Mary Engel, Los Angeles Times, August 30, 2007
White men in California can expect to live an average of seven more years than black men, according to a new study that echoes national surveys of the long-documented black-white gap. Heart disease and homicides account for much of the difference in life expectancies.
White women in California live on average about five years longer than African American women, in large part because of higher rates of diabetes and stroke in the latter group.
“What was surprising to me was how persistent this black-white gap has been over time,” said Helen Lee, a research fellow at the Public Policy Institute of California and the study’s lead author.
“Death in the Golden State,” released by the San Francisco-based institute last night, sought to answer that question—and potentially bridge the gaps—by identifying causes of death among different racial and ethnic groups.
Across all racial and ethnic groups, Californians with more than a high school education have longer life spans than those with a high school education or less. Higher education typically correlates with higher socioeconomic status—and better living conditions. Black-white disparities persisted, however, among those with similar levels of education.
The study found that Asians and Latinos in California had higher life expectancies than whites and blacks.
In addition, Latinos had significantly longer life expectancies than African Americans. Yet poverty rates for Latinos are similar to those for blacks, and Latinos are less likely to have health insurance. The differences are puzzling but may not last.
Mortality rates for Latinos and Asians may be underestimated because those groups are less likely than whites and blacks to report ethnicity on death certificates, the study noted.
People who immigrate here from nearby countries—such as Mexico—often go home to die, she said.
And immigrants overall tend to be healthier than subsequent generations that adopt such American habits as eating too much junk food and watching too much television.
If recent immigrants were excluded from the study, “You wouldn’t see as much of an advantage,” said Bob Prentice, director of the Bay Area Regional Health Inequities Initiative.
Many healthcare advocates and researchers attribute the persistent differences between African Americans and whites to “a pretty complicated souffle of poverty and racism and education and health issues,” said Dr. Robert Ross, president of the California Endowment, a private foundation devoted to healthcare solutions for the poor.
“The lion’s share of what explains health status and life expectancy has to do with non-healthcare factors. That’s when you get into the quality of the environment, poverty, racism and some messier factors.”
The study found that the average life expectancy for white men in California was 75.5 years, compared with 68.6 percent for black men.
Nationally, the black-white life expectancy gap has been documented since at least 1900, when whites lived to be, on average, 47.3 years and blacks 33 years. (A study released earlier this year determined that the black-white life expectancy gap had narrowed from a 7.1-year gap in 1993 to a 5.3-year gap in 2003.)
Accidents were the fourth-leading cause of death for African American men, and homicide was sixth. For Latinos, homicide was the seventh-leading cause of death; in whites, it was 20th.
Homicide, accidents and HIV—the eighth-leading cause of death for black men—tend to kill at younger ages. For black men who survive to 25, the life expectancy gap with white men shrinks from 6.9 to 5.6 years.
[Editors Note: “Death in the Golden State,” by Helen Lee and Shannon McConville, can be read or dowloaded as a PDF here. Scroll down to read the press release.]
Death—In Depth: Racial, Ethnic Mortality Patterns In California
Black Males Have Lowest Life Expectancy; Differences in Diseases, Injuries Underlie Disparities
SAN FRANCISCO, California, August 29, 2007—The average black man in California can expect to live a shorter life than the average man in North Korea. This is the shocking opening statistic in a new study released by the Public Policy Institute of California (PPIC). The analysis finds that there has been no improvement in the well-documented mortality disadvantage of blacks. It also provides new detail about causes of death for all major racial/ethnic groups in the state.
Black men in California live far fewer years than men in all other major racial and ethnic groups. The average life expectancy for all males in the state is 75.9 years. However, for a black male, it is 68.6 years, compared to 75.5 for whites, 77.5 for Hispanics, and 80.4 for Asians. The historical perspective is also cause for concern: Although one of the great accomplishments of the 20th century was enormous improvement in health and longevity, there has been no sustained reduction in the gap between black-white life expectancy in the United States since the end of World War II.
Differences in causes of death account for much of the disparity. Heart disease is responsible for the largest difference in life expectancy between black and white men (30%), followed by homicide (12%). Although eliminating these two causes of death would reduce the male white-black gap by more than 40 percent, blacks—both men and women—still have higher death rates than whites for nearly all chronic illnesses and injuries.
The disparities between women are not as large, and women enjoy longer life expectancies than men across all groups. Nevertheless, the average black woman in California can still expect to live five fewer years than the average white woman.
The black-white gap also defies some conventional wisdom. “One of the most troubling things is that this gap persists even among people with similar education levels,” says PPIC research fellow Helen Lee, who co-authored the study with PPIC research associate Shannon McConville. “Different socioeconomic characteristics have long been tied to differences in mortality; here, we have to ask if something else is responsible.”
Although not nearly as pronounced, mortality rates differ across other racial and ethnic groups and are also primarily driven by disparate causes of death. Overall, Hispanics and Asians have slightly longer life expectancies than whites, and this advantage is driven mostly by lower death rates from diseases such as cancers, chronic lower respiratory disease, and heart disease. Hispanics and Asians would have an even larger advantage if they were not more susceptible to other diseases. For example, Hispanic men would have a 30 percent higher mortality advantage over white men if diabetes and liver disease/cirrhosis of the liver were eliminated. Diabetes also lowers the advantage for Hispanic women, who are nearly two and a half times more likely than white women to die of the disease.
“Clear racial and ethnic patterns emerge for many conditions,” says Lee. “A more detailed understanding of the patterns could help health officials develop strategies that both target the leading causes of death and reduce disparities between groups.” A selection of findings from the study, Death in the Golden State: Why Do Some Californians Live Longer?, reveals the varied and complex landscape of mortality:
* Diabetes death rates are about twice as high for Hispanic men and women as for their white counterparts. The diabetes death rate for black women is three times higher than for white women.
* Death rates from heart disease are approximately 40 percent higher among black men, and 50 percent higher among black women, than they are among whites.
* HIV infection ranks in the top ten causes of death for black and Hispanic men. It is also the 11th leading cause of death for black women, compared to the 29th for white women.
* The homicide death rate for black men is nearly 10 times higher, and for Hispanic men nearly two and a half times higher, than it is for white men.
* If black men reach age 25, their mortality gap with white men shrinks by more than one year due largely to a decline in homicide deaths after that age.
* Asian men have slightly higher death rates than other groups from stroke and stomach cancer.
* Asian women have the longest life expectancy rates. At 85.2 years, they can expect to live, on average, more than 15 years longer than black men.
* White men and women are more likely than any other groups to die of Alzheimer’s disease and suicide.
The Public Policy Institute of California is a private, nonprofit organization dedicated to informing and improving public policy in California through independent, objective, nonpartisan research on major economic, social, and political issues. The institute was established in 1994 with an endowment from William R. Hewlett.