Black Americans living longer, but racial gap remains, CDC says


— When it comes to the overall health of black Americans, there’s good news and bad news, according to a report released by the US Centers for Disease Control and Prevention on Tuesday.

The good news is that the overall death rate for black people in the United States has declined about 25% in recent years.

The bad news is that, although blacks are living longer, a racial disparity remains: The life expectancy of blacks is still four years less than that of whites.

Younger blacks are more likely to live with or die from conditions typically found in older whites, such as heart disease, stroke and diabetes, according to the report.

The new report included health data and age-adjusted death rates for black and white Americans from 1999 to 2015. Additionally, age-specific data and death rates were examined. The data were analyzed for age-specific trends among four adult age groups: 18 to 34, 35 to 49, 50 to 64 and 65 and older.

The data came from the US Census Bureau, the National Vital Statistics System and the CDC’s Behavioral Risk Factor Surveillance System.

The data showed that from 1999 to 2015, death rates decreased significantly in both black and white populations, and the racial disparity in death rates between the two populations fell from 33% in 1999 to 16% in 2015.

‘Many of the disparities … are largely preventable’

Black Americans saw notable declines in age-specific deaths related to heart disease, cancer and HIV from 1999 to 2015, said Timothy Cunningham, an epidemiologist at the CDC Division of Population Health and lead author of the new report, at a telebriefing Tuesday.

“Death rates from HIV among blacks went down about 80% in 18- to 49-year-olds,” he said.

Dramatic decreases in HIV deaths were seen among whites too, the data showed. Yet a racial disparity remains, as blacks are still more likely to die from HIV, according to the report.

The data also showed that blacks in the 18 to 34 and 35 to 49 age groups were nearly twice as likely to die from heart disease, stroke and diabetes as whites.

For blacks 18 to 64, the data showed that they were at a higher risk of early death than whites.

“These findings are generally consistent with previous reports that use the term ‘weathering,’ which suggests that blacks experience premature aging and earlier health decline than whites and that this decline in health accumulates across the entire lifespan and potentially across generations. This happens as a consequence of psychosocial, economic and environmental stressors,” said Leandris Liburd, director of the CDC’s Office of Minority Health and Health Equity.

Liburd was not an author of the new report, which was published in the CDC’s Morbidity and Mortality Weekly Report.

For adults 65 and older, the racial death rate gap appeared to close, the data showed. In general, the leading causes of deaths for blacks are heart disease, cancer and stroke, Liburd said.

“I can’t say enough that we need to continue to understand both the relationship between social and economic conditions and how they impact health disparities and then identify ways that we can work to improve those conditions,” she said. “African-American health is improving, and many of the disparities we see in the chronic diseases are largely preventable.”

‘Where we live determines our health’

The new report pointed to social and economic conditions, such as poverty, limited access to health care, educational attainment and home ownership, as factors influencing the racial health gaps that remain.

For instance, “disparities in premature deaths associated with heart disease, stroke and diabetes are due to our inability to provide adequate disease management for blacks who are diagnosed with hypertension and diabetes,” said Darrell Gaskin, director of the Johns Hopkins Center for Health Disparities Solutions and a professor at the Johns Hopkins Bloomberg School of Public Health. He was not involved in the new report.

“We see similar disparities in treatment for cancer patients,” he said.

The new CDC report showed that blacks have the highest death rate for all cancers combined compared with whites.

Also, in all age groups, blacks were more likely than whites to describe not being able to visit a doctor in the past year due to cost, according to the report.

“The good news is that disparities in mortality rates are narrowing in the major categories. However, we have long ways to go,” Gaskin said about the report.

The National Urban League, a civil rights group, released a separate report Tuesday titled “State of Black America 2017: Protect Our Progress.”

The report notes that President Donald Trump’s efforts to dismantle the Affordable Care Act could disproportionately burden the black community, which already faces a disparity in access to care.

All in all, Gaskin would call the racial health disparities in America a “crisis,” he said.

“It is like a massive wildfire that is burning the African-American community, and society has not devoted sufficient resources to control it, much less extinguish it,” he said.

Gaskin proposed that community resources — such as access to public safety, quality foods, public recreation and medical care — could help diminish such disparities.

While individual behaviors, such as eating a healthy diet and exercising regularly, are important, investing in black communities and expanding access to care also remain important for improving overall health, said Cunningham, the report’s lead author.

“What we do know from other studies that have documented changes in mortality and changes in life expectancy over time is that they are often associated with improvements in health care access, such as screening for chronic conditions, regular followup visits, taking medication regularly,” Cunningham said at the news conference.

“Where we live determines our health; it determines our quality of housing, the schools we attend, our employment opportunities,” he said. “Individual behaviors are important, but one challenge we face is that we have to invest in the places where people live.”