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Another Voice: What is killing African-Americans?

By Larry Zielinski

Rod Watson’s article in the March 31st edition of The Buffalo News highlighted the many areas where the African-American community is still striving to “overcome,” as we remember the 50th anniversary of the death of Martin Luther King Jr.  One of the most crucial is in health care, where the disparities between white and black America are striking and alarming.

According to the CDC, a black boy born today can expect to live 5 years less than a white baby boy. A 2012 Health Affairs study overlaid educational differences to race and came up with this startling conclusion:  white men who have completed college can expect to live 14 years longer than black men who have not completed high school. The gap is 10 years among white and black women. The authors concluded that we have “two Americas.”

The Kaiser Family Foundation has measured 29 different health status and outcome measures by race. African-Americans have worse results in 24 of those metrics.  African-Americans have higher incidences of disease and death rates than whites in nearly all of the leading causes of death in America:  heart disease, cancer, and diabetes are prime examples.  The obesity rate – a primary precursor to health problems and early mortality – is 38% among African-Americans, compared to 28% among whites.

The health disparities among children is heart-breaking.  African-Americans have higher pre-term birth rates (13% vs. 9% among whites), low birth weights (13% vs. 7%), asthma incidence (17% vs. 10%) and childhood obesity rates (20% vs. 15%).  The infant mortality rate among African-American babies is 11.1/1000 live births, compared with a white America rate of 5.   According to the World Bank, the African-American infant mortality rate compares with countries like Albania, Libya, and Thailand.

What is killing African-Americans?  Access to health insurance and preventative health care are obviously crucial elements, but equally – or more – important are the social determinants of health.  The economic stability of neighborhoods, the level of poverty and unemployment, education levels and quality, family and social cohesion, access to healthy foods, safe and affordable housing, levels of crime and violence, and environmental quality – all of these factors substantially impact the health of a population.  All of the “value-based” models of care that are becoming so prevalent understand that dealing with the social determinants are critical success factors.

If you are interested in learning more about this crisis in Buffalo, what we can learn from other communities, and what we can do about it, please think about attending a conference entitled “Igniting Hope – Building a Just Community with a Culture of Health and Equity.”  It will be held on April 28th at the Jacobs School of Medicine and Biomedical Sciences.  Register for free at

Larry Zielinski is Executive in Residence, Health Care Administration at the University at Buffalo School of Management.

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