Everyone knows that whites live longer than blacks in the United States. Everyone knows that this outcome is the result of the institutionalized and systematic racism of "White America" against "Black America." As we're about to show you, "everyone" would appear to be wrong.

We stumbled into a unique discovery yesterday as we reviewed the National Center for Health Statistics' United States Life Tables, 2004, which we used to create our tool for estimating the remaining lifespan the average American of any age from 0 through 120 might reasonably expect to see.

The data we used to create our tool was extracted from Table 1 of the NCHS' life tables. We wondered what we might find if we compared some of the report's subset data. Table 4 provided the Life Table for the "white" population of the United States and Table 7 provided the same information for the "black" population of the United States.

Here's the chart we produced directly from the data in the life tables, for which we provided an enlarged inset of the area of the chart that we didn't expect to see based on what we've heard from "everyone":

Looking at the data, we see several things that stand out. First, we see that at younger ages, the "white" population of the United States is more likely to live longer than the "black" population, but what's unexpected is that at older ages, specifically over Age 80, the members of the "black" population who reach this age are much more likely to live longer than their peers in the "white" population (the inset we magnified in the chart).

If remaining life expectancy is truly affected by systematic racial discrimination, how on Earth could the people who have presumably experienced the most of it, the aged "black" population, be much more likely to live longer that their "white" counterparts?

Based on what you've heard from "everyone," would you have ever expected that result? If racism really drives lower life expectancies for minorities, we wouldn't expect a racist health care system to stop mistreating the members of the "black" population just on account of the patient's age....

We also see that the remaining life expectancy curves for the "white" population and "black" population are very smooth from Age 1 upward. There's nothing that leaps out to make people of a given age really stand out compared to people either slightly older or younger than themselves. This result suggests that the higher life expectancy of the older members of the "black" population is not a defect in the data, but rather a natural characteristic of the population.

The exception is between Age 0 and Age 1, where there's a marked difference between life expectancy between ages, which corresponds to the well-established increased mortality rate for infants. While this occurs for both the "white" population and the "black" population, we see the effects of infant mortality are more pronounced for the "black" population.

Now, what if all these things are somehow related? What if there are environmental, hereditary or genetic factors that act to reduce the natural life expectancy of the "black" population of the United States at younger ages, as compared to the "white" population, that in turn, makes those who survive into old age much more likely to live longer that their peers in the "white" population? The data we've presented above hints that might be the case.

So why make a racial issue out of something that perhaps isn't?

Speaking of which, who is this "everyone" that we identified at the beginning of the post who keeps pushing the "blacks don't live as long as whites because of racist disparities" mantra?

Aside from those who derive political or economic benefit by inflaming racist ideologies, would you believe those who attended a symposium on the topic sponsored by the Harvard School of Public Health?:

Whites live longer and healthier lives in the United States than minorities. In fact, while the health and lifespans of white Americans have been steadily improving, racial disparities in disease and death are larger now than they were in 1950, said a report last year from the Institute of Medicine.

More interesting, the attendees of the Harvard-wide symposium were somewhat distressed that most people didn't see the world the way that they do:

Racial and ethnic health disparities are real, if poorly defined and inadequately researched, but most people–even most doctors and people in minority groups–don’t believe the inequities exist, said speakers at a recent Harvard symposium on US racial and ethnic disparities research. That’s a problem, because history suggests that substantial change in health policymaking results from pressures of public opinion.

"The general public does not believe in many cases that health disparities exist," said Kalahn Taylor-Clark, W.K. Kellogg Fellow in Health Policy Research, in a joint presentation with Robert Blendon, a professor in the Department of Health Policy and Management. In most communities, minorities are not aware that health disparities exist. Based on lack of knowledge and concern, there is not yet a national commitment to address the issue, said Clark, who helped organize the symposium.

Perhaps most people, "even most doctors and people in minority groups," don't see inequities affecting life expectancy because what they do see is fully consistent with they would expect given what they know of their genetic and hereditary backgrounds. Of course, at least one of those motivated to attend the Harvard symposium sees such people differently:

"You have to be in some sort of delusional state to think it’s not a problem," said Thomas LaVeist, director of the Center for Health Disparities Solutions at Johns Hopkins University.

The solution? Here are two excerpts from the Harvard School of Public Health article:

... Even so, Blendon said, "Science plays a big role in long-term policy in the United States. It’s important that health disparities research be established as a field of study at schools across Harvard University."

Naming the problem, thinking clearly about how racism harms health, and methodically testing the ideas are critical to advancing research, said Nancy Krieger, an associate professor in the Department of Health and Social Behavior.

Notice how the proposed responses to the problem perceived by those attending the Harvard-wide symposium somehow involve courses of action that would directly benefit the people proposing them? Maybe we shouldn't have put "those who derive political or economic benefit by inflaming racist ideologies" aside so quickly!...

Racial Disparities in U.S. Life Expectancies

Although we didn't know it when we originally wrote this post, it turned into the launching point for a series of posts looking into the reasons for the racial disparity in life expectancies in the United States. The posts below will take you to the other posts of the series and what we found:

Blacks Living Longer Than Whites

The post that started the whole thing! We were surprised to find that blacks over the age of 80 had longer remaining life expectancies than whites of the same ages in the U.S. We also used the opportunity to ridicule some pretty blatant rent-seeking behavior on the part of researchers seeking funding for their work.

Erasing the Gap in Racial Life Expectancies

We revisited the life expectancy figures between blacks and whites and took a closer look at the underlying data, which allowed us to reject racism as an explanation for what we observed. We also began asking "why this, but not this?" in comparing not just the survivorship of the black and white populations of the United States, but urban vs rural blacks, immigrant vs native-born blacks, and the effect of older vs younger mothers for African American infant mortality.

The Disproportionate Killers

You can't address racial disparities in life expectancies unless you know what chronic health conditions disproportionately affect the black population of the United States compared to other racial or ethic groups.

African Blessings, African Curses

Chronic diseases often have a very strong genetic or heredity component in determining who is vulnerable to them. In this post, we explored the idea that what doesn't kill you either softens you up for what will or makes you more vulnerable to other health hazards in comparing the black population of the United States to sub-Saharan Africans who share much the same genetic anthropology, while also discovering very recent research whose results potentially explain why all peoples of African descent are more vulnerable to the things that disproportionately kill African Americans.

A Seemingly Simple Solution

Does a chronic vitamin deficiency explain why the disparities between black and white life expectancies in the U.S.? We explore this possibility and why it may not as easy to address as you might think on first glance, as well as how individual African Americans might do so successfully.

Labels: health, health care

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