A viewpoint recently published in JAMA revealed a reduction in the gap between African-American and Caucasian life expectancy in the U.S. and lists areas of interest, such as breast cancer, that could further trim the difference.
The viewpoint, by Victor R. Fuchs, PhD, of Stanford University, California, is titled “Black gains in life expectancy.”
“In recent decades the U.S. black population has experienced substantial gains in life expectancy, now becoming closer to the life expectancy of the white population,” wrote Fuchs, Stanford’s Henry J. Kaiser professor emeritus. “Between 1995 and 2014, the increase in black life expectancy at birth was more than double the white increase: a gain of 6.0 years from 69.6 years to 75.6 years for black people compared with a gain of 2.5 years from 76.5 years to 79.0 for white people.”
Fixing their lens on changes in black-white life expectancy differences between 1999 and 2013, researchers arrived at a narrowing of 2.3 years (from 5.9 to 3.6 years).
The improvement is mainly a result of progress in five medical fields: cardiovascular disease, cancer, human immunodeficiency virus (HIV), unintentional injuries, and perinatal conditions. Those five areas accounted for nearly 60 percent of the deflated gap in black-white life expectancy.
Fuchs explained that in order to identify which causes effect the gap decrease most, the causes must have had significant numbers in deaths and a higher age-adjusted death rate for African-Americans. Eleven causes of death met the criteria.
The causes in order of reported deaths were: HIV; homicide; hypertension and hypertensive renal disease; nephritis, nephrotic syndrome, and nephrosis; prostate cancer; diabetes mellitus; septicemia; breast cancer; cerebrovascular disease; colon, rectum and anus cancer; and heart diseases.
“It appears that progress in just a few causes probably will not be enough; progress in many causes will be required,” Fuchs wrote.
Fuchs noted that several causes, including essential hypertension, prostate cancer, kidney disease and septicemia, all with high black-white age-adjusted mortality ratios and a substantial number of total deaths, pose substantial research, prevention, diagnosis, and therapeutic intervention challenges. For example, continued progress in prevention and treatment for heart disease among black men could make a major contribution because of the larger numbers of deaths among that group relative to white men and black women.
But, addressing the high black-white ratio for deaths due to homicide, Fuchs wrote that public health measures, such as gun control, will likely have a bigger effect on the reduction of the black-white life-expectancy gap than medical care.
“In 1944, Gunner Myrdahl, Nobel Prize winner in Economics, wrote that black-white differences were arguably the United States’ biggest problem. Major advances in life expectancy that bring blacks closer to whites is a significant contribution to its solution,” he wrote.
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