The University Record, March 13, 2000

Black-white health gap is as large as it was in 1950, new U-M study says

By Diane Swanbrow
News and Information Services

The gap in death rates between Blacks and whites was as large five years ago as it was 50 years ago, according to a U-M study published in the current issue of the Annals of the New York Academy of Sciences.

“In 1950, the death rate for Blacks was 1.6 times higher than the rate for whites—identical to what it was in 1995,” says study author David R. Williams, a sociologist at the Institute for Social Research.

For the study, Williams compares the 1995 rates for the leading causes of death among Blacks and whites to 1950 rates, using data from the National Center for Health Statistics.

Although the overall death rates have declined for both Blacks and whites, he finds, the racial gap is wider today than in 1950 for several leading causes of death, including heart disease, cancer, diabetes and cirrhosis of the liver. The gap is smaller for the flu and pneumonia, and for homicide, and remains unchanged for stroke and unintentional injuries.

“The stability of racial differences in health is striking,” says Williams, a senior research scientist. “This is not an act of God. Neither does it simply reflect racial differences in individual behavior or biology. Instead, considerable evidence suggests that these striking racial differences in health and their persistence over time reflect, in large part, policies and practices that are linked to the historic legacy of racism, and that have created adverse living conditions that are pathogenic for minority populations.”

Racial differences in economic status play a large part in Black-white health differences, Williams explains. “For both Blacks and whites, men and women with higher household incomes have better health than those with lower incomes,” he says. “Moreover, the differences in health between high income and low income persons of each race are often larger than the overall differences between Blacks and whites.”

At the same time, at every level of income, he notes, Blacks tend to have higher death rates than whites. This could reflect the added effect of racism and discrimination, he maintains.

“Racism can affect health indirectly through institutional policies that reduce employment and educational opportunities for minorities,” Williams says. In addition, racism also can affect health directly in multiple ways. Residence in poor neighborhoods, racial bias in medical care and the stress of experiencing discrimination can all have negative effects on health.”

For the study, Williams also compares the current national mortality rates for whites to those of all other minority populations. He finds that Blacks have higher death rates than whites for eight of the 10 leading causes of death—heart disease, cancer, stroke, unintentional injuries, flu and pneumonia, diabetes, HIV/AIDS, and cirrhosis of the liver. Hispanics and American Indians have lower death rates than whites for the three leading causes of death in the United States (heart disease, cancer and stroke) but higher death rates for other leading causes such as diabetes and cirrhosis of the liver. Asian Americans have lower death rates than whites for all 10 of the leading causes of death in the United States.

“The relatively good health profile of Hispanics and especially Asians reflects in part the effects of immigration,” says Williams. “Seventy percent of Asians are foreign-born, and immigrants of all racial groups tend to have better health than their native-born counterparts. Unfortunately, the health of immigrants also declines as length of stay in the United States increases.”