Minority Issues

Race And Health

Despite advances by black Americans in such areas as housing, education and employment, their health remains poorer than that of whites. Government data and academic research show a widening gap between blacks and others in the incidences of asthma, diabetes, major infectious diseases and several forms of cancer.

  • The federal Centers for Disease Control and Prevention reports that from 1980 to 1994 the number of diabetes cases rose 33 percent among blacks -- three times the increase among whites.

  • The gap in cases of infectious diseases has increased by the same magnitude.

  • From 1990 to 1985, the death rate for all women from breast cancer fell from 23.1 per 100,000 to 21 -- but black women's higher rate did not budge from 27.5 per 100,000.

  • Blacks die at an average age of 70 -- six or seven years earlier than whites.

Experts say limited education, violence and addiction are partly to blame. Some analysts see poorer health care as an important factor.

Other health conditions which disproportionately affect blacks include obesity, homicide and fetal alcohol syndrome.

Other minority groups suffer from some diseases more than blacks: Indians have higher levels of diabetes; Hispanic-Americans tend to suffer more fatal and disabling strokes; and Puerto Rican children have the highest incidence of asthma.

Experts say that public health programs begun under the Clinton administration have had little more effect on the health gap than those of prior administrations. In fact, some conditions have even worsened since the late 1980s and early 1990s.

Source: Peter T. Kilborn, "Black Americans Trailing Whites in Health, Studies Say," New York Times, January 26, 1998.

Does Racism Raise Blood Pressure?

Some epidemiologists -- researchers who study the incidence of disease -- say racism in America is making black people sick. In the October issue of American Journal of Public Health, Harvard University epidemiologist Nancy Krieger claims that blacks have a higher incidence of high blood pressure due to the stress induced by their experience of racism.

There are racial differences in health. According to the National Center for Health Statistics, the average white lives seven years longer than the average black, and death rates from cancer, stroke and heart disease are all higher in blacks -- nearly two-fold in the case of stroke.

These differences are largely explained by behaviors (such as smoking and diet) and by various genetic differences.

Krieger and co-author Stephen Sidney asked 4,086 blacks and whites about their experiences with racial discrimination. They compared the responses to individuals' blood pressure readings, correcting for known risk factors. Initially, the data showed no correlation between experiences with bias and blood pressure:

  • Blacking working class men and women who reported zero episodes had higher pressure than those reporting one or more.

  • Black professional women who reported one or two episodes of discrimination had lower pressure readings than those with none or those with three or more.

  • And for black professional men those with one or two episodes of discrimination had higher readings than those with none or with three or more.

Krieger and Sidney rationalized that some blacks must have underreported experiences of discrimination, so they adjusted the figures. However they did this only in the case of working-class blacks, not the professionals whose blood pressure tended to be lower.

Critics of the study say the data were both muddled and didn't establish a cause-and-effect relationship. In fact, some researchers say epidemiology can't establish causation, only a correlation, and they say that such data is frequently misused.

Source: Sally L. Satel (Yale University School of Medicine), "Race for the Cure," New Republic, February 17, 1997.

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