/nchs/nvss/mortality_tables.htm#lcod

4 http://minorityhealth.hhs.gov/omh/browse.aspx?lvl=3&lvlid=61

5 http://www.cdc.gov/nchhstp/socialdeterminants/definitions.html

6 Keegan, T. H., Kurian, A. W., Gali, K., Tao, L., Lichtensztajn, D. Y., Hershman, D. L., … & Gomez, S. L. (2015). Racial/ethnic and socioeconomic differences in short-term breast cancer survival among women in an integrated health system. American journal of public health, 105(5), 938-946.

7 http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/declaration-professional-responsibility.page

Black & White: Death & Dying by Race & Ethnicity

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