Heart disease is one reason why white people in America live longer than black people

Susan Brink:

Called the black-white life expectancy gap, it has widened, narrowed and widened again during the last 100 years. Now that gap has narrowed to a historically low level, from a 7.1-year gap in 1993 to a 5.3-year gap in 2003, the latest year for which national statistics are available.

In a study in last week's Journal of the American Medical Assn., researchers from Canada, England and the U.S. parsed the numbers from the National Center for Health Statistics to explain the trend — and why a longevity difference remains.

They found some bad news, some good news and considerable challenges ahead in bringing African American life expectancy in line with that of whites. "With a century-long view, it looks like a lot of progress," says Sam Harper, an epidemiologist at McGill University in Montreal and lead author of the study. "But there still remains a pretty substantial gap in 2003. Despite the improvements we've seen in homicide and HIV, the gap in heart disease still remains."

That, he says, is the chief culprit behind the shorter life expectancy for black people.

Although HIV/AIDS, which disproportionately affects black people in America, added to the gap until 1996, life-saving drugs then became available and more people — regardless of race — began living with it as a chronic disease.

The high homicide rate of the 1980s also disproportionately affected young African Americans, contributing to an overall decrease in black life expectancy. The homicide death rate for all Americans has dropped from 10.4 per 100,000 in 1980 to 5.9 per 100,000 in 2004. While young black men, ages 15 to 24, are still victims of homicide in staggeringly high numbers — 77.6 per 100,000 in 2004 — those numbers have fallen from a high of 137 per 100,000 in 1990.

African Americans continue to face some sobering health challenges. Among them, the death rate from heart disease is about 30% higher than whites, according to the Centers for Disease Control and Prevention. The prevalence of diabetes is about 70% higher, and diabetes significantly increases the risk of heart disease.

"African Americans have greater coronary disease, it happens earlier, and the mortality rate is higher," says Dr. Karol Watson, cardiologist and co-director of preventive cardiology at UCLA and spokeswoman for the American Heart Assn. "There are a whole lot of theories about why, but no one knows for sure."

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