Closing the Health Gap for Black Patients

No one should give up four years. But that’s the gap between the average life expectancy for non-Hispanic/Black Americans compared to White Americans, according to the Centers for Disease Control.³ 

As an African American physician, the disparities in health and health care for people of color hits close to home. It’s a complex issue I see in my practice as a family physician who also provides obstetrics/birth and women’s health care.  

For example, Black, American Indian and Alaska Native (AI/AN) women are two to three times more likely to die from pregnancy-related causes than white women, according to a report from the CDC.¹ 

Contributing Factors for Racial Disparities

Several factors contribute to this risk, including high blood pressure, obesity, cardiomyopathy, and pulmonary embolism. They were found to be associated with a higher share of pregnancy-related deaths among Black women compared to White women from 2007 to 2016.  

What makes this particularly heartbreaking is that most pregnancy deaths are preventable. It’s important as providers raise awareness about these disparities while widening access to quality care for preconception, pregnancy and postpartum care. There is some good news mixed in with this challenging issue. For example, the death rate primarily for those African Americans age 65 and older has declined 25% over 17 years, which means they are living longer.² 

But younger African Americans -- those in their 20, 30s and 40s -- are being diagnosed with and dying of conditions typically found in older White Americans, according to the CDC.² Compared to White Americans, non-Hispanic Black Americans are: 

• 2 times as likely to die from heart disease for those ages 18-49.
• 50% more likely to have high blood pressure for those ages 35-64 years.
• 2 to 3 times more likely to suffer these diabetes complications.
• Far more likely to die from breast cancer.
• 55% of women over 20 years of age struggle with obesity.
• 1.5 times more likely to develop prostate cancer and 2 to 3 times more likely to die from it.

How Preventive Care Reduces Disparities

Preventive care can go a long way to turning these disparities around. We know that, compared with White Americans, members of racial and ethnic minorities are less likely to receive preventive health services. They also have worse health outcomes for some conditions. 

That’s why I regularly talk to my patients about the importance of preventive care, regardless of whether they are Hispanic, Black, Asian or White. It’s still the best way to  prevent or manage serious illnesses such as diabetes, heart disease and cancers. 

• Diabetes - the American Diabetes Association recommends that testing begin at age 45 for all people.
• Cervical and colorectal cancer screening- the American Cancer Society recommends cervical cancer screenings begin at age 25 and colorectal cancer screenings begin at age 50.
• Heart disease -- According to the American Heart Association, screening tests for coronary artery disease should begin at age 20, and blood glucose screening should begin at age 45.
• Breast cancer - Women ages 40 to 44 should have the choice to start annual breast cancer screening with mammograms (x-rays of the breast) if they wish to do so. Women age 45 to 54 should get mammograms every year. Women 55 and older should switch to mammograms every 2 years, or can continue yearly screening.
• Prostate cancer - Start talking to your physician about screening at age 50 for men with average risk, 45 for high risk and 40 for even higher risk.

Seeing your provider regularly and talking about the timing of preventive screenings, particularly if you are a person of color, is a key step in protecting your health for years to come.

¹ https://www.cdc.gov/mmwr/volumes/68/wr/mm6835a3.htm

² https://www.cdc.gov/vitalsigns/aahealth/index.html

³ https://www.cdc.gov/healthequity/racism-disparities/index.html