Heart disease. Lung cancer. Diabetes. Asthma. These diseases all have one thing in common: They’re more deadly to African Americans than they are to Caucasians. In observance of Black History Month, this post looks at African American health problems to understand why race is often considered a risk factor.
Chronic Conditions Diagnosed Earlier in African Americans
As we age, we’re all more likely to develop a number of chronic conditions, particularly those that occur as the result of lifelong habits. However, according to the Centers for Disease Control (CDC), these diseases strike African Americans much earlier than they do Caucasians.
Starting in their mid-30s, Black Americans are at higher risk of a variety of conditions compared to their white counterparts.
African Americans aged 35 to 49 are also over 41 percent more likely to die from any cause, and nearly 45 percent more likely between the ages of 50 and 64.
The good news is that the overall death rate for African Americans dropped 25 percent since 1999. What’s more, leading causes of death for African Americans aged 65 and older dropped even more:
- Heart disease deaths: Down 43 percent
- Cancer deaths: Down 29 percent
- Stroke deaths: Down 41 percent
While this is great news, researchers say we’re still at the beginning of understanding the issues negatively impacting Black Americans’ health. Experts believe there are a variety of reasons for these disparities, from genetics to cultural differences to systemic issues. We discuss these next.
The Role of Genetics
Doctors don’t know for sure why Black Americans are more likely to develop a variety of chronic diseases – and suffer greater complications from them – but they believe genetics may play some role.
The question becomes, do genes play a role in getting the disease, or is it more about how effective treatment is?
For example, sickle cell anemia is a disease known to most commonly affect black people. It is an inherited condition, meaning one you are born having. Other races may inherit the condition, but it is much more rare. On the other hand, heart disease kills twice as many African Americans as Caucasians. But, researchers don’t believe this is due to an inherited condition. Rather, they ascribe it to numerous reasons, one of which is the fact that treatments that work well for white people may not be as effective on black people. However, recent research proves heart medications that did not work well for Caucasians were highly effective when used by African Americans. This is why the question of genetics is multifaceted.
Do Cultural Differences Play a Role?
Some scientists wonder whether cultural differences play a role in how African Americans approach healthcare. Studies find that Black Americans are less likely to follow their doctor’s directions regarding medication, diet, and exercise, particularly as regards diabetes and high blood pressure.
Doctors also note that their black patients are more likely to express fatalistic sentiments: It’s God’s will. Everyone in my family has it. I can’t do anything about it. These patients are also less likely to take an active role in their treatment.
Specialists remark that the percentage of African American patients they treat is lower than their representation in the population as a whole. The prevalent idea is that white patients are more likely to ask their doctor for a referral to a specialist. Of course, the earlier a patient begins treatment, the more effective that treatment is. Any delay leads to more complications and higher risk of mortality.
Systemic Issues Impacting Black Health
Finally, we look at the underlying causes of many of the factors listed above: systemic issues.
Harking back to the CDC report linked to above, we find a variety of societal factors that play a direct role in race being a risk factor for numerous diseases.
For example, compared to whites, Black Americans are three times more likely to die from asthma, three times more likely to die from sarcoidosis (scarred lungs), and 50 percent more likely to get lung cancer. Doctors believe where they live plays a large role in these disparities. That’s because African Americans are also more likely to live near transportation corridors, areas that violate EPA air pollution regulations, and toxic waste dumps (and the factories producing that waste). This means that the air they breathe is more harmful and therefore more damaging to their lungs. If they do develop a chronic respiratory illness, their lungs are already weakened by their environment. Therefore, it isn’t surprising that they have higher rates of complications and mortality.
Another societal factor impacting African American health problems is their comparative lower socioeconomic status, which is directly linked to higher rates of disease. This is due in large part to reduced access to quality healthcare. It also affects education, which some doctors believe contributes to their black patients having less understanding of their healthcare options and the importance of diet and exercise.
Speaking of diet and exercise, African Americans are more likely to live in neighborhoods without easy access to fresh fruits and vegetables. These areas are also more likely to have higher crime rates, making them dangers for regular physical activity, such as walking and jogging.
Systemic issues may also play a role in factors such as medications that aren’t as effective on African Americans. The majority of medical research involves Caucasian men. Just as doctors realized in recent years that women’s heart disease was under-diagnosed because their symptoms differ from men’s, similar discoveries have been made about differences between white and black patients.
Can Things Change?
Although there’s a long way to go, changes have already begun. Healthy People 2020 is a government program with the goal of creating “social and physical environments that promote good health for all.” The government has also partnered with various groups to address specific African American health concerns, such as Million Hearts.
It’s also vital that African Americans – and all patients, really – be proactive about their health. Talk to your doctor about ways to manage your conditions and implement healthy lifestyle changes. Take advantage of preventive screenings, starting with your annual wellness visit.
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