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Life expectancy for people who live in Black-majority neighborhoods declined by at least four years in 2020—largely due to COVID-19, a recent study by the Brookings Institution says.
The report also indicates for that neighborhoods with at least a 10 percent Black population, life expectancy declined by 4.1 years, neighborhoods of less than 1 percent Black population have a higher life expectancy by about one year, with the national average of 78.7 years.
COVID-19 reportedly has killed Black people at double the rate of whites, but health inequities didn’t begin when the coronavirus spread across the United States. Experts say it only illuminated the stark racial health disparities that already existed for African Americans.
Those determinants include factors such as food insecurity, transportation issues, living conditions, cultural beliefs and habits due to race and ethnicity that influence patients’ lives long before they enter the health care system.
Lead study author Andre M. Perry said experts continually cite that Black people are dying at higher rates from COVID due to “preexisting” health conditions, but that analysis side steps “the preexisting conditions of structural racism” that force people into social situations that also reduce the quality of life and longevity.
“We know that wealth and income predict life expectancy, as well,” Perry, a senior fellow at Brookings Institution in Washington, D.C.
When compared to their white counterparts, African Americans generally are at higher risk for conditions such as heart disease, kidney disease, stroke, cancer, influenza and HIV/AIDS, according to the Office of Minority Health, a division of the U.S. Department of Health and Human Services.
The Centers for Disease Control and Prevention reports that while African Americans are more likely to die early for all causes, one contributing factor is more young African Americans are living with diseases that typically are more common in older ages for other races.
For example:
- High blood pressure is common in 12 percent of Blacks compared to 10 percent of whites ages 18-34 years, and more common in 33 percent of Blacks compared to 22 percent of whites ages 35-49 years.
- Diabetes is common in 10 percent of Blacks ages 35-49 compared to 6 percent of whites.
- Stroke is present in 0.7 percent of Blacks ages 18-34 compared to 0.4 percent of whites the same age. But it is common in 2 percent of African Americans compared to 1 percent of whites ages 35-49 and 7 percent vs. 4 percent, respectively, in those aged 50-64.
Perry said that space and place also may contribute to the Black death toll due to COVID-19 because Blacks tend to live closer together and have higher numbers of intergenerational households.
“Over the course of two years Black people are being blamed for their own demise and not the underlying social political and economic conditions that influence outcomes,” said Perry, who is Black.
“My research lays blame on policy, not people. In this case, it’s about segregationist federal, state and local policies that highly influenced where we have lived for generations. It’s also about the labor market and the inability to create affordable housing and jobs with fair wages that offer health insurance.”
Dr. Herbert C. Smitherman Jr. said that while disparities in COVID-19 infections and death among African Americans is related to the higher burden of chronic disease, he doesn’t believe it has anything to do with Black people living closer together in high concentrations or in intergenerational households.
And, at best, he said, the phrase, “life expectancy” is misguided and is inconsistent with the literature or any kind of scientific research.
Smitherman, vice dean of diversity and community affairs and a professor of medicine at Wayne State University School of Medicine/Detroit Medical Center, also believes only white health experts and researchers are grappling with the reasons why COVID-19 is so deeply impacting Black people.
The Brookings report says disproportionate health disparities help to explain why, when adjusting for age, Black people account for about 22 percent of the nation’s Covid-19 deaths despite only comprising 12.8 percent of the population.
Black and Brown researchers and health experts know the reasons include the more than 400 years of negative American social, economic, political and health policies resulting from slavery, Jim Crow, lynching and segregation, Smitherman said.
Additionally, driving factors include segregation, mass incarceration tied to an inequitable justice system that destroys Black families, redlining, unfair housing policies and employment practices, discriminatory education policies and disparate health policies.
“COVID-19 has simply exposed how a long history of racial discrimination and institutional race-based policies has uniquely tied African Americans to the bottom of the U.S. economic and class hierarchy,” Smitherman said.
Despite this, he believes the vaccine is critical to ending the pandemic and adds that white health experts blame Black people for vaccine hesitancy and low vaccine rates, but don’t address the healthcare systems and practices that historically caused the mistrust.
He points to examples such as the infamous Tuskegee Experiment, where the CDC conducted a 40-year syphilis study on 400 African Americans with syphilis and left them untreated. Henrietta Lacks, a Black woman, whose cervical cancer cells were used for research at Johns Hopkins Hospital in Baltimore without her permission, is another case.
So, when Smitherman’s patients tell him they don’t plan to take the vaccine, he doesn’t treat them as if they are less than intelligent or misguided. Instead, he discusses their feelings with them and shares that he and his family are vaccinated.
“Black people are responding to years of abuse,” he said. “It has reinforced distrust in Black and Brown communities. Since there’s been nothing done to address it, we are addressing it in our private offices.”
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