Kaiser Daily Health Policy Report, August 30, 2007
White men in California live an average of seven years longer than black men, and white women in the state live an average of five years longer than black women, according to a study released on Wednesday by the Public Policy Institute of California, the Los Angeles Times reports (Engel, Los Angeles Times, 8/30). For the study, titled “Death in the Golden State,” co-authors Helen Lee and Shannon McConville, both of the institute, examined 694,317 death certificates issued in California between 2000 and 2002 and compared the causes of death among the largest racial and ethnic groups in the state.
The study found that Hispanic men in California lived an average of two years longer than white men and that Hispanic women in the state lived an average of three years longer than white women. In addition, the study found that Asian men and women in California lived an average of five years longer than white men and women.
The study also found that:
- Asian men in California lived to an average age of 80, and Asian women lived to an average age of 85, with common causes of death that included heart disease, cancer, strokes and aneurysms;
- Hispanic men in California lived to an average age of 77, and Hispanic women lived to an average age of 83, with common causes of death that included heart disease, cancer and diabetes;
- White men in California lived to an average age of 75, and white women lived to an average age of 80, with common causes of death that included heart disease and cancer; and
- Black men in California lived to an average age of 68, and black women lived to an average age of 75, with common causes of death that included heart disease and cancer.
According to the study, although heart disease and cancer were common causes of death among all racial and ethnic groups in California, they affected whites and blacks at much higher rates than Asians and Hispanics (Olvera, San Jose Mercury News, 8/30). Men and women in all racial and ethnic groups in California with more than a high school education lived longer than those with less education, although disparities among whites and blacks remained for those with similar levels of education, the study found (Los Angeles Times, 8/30). Comments
Lee said, “The leading killers are similar across groups. If you target the risk factors for those conditions — and there are a lot of factors including family history, diet and exercise — that might lead to improvements for all groups” (Barbassa, AP/Contra Costa Times, 8/30). “Clear racial and ethnic patterns emerge for many conditions,” Lee said, adding, “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.”
Ellen Wu, executive director of the California Pan-Ethnic Health Network, said, “I think information like this can help us get to the next step” in efforts to reduce disparities among racial and ethnic groups in the state (San Jose Mercury News, 8/30).
California Endowment President Robert Ross said, “The lion’s share of what explains health status and life expectancy has to do with nonhealth care factors,” adding, “That’s when you get into the quality of the environment, poverty, racism and some messier factors” (Los Angeles Times, 8/30).
The study is available online (.pdf).
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These figures probably underestimate the effects of racism and poverty on life expectancy.Just within Berkeley California, a study of death records from 1995 to 1997 showed an astounding 20 year difference in life expectancy between blacks living in the flatlands and whites living in the hills. In the words of December 23, 1999 California Healthline,
“Life expectancy for Berkeley residents varies dramatically depending upon which side of the city people live, according to the city’s third annual Health Status Report that studied death records from 1995 to 1997. Life expectancy for residents living in South Berkeley — which is 73% African-American — is 62 to 64 years, the lowest in the study. In contrast, those living in the Berkeley hills — an area that is between 73% and 90% white — are expected to live an average of 80 to 84 years. Further, incomes in the predominantly white neighborhood are much higher than in South Berkeley. Jose Ducos, senior health analyst and statistician for the state Department of Health and Human Services, used the example of breast cancer to explain the difference. Even though breast cancer is more common among white women, the mortality rate is higher for black women, he noted. Ducos said, “White people get it detected in time, while blacks don’t have the same access to health care,” adding, “One of the things we are trying to highlight is the disparity among races; the difference between whites and blacks, and in Berkeley, it’s huge. Our goal between now and 2010 is to eliminate the disparity.” Overall, the life expectancy for Berkeley residents is 78.8 years, with heart disease being the no. 1 killer. But “lower incomes, lack of education and less access to health care all combine to shorten life,” the Oakland Tribune reports (Burt, 12/21).” Also see the SF Chronicle Jan 3, 2000.
A recent SF Chronicle article (Aug 24, 2007) showed blacks in San Francisco died at a higher rate, and lost more years of life in 2003 and 2004, from practically every cause of death tracked, including heart disease, strokes, various cancers, drug overdoses, alcohol abuse disorders and diabetes. And a recent study has shown again that black infant mortality in the US is twice that of whites. In 2001, the HIV/AIDS death rate was over ten times greater for blacks than whites.
It is tempting, of course, to attribute these differences to lack of access to healthcare. There are reasons to believe that the lack off access to healthcare has a smaller role in poor health than social, economic, and political inequality, particularly racist inequality.
In a few months, PBS will show a series “Unnatural Causes – Is Inequality Making Us Sick” and the accompanying website is partially available.