Date: Oct. 2, 1997
Contacts: Dan Quinn, Media Relations Officer
Dumi Ndlovu, Media Relations Assistant
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[EMBARGOED: NOT FOR PUBLIC RELEASE BEFORE 5 P.M. EDT THURSDAY, OCT. 2]
Health Differences Among Racial and Ethnic Groups
Persist; Multiple Causes May Be to Blame
Although white Americans still live longer than blacks, the gap in death rates has declined over the past 30 years. There is some evidence -- though controversial -- that blacks actually have a lower death rate in their 80s and 90s than whites. And older Americans who identify themselves as Hispanics, Asians, or Pacific Islanders have a lower death rate than either whites or blacks. Black men have a 20 percent greater incidence of prostate cancer than whites, and white women have a 30 percent greater incidence of breast cancer than blacks. Beyond simply documenting these differences, the challenge facing researchers is to pinpoint the extent to which the differences can be explained by genetics, socioeconomic status, health-promoting behaviors, access to health care, and other factors.
A new collection of papers from a workshop hosted by the National Research Council examines the differing rates of mortality, disability, dementia, cardiovascular disease, and use of medical care among various ethnic and racial groups. The papers say that although researchers have begun to piece together some of the explanations for these differences, research is limited by gaps in nationally representative data, by not having a full range of measures to compare life histories, and by ethical and legal obstacles to linking survey data with genetic information.
Among the papers' conclusions:
> At younger ages, the death rate for blacks exceeds that for whites by as much as 2-to-1, but the differences gradually narrow and may actually switch as both groups get older. A lack of reliable information on older people leads some researchers to question whether death rates actually reverse, or whether the death rate for whites remains lower throughout the life span.
> Historically, blacks in America have had less access to health care than whites. Blacks now spend as much as whites per capita on medical care, as measured in physician visits and inpatient hospital stays. However, surveys show that blacks are more likely to experience illness than whites, so they should actually be spending more, a fact that suggests that there still may not be equal access to care.
> Differences in rates of dementia, including Alzheimer's disease, appear to be related to education, as there is a lower level of dementia among those with higher education levels. There is no real difference in rates of dementia among racial and ethnic groups when researchers account for education levels.
> Studies have shown a twofold to threefold difference in the incidence of coronary heart disease between Japanese men living in the United States and Japanese men living in Japan. The higher rates in America can be explained largely by an increase in the major risk factors for heart disease, including higher cholesterol, glucose, and blood pressure levels, and greater consumption of alcohol and tobacco.
The papers underscore that race and ethnicity are not biological definitions, but fluid categories whose meanings vary according to the social and historical context. Much of how people are identified results from the way they respond to multiple-choice question in censuses and surveys and from classifications made for official government statistics. As understanding of the differences in health among various groups grows, researchers will need to develop ways of analyzing and testing how these differences emerge, and how intermarriage, socioeconomic integration, and other cultural changes affect them.
The project was funded by the National Institute on Aging. Copies of Racial and Ethnic Differences in the Health of Older Americans are available from the National Academy Press for $42.00 (prepaid) plus shipping charges of $4.00 for the first copy and $.50 for each additional copy; tel. (202) 334-3313 or 1-800-624-6242. Reporters may obtain copies from the Office of News and Public Information (contacts listed above).