Black people make up only 12% of the US population, and yet a higher proportion of this group is affected by health issues than other races/ethnicities.
This Black History Month, we thought it’d be a good time to remind you that despite all the good work that’s been done, there’s still a ways to go to improve black health and health care in the US.
A quick history lesson: The Office of Minority Health was established in 1986 as a result of the so-called Heckler Report, named after then–Health and Human Services secretary Margaret M. Heckler. The report detailed differences in health between white people, black people, and other minorities, and led to all sorts of changes in policies, programs, research, etc. on the national and state level.
There are many different factors that contribute to the health disparities affecting black people in the US, including poverty, education, housing, access to healthy foods, and violence and crime. Conscious and unconscious biases also manifest as discrimination in doctor's offices, affecting people's health in various ways, and sometimes even discouraging people from seeking care or adhering to treatment. While there’s been some progress in combating these issues and closing the disparity gap — the death rate (the ratio of people who die in a given population during a certain time period) among black people in the US has dropped 25% in the last two decades — the truth is there’s still a lot of work to do.
Here are some health disparities you may or may not have heard of.
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Young black Americans are more likely to develop and die from chronic diseases that don’t show up in white Americans until older age.
Black people in the US may be living longer these days, but that applies mostly to people who are already 65 years old or older, according to the Centers for Disease Control and Prevention. That said, there’s still a gap in life expectancy between black people and white people — about 3.4 years, according to CDC data from 2014 — and it has a lot to do with younger black people developing chronic health conditions earlier in life, which then lead to an early death. These include high blood pressure, diabetes, stroke, and heart disease, which black people aged 18–49 are twice as likely to die of as white people who are the same age.
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Black people are more likely to die of all cancers combined than any other racial or ethnic group.
The death rate from cancer is 25% higher among black people than white people. In part, that's because black men are more likely to be diagnosed with cancer than any other racial/ethnic groups — there were 592.3 cancer diagnoses per 100,000 black men between 2008 and 2012 compared with 528.9 per 100,000 white men, according to the American Cancer Society. And although black women are generally less likely to be diagnosed with cancer than white women, they're still more likely to die from it. The National Cancer Institute suggests it’s because women are not getting screened for cancer and/or they are diagnosed with it at a later stage, they lack health insurance, or they are more likely to smoke or be physically inactive compared to other women.
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Black women are over three times as likely to die from a pregnancy-related issue as white women.
Pregnancy-related deaths are defined as death occurring during or up to one year after the end of a pregnancy. Between 2011 and 2013, there were 43.5 deaths per 100,000 live births for black women compared to 12.7 deaths per 100,000 live births for white women and 14.4 deaths per 100,000 live births for other women. Cardiovascular disease and infections were among the top reasons for these deaths.
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Black children are also more likely to die before their first birthday when compared to others.
A little over twice as many black infants as white infants died in 2015, with more deaths in the South and some states in the Midwest. According to the CDC, the five leading causes of infant death are birth defects, preterm birth or low birthweight, sudden infant death syndrome, pregnancy complications, and accidental injuries like suffocation.
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A higher proportion of black people are newly diagnosed with HIV, living with it, or diagnosed with AIDS than any other race or ethnicity.
Actually, despite only making up 12% of the population, black people made up 44% of new HIV diagnoses in 2016 and 43% of the total number of people living with HIV at the end of 2014. That's a huuuge chunk of the HIV-positive population. There are a few reasons for such a disparity, the CDC says, including limited access to quality care, a lack of HIV prevention education — 16% are unaware they even have an infection — and the tendency to have sex with people of the same race, which can increase risk when you consider how prevalent it is among the population.
In 2016, men who have sex with men made up over half (58%) of black people who were diagnosed with HIV, and even though there was a 30% increase in new diagnoses in those aged 25 to 34 from 2011 to 2015, overall rates remained stable. Some sort-of-good news: in that same timeframe, diagnoses among all black Americans dropped 8%.
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Many other sexually transmitted infections also disproportionately affect the black community.
In 2016, that included gonorrhea, which affected black women and men 8.9 and 8.4 times as often as white men and women, respectively; chlamydia, which affected 6.6 and 5.1 times more black men and women than white men and women, respectively; and syphilis, which occurred in black men and women 4.6 times and 7.0 times more often than white men and women, respectively.
The good news? These rates have gone down since 2014.
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Black people in the US are more likely to have mental health problems than other people.
These include major depression and attention deficit hyperactivity disorder, and post-traumatic stress disorder. The reasons for this increased risk could probably make up a whole other post, but the National Alliance on Mental Illness lists the following as a few:
- Homelessness and exposure to violence are linked to an increased risk of a mental illness.
- Some people may misunderstand or stigmatize mental health problems, or believe that mental illness is a personal weakness — like thinking of depression as just “the blues.”
- A tendency to rely on other sources of support for healing, like family, community, or religion, as opposed to a health care professional.
- Reluctance or an inability to seek mental health services, whether it's because of covert or outright racism, prejudice, discrimination, or unconscious bias. It can be hard to trust health care providers to provide compassionate care — and that's if you or your insurance can pay for it in the first place.
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More black children kill themselves than white children, and it’s a rising trend.
It's true that suicide among elementary-aged kids is rare, but that doesn't mean it's any less important, and two recent studies — in the July 2015 issue of JAMA Pediatrics and the October 2016 issue of Pediatrics — have found dangerous trends in which the suicide rate for black kids aged 5 to 11 has been going up. Specifically, suicide rates among black children went from 1.36 per million between 1993 and 1997 to 2.54 per million between 2008 and 2012. (During that same time the rates declined for white children.) And according to the most recent study, 36.8% of elementary-aged kids who committed suicide between 2003 and 2012 were black. These children were more likely to be male and less likely to exhibit depression, and the most common precipitating circumstance seemed to be relationship problems with family and friends. However, suicide rates between racial groups flip over as kids get older, and black teens and adults are less likely to kill themselves than whites.
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Finally, black people are victims of violence at farrrr higher rates than the general population.
Black people have a rate of death due to homicide that is eight times that for white people, according to the CDC, and gun violence is the leading cause of death for black men between 10 and 24 years old. Such violence can cause a ripple effect, leading to some of the aforementioned disparities. One study, for example, found that kids who were exposed to violence within a half mile of their home were more likely to have higher levels of anxiety and poorer cognitive performance — which, as you might imagine, might also be linked to a risk of mental illnesses like PTSD and depression.
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