However, when the UCLA-led group of researchers compared life expectancy on a state-by-state basis, they found that states with the smallest differences were often not because African Americans lived longer, but because whites were dying younger than the national average. Furthermore, they discovered that the region with the largest differences was not a state, but the capital of the United States, Washington D.C.
Dr. Nazleen Bharmal, lead researcher of the study and a clinical instructor in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA, said:
"In health-disparities research, there is an assumption that large disparities are bad because vulnerable populations are not doing as well as they should, while areas with small disparities are doing a better job at health equity. In our study, we show that the reason there are small disparities in life expectancy is because white populations are doing as poorly as black populations, and the goal in these states should be to raise health equity for all groups."
The team used data that included both health-related and non-health-related deaths, such as accidents and murder. According to the researchers, the findings from the study still underline the need to enhance the health of the nation's African Americans.
The researchers examined death-certificate data of 17,834,236 individuals in all 50 states and the District of Columbia, from the U.S. Multiple Cause of Death, from 1997 to 2004. The team recorded the sex, race/ethnicity, age at death and the state where each individual was born, lived and died.
They found that the overall national life expectancy was 74.64 years for black women and 79.84 years for white women, and 67.66 years for black men and 74.79 years for white men. The team found that the gaps were smaller between women than men in every state.
The District of Columbia had the largest disparities between blacks and whites (13.77 years for men and 8.55 years for women), while New Mexico had the smallest (3.76 years for men and 2.45 years for women).
The states with the largest disparities between white and black men were Nebraska, Michigan, Illinois, New Jersey, Wisconsin, and Pennsylvania and the nations capital Washington, D.C. The researchers found that in these states the gap was more than 8 years as white men's life spans were either equal or greater than the national average and African American men's lives were shorter than the national average.
The states with the largest disparities between white and black women were Kansas, New Jersey, Minnesota, Iowa, Nebraska, Florida, Illinois, Michigan, Wisconsin, Rhode Island, and the nation's capital Washington, D.C. The team found that in these states the gap was more than 6 years. Black women had either average or lower life expectancy and white women lived longer than average.
New Mexico, Kentucky, Oklahoma, Colorado, New York, Arizona, Washington, Nevada, and West Virginia had the smallest black-white disparities of less than six years among men.
In Nevada, Kentucky, Oklahoma, and West Virginia, the smaller disparities were because white men had shorter lives and African American men living longer than the national average.
However, in New York, New Mexico, Arizona, Washington, and Colorado, African American men and white men liver longer than the national average, with African American men having life spans particularly longer than average.
The researchers found that among women, Alabama, West Virginia, New Mexico, Kentucky and New York had the smallest disparities - less than 4 years. In these states white women lived shorter than average, and black women lived longer than average.
58% of African Americans live in Louisiana, New York, Illinois, Missouri, Texas, Georgia, Maryland, Florida, North Carolina, and California. According to the researchers eliminating the differences in just these 10 states would lower the national difference considerably. For example, eliminating the difference in Florida would lower the national difference from 5.20 years to 4.74 years for women and from 7.13 years to 6.63 years for men.
The researchers explain that as health promotion and disease prevention efforts identify and monitor the extensiveness in differences, findings from this study could lead to new methods that government agencies can use to track and measure disparities in health outcomes. According to the team, these disparities should be taken into consideration when funding health programs at local and national levels. In addition, they explain that as the coverage through health programs, such as Medicaid differs considerably among states, state governments should consider these disparities in black-white longevity in formulating health policy.
Limitations of the study were that the team did not consider the tendency of people to move from place to place, which could influence health; they did not take into account populations during the years covered in their examining. However, they said its unlikely such changes would alter the overall findings; and they were unable to use data from 11 states, although those regions had such small numbers of African Americans that the estimates would not be reliable.
The investigation covered all causes of death, including accidental deaths and murder. The team plan to study differences in life expectancy by case of death.
Other researchers of the study included Chi-Hong Tseng and Mitchell Wong of UCLA and Robert Kaplan of the National Institutes of Health.
Bharmal received support by the Robert Wood Johnson Clinical Scholars Program and a National Research Service Award Fellowship at UCLA.
Written by Grace Rattue