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Whites still outlive blacks, study finds

Health issues and homicide are among the reasons for a persistent disparity in groups' life expectancies, but some findings are puzzling.

August 30, 2007|Mary Engel | Times Staff Writer

White men in California can expect to live an average of seven more years than black men, according to a new study that echoes national surveys of the long-documented black-white gap. Heart disease and homicides account for much of the difference in life expectancies.

White women in California live on average about five years longer than African American women, in large part because of higher rates of diabetes and stroke in the latter group.

"What was surprising to me was how persistent this black-white gap has been over time," said Helen Lee, a research fellow at the Public Policy Institute of California and the study's lead author.

"The fact that it has persisted to this day is concerning and begs the question of why."

"Death in the Golden State," released by the San Francisco-based institute last night, sought to answer that question -- and potentially bridge the gaps -- by identifying causes of death among different racial and ethnic groups.

Some of the findings raised as many questions as they answered.

Across all racial and ethnic groups, Californians with more than a high school education have longer life spans than those with a high school education or less. Higher education typically correlates with higher socioeconomic status -- and better living conditions. Black-white disparities persisted, however, among those with similar levels of education.

The study found that Asians and Latinos in California had higher life expectancies than whites and blacks.

In addition, Latinos had significantly longer life expec- tancies than African Americans. Yet poverty rates for Latinos are similar to those for blacks, and Latinos are less likely to have health insurance. The differences are puzzling but may not last.

Mortality rates for Latinos and Asians may be underestimated because those groups are less likely than whites and blacks to report ethnicity on death certificates, the study noted.

The data for the study were drawn from California death certificates from 2000 through 2002.

Immigration probably also contributed to the longer life expectancies for both Latinos and Asians, Lee said.

People who immigrate here from nearby countries -- such as Mexico -- often go home to die, she said.

And immigrants overall tend to be healthier than subsequent generations that adopt such American habits as eating too much junk food and watching too much television.

If recent immigrants were excluded from the study, "You wouldn't see as much of an advantage," said Bob Prentice, director of the Bay Area Regional Health Inequities Initiative.

"If they continue to live in poor neighborhoods and experience the legacy of racism, though in a different way than African Americans, then in fact their health may get poorer."

Many healthcare advocates and researchers attribute the persistent differences between African Americans and whites to "a pretty complicated souffle of poverty and racism and education and health issues," said Dr. Robert Ross, president of the California Endowment, a private foundation devoted to healthcare solutions for the poor.

"The lion's share of what explains health status and life expectancy has to do with non-healthcare factors. That's when you get into the quality of the environment, poverty, racism and some messier factors."

The study found that the average life expectancy for white men in California was 75.5 years, compared with 68.6 for black men.

Nationally, the black-white life expectancy gap has been documented since at least 1900, when whites lived to be, on average, 47.3 years and blacks 33 years. (A study released earlier this year determined that the black-white life expectancy gap had narrowed from a 7.1-year gap in 1993 to a 5.3-year gap in 2003.)

In 1900, the leading causes of death were flu, pneumonia, diphtheria and tuberculosis -- diseases that have drastically declined because of immunizations, medications, better nutrition and improved sanitation.

More than 100 years later, heart disease and cancer were the leading causes of death among all California adults ages 25 and older, and stroke was No. 3, except in Latino men, who more often died in accidents.

Accidents were the fourth-leading cause of death for African American men, and homicide was sixth. For Latinos, homicide was the seventh-leading cause of death; in whites, it was 20th.

Homicide, accidents and HIV -- the eighth-leading cause of death for black men -- tend to kill at younger ages. For black men who survive to 25, the life expectancy gap with white men shrinks from 6.9 to 5.6 years.

"When you look at it in terms of mortality, you're underestimating the magnitude of the disparity," said Dr. Toni Yancy of the UCLA School of Public Health Center to Eliminate Health Disparities.

"HIV and violence kill relatively young people. Rather than just comparing death rates, compare the years of potential life lost."

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mary.engel@latimes.com

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