With advances in practically everything from medicine, personal well-being and leaps and bounds in transportation safety, it would be believed that Americans are living longer. That assumption was refuted not long ago by a report issued by the National Center for Health Statistics (NCHS) that indicated that American life expectancy is in decline for the first time in more than two decades.
Researchers can’t point to a single qualifier as to why we’re not living longer. Instead, it may be due to a number of factors—from heart disease to suicides—that have contributed to the drop. The scientists see the drop as particularly alarming, when during much of the past century, life expectancy has generally risen for all sectors of American society, even when HIV-related deaths were at their peak in the early 1990s.
Heart disease America’s top killer
For the researchers, the numbers may reflect a combination of problems: Eight of the top 10 causes of death demonstrated an increase in death rates such as those from heart disease (the nation’s number-one killer), diabetes and kidney disease, and, rising precipitously in the past 20 years, death from Alzheimer’s which has spiked 15.7 percent. Unintentional injuries are said to have increased by 6.7 percent, and suicide has risen by 2.3 percent. Even the infant mortality rate—once a major cause of early death but now held in check by better pre- and post-natal practices—has risen slightly.
Scientists contend that the popular theories for the cause of the decline in life span (e.g. increase in obesity rates, the opioid epidemic) fail to explain a problem that, to them, feels even broader. Today, the average White male American can expect to live for 78.8 years, representing a decrease of 0.1 from 2014. In more morbid terms, the overall death rate increased 1.2 percent, representing about 86,212 more deaths than those recorded two years ago.
“This is a uniquely American phenomenon,” said Peter Muenning, Ph.D., with Columbia University’s Mailman School of Public Health. “A 0.1 decrease is huge. Life expectancy [traditionally] increases in the developed world and that’s very consistent and predictable. To see it decrease is very alarming.”
Blacks die about five years earlier
The study may serve as further confirmation of a decline in health in different racial populations. The NCHS research revealed that death among non-Latino Black males rose 0.9 percent, and 1 percent among non-Latino White males. Rates for non-Hispanic White females rose 1.6 percent, while the mortality of non-Latino Black females, and Latino males and females have held steady from 2014-2015.
Muenning explained that the drop in life expectancy is not occurring among Black males, a group that once had a significant death disparity with Whites males. The gap, according to Muenning, is narrowing with life expectancy between Black and White people now closing to 3.4 years (statistics from a Centers for Disease Control and Prevention (CDC) report this figure is down from 3.8 years in 2010, and far down from 7.6 years in 1970).
However, the CDC reported that during the same period of the NCHS study, Black Americans still die almost four years earlier than White Americans. Although these disparities were much more pronounced in the past, the CDC report cited cancer, diabetes, heart disease, murder and stroke among Black males as some of the reasons why Black men live shorter lives than any other group in the United States.
Experts agree that the news represents a “mixed bag” of findings. Black males are, indeed, closing the gap with White males in longevity, but a lack of education regarding how to live a more healthy life still eludes the Black male population.
Education, wealth have no bearing
“It’s not surprising that heart disease, cancer and homicide account for the majority of the difference, since the first two at least account for the majority of all deaths in the U.S.,” said Stuart Olshansky with the School of Public Health at the University of Illinois-Chicago. “We still don’t know why death rates from these causes are always higher among Blacks.” Olshansky’s team released a study in 2013 which examined these differences by level of education. They found that disparities between the least educated Blacks and the most highly educated Whites show a mortality rate between the groups even larger than the disparities their study had revealed. He also said that neither education nor access to healthcare are determining factor(s) in the mortality gap between Black and White males.
“Even among the most educated subgroups of the population (i.e. African Americans with college degrees), disparities exactly like those we discovered are persistent,” Olshansky noted.
The CDC reported in 2013 that the average life expectancy for Black men was 71 years, compared to 76 for White men. The researchers, then as now, are not sure why this happens, but a number of theories questioning everything from diet to sleep habits have been posited by scientists for many years. Sometimes regional differences can play a role. For instance, the CDC found that Black life expectancy in the nation’s capitol was “dramatically more unequal than every other state” when in 1990 it was a 14.4-year difference for Black men/White males, and 10.4 years for Black women/White women of comparable ages.
So, what is killing Black persons? The CDC investigated the most persistent causes, and determined that “… higher death rates due to heart disease, cancer, homicide, diabetes and prenatal conditions” accounted for at least 60 percent of the gap nationally. The disparity would be “even wider,” their report stated, if not for the lower death rates among Black people for “suicide, unintentional injuries, and chronic lower respiratory diseases such as asthma/bronchitis.”
Statistically, the general age that White men died in 1970 (71.5 years) is where Black men are today. Death rates today for Black men were found to be higher than for those in the White male population for eight of the 15 leading causes of death. African American males are likelier to die from heart disease, for example, and White men are more than twice as likely to die from suicide. The CDC qualified this finding by noting that heart disease remains the number-one killer of all American citizens, with suicide listed as the 10th leading cause of death.
The frequent news of Black-on-Black crime in America’s inner-cities may lead many observers to point to homicide as the main cause of death for Black males 15 to 35 years.
Juan Williams, a commentator with Fox News, believes civil rights activists and Black leaders have failed to address this issue which is contributing to the latest social meme of “missing Black men.”
“The national conversation about racial justice and police use of force has ignored [this] critical point,” Williams said. “I think there’s fear of intimidation, harassment being legitimized by the fact that there is a high crime rate, especially among young Black men. The number-one cause of death for young Black men is murder. Who’s committing the murder? Not police. [It’s] other Black men.”
‘Laws of aging’ play significant role
Williams’ statement aligns with findings from the CDC which in 2013 revealed that homicide was, in fact, the primary killer of young Black males (15 to 34 years), followed by accidents (25 to 34 years), suicide (15 to 24 years) and heart disease (24 to 34 years). The CDC study further revealed that in 2012, the focus year for the study, 40 percent of Black males 15-34 years were murdered, compared to 3.8 percent of age-comparable White males who died that year.
Black-on-Black homicide and its contribution to mortality among African American males should be placed into the context of the “laws of aging,” said James Fox, a professor of criminology at Northeastern University in Boston, Mass. Because younger men are less prone to fall victim to natural causes of death, he explained, they are more likely to die of unnatural causes. Even common incidents of traffic accidents can often shift the racial disparity within causes of death. He offered an example:
“Suburban Whites drive more than urban Blacks and are putting in more miles on highways—that’s important because not a lot of people are going to get killed in fender benders in neighborhood streets,” Fox said. “Compared with [White] suburbia and how much time the average commuter spends on the road, there are relatively few auto accidents in Black urban areas.”
Racism eating away years?
Beyond driving habits, Fox noted, the criminal homicide rate among young Black males is significantly higher than others. This, experts agreed, has to do with poverty and geography. Most experts within the debate, like Fox, contend that the difference in social structures, access to jobs, educational opportunities and many other factors between impoverished Black neighborhoods and others is often a matter of life and death. “People have heightened survival instincts, will do anything to survive, and they’ll seek retribution for anything … because, they don’t trust law enforcement,” said Eli Silverman, professor emeritus at John Jay College of Criminal Justice in New York City.
The social pathology of Black-on-Black homicide, however, may not prove to be the most definitive mode of death for Blacks. Vickie M. Mays, Ph.D., a clinical psychologist and professor of health policy and management at UCLA, points to institutional racism and its contribution to high morbidity and mortality in African Americans. She said that not enough attention is paid to the lethal consequences of historic discrimination Black men face every day. Therefore, her department conducted a study last year of Black men aged 40 to 65 years who said they had experienced racism in its worst form but remain in good physical and mental health, despite common diagnoses of hypertension among many of the participants.
UCLA study provides evidence
“Race-based discrimination is an every day occurrence for many African American men, such as being watched while in stores, walking along the street and having someone cross the street in fear of them, to being pulled over by the cops,” Mays said. “Ask any African American man and he will tell you it began with a look of fear, disdain, subtle behaviors that sent a clear message that they were untrustworthy, criminal, violent and feared to be ‘up to no good.’”
Mays explained further that in some of the men studied, the cases of hypertension have eventually led to diabetes, heart disease and prostate cancer among the older participants. She added that these and other acquired medical conditions are not the result of coincidence, but have often occurred because of the psychological and emotional impact on the brain and body when consistently faced with experiences of discrimination that “… play a role in the health of these men.”
Two years ago, the American Journal of Preventative Medicine published what could be called a forerunner to the UCLA study. In “Discrimination, Racial Bias and Telomere Length in African American Men,” a group of scientists led by David Chae, Ph.D., an epidemiologist with the University of Maryland, in 2010 gathered 95 Black men between the ages of 30 and 50 years and measured their white blood cell telomere lengths. Telomeres are repetitive sequences of DNA that sit like plastic protective caps at the ends of shoelaces. When while blood cells replicate, DNA sequences at the very ends get chewed away and telomeres are there to serve, as Chae explained, as the “sacrificial lambs” to protect the more crucial DNA from being damaged.
Telomere length is associated with mortality and age-related diseases like dementia, heart disease and Alzheimer’s. Basically, the shorter they are, the higher the risk of contracting one of these diseases, therefore they are seen by scientists like Chae as a good indicator of physiologic age. Chae said his study demonstrated that telomeres are also sensitive to psychological stress, which can speed up their depletion.
How DNA is affected
But what does this have to do with early mortality of Black men? Chae explained that people start out with roughly 8,000 base pairs of telomere which wear down at a rate of 50 to 100 each year. Among African American men who had internalized “strong anti-Black biases” (i.e. persistent racial discrimination), those who experienced high levels of racial discrimination had on average 140 fewer base pairs of telomeres than those who reported low levels of racial discrimination. In short, the combination of high levels of external racial discrimination and internalized anti-Black sentiment was a toxic mix.
“Racism and racial discrimination is an assault on one’s self concept,” Chae said. “And it involves not only physical acts but also the internalization of an ideology that posits that some groups are better or worse than others.” Chae offered that scientists sometimes theorize that when an African American person has internalized strong anti-Black attitudes, the racism they encounter in daily life can feel deserved. The cumulative psychological toll, he said, can impact telomere length and shorten their lives.
Chae’s study further indicated that racism can influence a person’s physical health in many indirect ways, such as the stress from lack of access to health care, poor housing opportunities, lack of a healthy diet, etc. But this stress can also have more direct consequences.
“Think about what happens to your heart rate and blood pressure when someone treats you harshly or unfairly?,” Chae asked. “Cutting you off on the freeway or pushing you out of the way to get to a subway. We have psychological reactions to stress. Now imagine it’s racism we’re talking about—something people can experience on a routine, chronic, every day basis. It wears out our biological systems because they are being continually engaged … and it can lead to this accelerated physiological wear and tear.”