Life expectancy is a measure that describes the estimated maximum age that a person or group of people will reach. This predicted age reflects the length of life expected under the assumption that the risk of death remains constant within the respective group. The risk of death is influenced by a wide variety of health factors that unequally affect different ethnicities. For example, certain African Americans and Hispanics are less likely to have health insurance or access to quality care. Without proper healthcare, these underserved groups will have a higher risk of death and, therefore a shorter lifespan. These differences in life expectancy reveal the vast of underlying health inequalities that continue to marginalize certain racial groups.
In the United States, life expectancy has generally increased because of advances in healthcare and technology but these benefits have been unequally distributed. According to the CDC, in 2009 White females had a life expectancy of 81.2 years compared to African American women who had a life expectancy of 77.6 years. In addition to the shortened lifespan experienced by vulnerable populations, the rate at which their life expectancy improves is also usually lower. While recent studies have suggested that the gap may finally be decreasing between African Americans and Whites, researchers have proposed that this is partially explained by an increase death risk of poisoning and drug-overdose by Whites. Comparison of life expectancies between groups requires that we also understand why and how healthcare influences these groups and whether external factors such as income, education or work status are additional barriers. African Americans have commonly reported how past inhumane and racist healthcare treatment has left many avoiding or fearing any medical attention. In certain cases where patients of color do seek healthcare, the price is often too high or the care offered is insufficient and of low quality. The fact remains that communities of color face health disparities tied to social, economic and racial factors outside of the structural discrimination of access and coverage.
Not only does this discrimination affect life expectancy for select groups but the resulting poor health also increases the number of people of color suffering with poverty and disability due to these same health inequalities. Low quality healthcare creates a sub-group population that are more severely and continually sick than the general population. For those belonging to such a group, like most minorities do, means a greater difficulty of maintaining or finding employment and also requires a larger portion of funds to be dedicated to healthcare. The obstacles for minorities to obtain access to high quality healthcare are significant, but of equivalent concern are the numerous social-economic-environmental factors underlying the reason for the gap between White Americans and the rest of society. As we see in the study conducted by Murray et al, not any single factor will fully explain current gaps and therefore will need a collaborative effort in order to successfully reduce disparities.
Health professionals are normally regarded with a degree of admiration and trust. This ancient respect was built on the knowledge that these individuals could cure and heal the body. In the United States, this relationship between patient and health provider is still observed but often at a price. The value of good health has created a market that divides society by those who can afford healthcare and those who do not. For those without money or more importantly insurance, their options are few and their outcomes are most often detrimental. Even for those fortunate to have some sort of insurance, the levels of access and condition of quality are diverse between social and economic groups.
Cultural and educational differences among the provider and patient population can be disregarded and lead to an unspoken divide. The respect traditionally given to providers is either compromised or damagingly placed before the patients concerns and wishes. In both cases, a problem exists in where the patient is at higher risk of treatment failure and is isolated from the quality care they deserve.
Health issues associated with diet have become a main focus for the United States. In the last two decades, the drastic increase of individuals suffering from obesity, diabetes and other food-related issues has created an effort to understand influential social and environmental factors. Although food-related outcomes have increased throughout the country, the rate at which populations are effected can be quite diverse. For Blacks and Hispanics, the proportion suffering with such outcomes is significantly higher than other races even when weight control practices are similar across racial groups. In addition to social factors, a greater focus on the construct of the environment around these higher risk groups is being explored.
A food desert is broadly defined as an area with minimal or no low-cost quality food options. While these areas are generally associated with communities of color and low income individuals, the term food desert is based on the limited food options residents have access to. Urbanization and the rise of supermarkets are believed to be at the source of food desert creation. As cities grow, large and dominant corporations form metropolitan centers, where an abundance of public goods can be found. Just outside of these areas, food markets and quality food retail stores have been forced to close their doors leaving only gas-stations, convenience stores and fast-food restaurants left to thrive. In short, the effect of this type of urbanization is being labeled a cause of food deserts and additionally further creates disparities in the access to other public goods for these same citizens. Apart from the limited food options in food deserts, the condition and quality of available healthy foods such as vegetables and fruits are lower. Select communities are left with a choice between overpriced low-quality “health” foods or the highly marketed cheap and empty calorie meal.
Outside of the city, the increase and severity of rural food deserts is more extreme. The consequence of chain supermarkets and businesses dominating the market is amplified within small towns and rural areas. Food deserts found in rural towns not only lack access to quality food, but the distance becomes a feat of at least 10 miles to the nearest supercenter. Along with losing main food markets, rural communities suffer the loss of growth and employment opportunities and force young families to move to urban areas. This cycle of migration and rural decline has created high food insecurity, when basic food needs are not met due to economic hardship. This insecurity is reflected in the health and health-related outcomes seen across the country.
An interactive map provided by US Dept. of Agriculture highlights food deserts found throughout the United States. Interest and research has made this a hot topic issue that has motivated individuals to take notice. The effects of food deserts have become more evident in the last few years. The once rare type II diabetes is now more commonly diagnosed in adolescents. High sugar diets are the most affordable within food deserts. Biologically, the body becomes intolerant to the accumulation of sugar in the blood and requires lifelong treatment. The cost and increased risk for secondary health issues caused by diabetes is a huge problem for today’s youth. Other diseases on the increase in these areas are obesity, cardiovascular disease and cancer. Consuming low-quality meals for extended periods of time leads families being mal-nourished and unhealthy. These mainly sugar and carb diets also promote higher amounts of consumption that the body stores as fat. With time, the body struggles to function under high cholesterol levels and blood pressures creating stress and disease. In order to prevent more of these food desert consequences, research and development is key to increase access to affordable nutritional foods
African Americans are more heavily affected than the general population by the following health issues: cardiovascular disease, diabetes and stroke. Obesity, a contributing risk factor for these diseases, affects a large portion of African Americans. According to the CDC in 2010, 38.1% of men and 54.2% of females were obese among African Americans. Diet and health behaviors such as smoking and physical activity are generally associated with these diseases, but their effects can become much more significant if accompanied with low education and poverty. For instance the prevalence of stroke for Blacks is 3.9 but this jumps to 6.2 for those struggling with poverty. The complex reasons responsible for the high prevalence of these diseases are not completely understood but what is clear is that it goes beyond genetics. Research has supported the influence social, economic and environmental factors have on health and how their unequal distribution among races to create health disparities. For Native Americans/Alaska Natives, this disparity in comparison to Whites is obvious in the age-adjusted prevalence of diabetes which is 16.5 versus 9.02 which is also highest among any racial groups. Racial differences are independently assumed to be weak predictors of health outcomes but accompanied with racial inequality the factor of race modifies the chance and outcome of most diseases.
Risky behaviors found to be proximal causes of disease, for example alcoholism, are studied within racial classes to better gauge risk of disease. Native Americans/Alaskan Natives are the race most common to be told they have heart disease (14.7%) and could possibly be associated with the 32.7% of this group to be smokers (as compared to Whites (22.5%), Blacks(20.6%), Hispanics(14.4%) and Asians (10.4%). Apart from risk behaviors, childhood health outcomes are different dependent on race and could lead to further disparities in adulthood. Asians are not as common to participate in risky behaviors for heart disease and stroke and yet suffer with these as leading causes. Instead, the contributing factor to these health issues may arise from health problems that occur in childhood. 6.7% of Asians under 18 have food allergies and is higher than any other racial group. The same underlying causes of this childhood health outcome could be associated with adulthood risk of heart disease and stroke. More research is needed to understand the risks throughout the life course but this area of study has become of major interest
African Americans are more heavily affected by health issues relating to cardiovascular disease, diabetes and strokes than the general population. While the factors attributed to the increase risk among this racial group are not completely understood, the association to lifestyle and behavior are often cited. Malnutrition, alcohol use and low physical activity are well-supported causes of these same diseases which tend to support the importance of lifestyle and behaviors on health. What is harder to understand and perhaps address is the structural influences that restrict and place vulnerable communities at higher risk.