Academic journal article The Western Journal of Black Studies

Reassessing the Sources of Racial and Ethnic Disparities in U. S. Adult Mortality

Academic journal article The Western Journal of Black Studies

Reassessing the Sources of Racial and Ethnic Disparities in U. S. Adult Mortality

Article excerpt

Introduction

Although there have been significant declines in US mortality rates in the past thirty years, there remain significant racial/ethnic differentials. For instance, in 2001, overall mortality was 31 percent higher for African Americans than for white Americans. When specific causes of death are considered, in 2001, age-adjusted death rates in the African American population exceeded those in the white population by 40 percent for stroke, 29 percent for heart disease, 25 percent for cancer, and nearly 800 percent for human immunodeficiency virus disease (NCHS 2003, p. 7).

In a study presented at the International Stroke Conference, Howard and Associates (2005) reported that African American males 55-64, who live in the "stroke belt" (Alabama, Arkansas, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Florida, and Virginia ("Southern States"), were at a 51% higher risk for stroke deaths than for comparable whites (29%) living in the South. Furthermore, African American males living in New York were 2.1 times more likely to die from strokes than whites; for African Americans in South Carolina, the rate was 3.8 times (Howard & Associates 2005). In other words, African American males living in the South are more likely to die from strokes than those living in other geographic areas in the Unites States. Steyerberg, Earle, Craig, Neville, & Weeks (2005) reported that even though esophageal cancer is three times higher among African Americans than whites, they were under-treated for their condition. The researchers found that African American patients were less assessed by surgeons than their white counterparts (70% v. 78%) and that only 35% of African American patients versus 59% of white patients underwent surgery for esophageal cancer. The National Cancer Institutes (2003) as well as the American Cancer Society (2005a,b) reported that African Americans of all groups have the highest overall incidence and death rate for cancer as well as the highest rates for certain cancers such as colon, rectum, lung, bronchus, prostate, and breast. Finally, in a study reported by Glover, Greenlund, Ayala, & Kroft (2005) using National Health and Nutrition Examination Surveys (NHANES) data for 1999-2000, the age-adjusted prevalence of hypertension in Non-Hispanic African Americans was 40.5% versus 27.4% in non-Hispanic whites.

Reductions in age-adjusted death rates by race, sex, region, and urbanization level have been observed for various groups (NCHS 2004). For all regions measured at the large (L), medium (M), and small (S) metropolitan counties, the African American population age-adjusted death rates exceed those in the white population by 33% (L), 35% (M), and 35% (S) in 2000-2002, a drop of 5%, 3%, and 2%, respectively, from 1994-1996. When data for specific regions are examined, for example, in the South, the same pattern emerges for African American and white populations: for 2000-2002, African Americans death rates exceeded those of whites by 35% (L), 36% (M), and 28% (S) compared with 1994-1996 at 42% (L), 40 (M), and 32% (S). When sex is taken into account, the age-adjusted death rates for African American males in the South exceed those of white males by 41% (L), 42%, and 33% (S) for 2000-2002, compared with 49% (L), 45% (M), and 34% (S) for 1994-1996. For African American and white females, the pattern follows a similar path for the same periods. For instance, the age-adjusted death rate for African American females exceeded that of white females by 33% (L), 33% (M), and 26% (S) for 2000-2002 and 37% (L), 36% (M), and 31% (S) for 1994-1996 (NCHS, 2004; p. 160). While overall mortality rates for both African Americans and whites have declined, significant disparities remain and are observed over the spatio-temporal continuum.

When life expectancy is examined, substantial racial variations emerge especially between African Americans and whites. …

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