While recent research indicates that some causes of death are declining among Black Americans, the persistent disparities in mortality rates compared to white Americans remain concerning.
In some areas, these disparities are even widening, signaling that much work remains to achieve equitable health outcomes.
A study published in JAMA Network Open highlights these complexities by examining mortality data from 1999 to 2020.
Examining the Numbers: A Deep Dive into Mortality Data
The study analyzed death certificate data collected by the U.S. Centers for Disease Control and Prevention (CDC) over a 21-year period.
The researchers explored mortality rates for Black Americans relative to white Americans across common causes of death, including COVID-19 fatalities during the pandemic.
The findings revealed that Black Americans experienced excess mortality during the study period, with an average of 1.49 more deaths per 1,000 Black females and 2.84 more deaths per 1,000 Black males compared to their white counterparts.
Progress in Heart Disease and Cancer, But Rising Deaths in Other Areas
Behind these stark numbers lies a mixed picture of progress and regression.
Gains in Mortality Reduction (Pre-2010s)
For Black females, significant progress was made until 2015, with excess age-adjusted mortality rates declining by 5.7% annually. Improvements in heart disease, diabetes, cancer, accidents, and stroke were key contributors to this decline.
Similarly, for Black males, excess mortality rates fell by 5.2% annually until 2011, driven by reduced deaths from cancer, heart disease, accidents, and HIV.
Reversals and Emerging Disparities (Post-2010s)
However, these gains did not persist. Starting in the 2010s, disparities in mortality rates from heart disease, stroke, assaults, and accidents began to widen, with sharp increases recorded for Black males in 2012 and Black females in 2016. The COVID-19 pandemic exacerbated these trends, leading to a surge in excess deaths between 2019 and 2020.
Lead study author Adith Arun of Yale School of Medicine attributes these widening disparities to various systemic and societal challenges.
“Racial disparities for external causes of death — assaults, accidents, suicide — have increased significantly in recent years,” Arun noted.
“I think a number of things probably contributed, including but not limited to easier access to firearms, political division, food and housing insecurity, inflation, the rising cost of healthcare, and the unaffordability of daily living.”
Limitations of the Study
While the findings provide valuable insights, the study has notable limitations. Death certificates, the primary data source, can sometimes contain incomplete or inaccurate information about causes of death or demographic details.
Furthermore, the study focused exclusively on the relative differences in mortality rates between Black and white Americans without analyzing the specific reasons behind narrowed or widened gaps.
For example, disparities in heart disease and stroke are partially linked to high blood pressure, which is more prevalent and often poorly treated among Black Americans.
“The Black-white difference could be reduced by better treatment by physicians to better control blood pressure, particularly in the Black population,” said George Howard, DrPH, a public health professor at the University of Alabama at Birmingham.
“Things that I would recommend everybody do is to ask questions about their health, seek care from healthcare providers who listen to them, and engage in preventative measures such as resistance training, eating fresh vegetables and protein, walking, and sleeping eight-plus hours a day,” Arun advises.
He emphasized that while improving treatment is critical, addressing the higher prevalence of high blood pressure in Black communities is equally essential.
Strategies to Reduce Premature Deaths
Despite the troubling findings, there are steps individuals and healthcare systems can take to lower the risk of premature death. Arun recommends simple yet impactful health practices:
- Ask Questions About Health: Proactively engage with healthcare providers to better understand personal health risks.
- Preventative Measures: Incorporate resistance training, consume fresh vegetables and protein, maintain an active lifestyle with regular walking, and prioritize sleep (at least eight hours per night).
- Seek Supportive Healthcare: Access care from providers who prioritize listening and understanding patient needs.
Addressing systemic issues, however, requires coordinated efforts. Policies that expand healthcare access, reduce socioeconomic barriers, and improve the quality of care in underserved communities are critical to closing these gaps.
The Path Forward
This study underscores the complexities of health disparities in America. While some progress has been made in reducing deaths from diseases like cancer and heart disease, the persistence of racial disparities, especially in deaths from external causes like accidents and assaults, reveals underlying inequities that demand urgent attention.
Achieving health equity is not a simple task, but understanding the patterns and drivers of these disparities is a crucial first step. By focusing on systemic reforms, improving healthcare access, and empowering individuals with preventative strategies, it is possible to create a future where health outcomes are not determined by race or socioeconomic status.
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