Closing the Black-White Life Expectancy Gap

In the United States, great expectations within the healthcare sector are not endowed to everyone. Working-class citizens across the board bemoan insufficient access to healthcare. Still, the brunt of its effects is absorbed by Black and Brown people who continue to fall behind the average life expectancy of white populations—a chasm that has widened considerably in the wake of COVID-19. Though recent years saw a shrink in the gap between Black and white lifespans in the U.S., the pandemic brought the difference to its widest breadth since 1998 (NY Mag). 

In 2020, the average life expectancy for white Americans decreased by 0.8 years, but Latine and Black life expectancy dipped more notably, losing 1.9 years and 2.7 years, respectively. The gap is not new. According to a study conducted in 2009, Black men and women’s average life expectancy was 75, mirroring that of white populations back in 1979 (Business Insider). More specifically, in 2009, white men lived four years longer than their Black male counterparts. The disparity was larger when factoring in education, with white men living 14 and white women living 10 years longer than Black men and women with less formal education. 

TAKE ACTION

• Explore the Kaiser Family Foundation to advocate for health reform; push for medicaid expansion and learn about the causes of the life expectancy gap and what is needed to reverse it in your state through the Health Resources & Services Administration and the Office of Minority Health at the Centers for Medicare and Medicaid Services.

• Use resources from the Equal Justice Initiative website to dissect America’s racist roots and learn how to be engaged in the current fight for equal rights.

• Support the People’s Institute for Survival and Beyond with a charitable contribution, and attend one of their community workshops—whether in person or virtually. The Institute seeks to organize diverse networks of people in order to understand and undo racism on a personal and global level.

• Watch The Essentials documentary that addresses health equity and immigrant health at the Center for Health Progress website.

The gap in life expectancy is neither a mere coincidence nor a product of genetics or biological fitness. This lag in Black survival is largely a product of an inequitable U.S. healthcare system. Health issues like heart disease, cancer, diabetes, and perinatal conditions accounted for 60% of the black population disparity in life expectancy in 2010, despite being either preventable or treatable with access to healthcare (CDC). 

During the 1980s, a swell in the gap between Black and white life expectancy was marked by the devastating impact of the HIV/AIDS epidemic on Black and other communities of color (CDC). The latest national health crisis—the COVID-19 pandemic—has similarly disproportionately ravaged these communities.

One in 275 Black Americans has died from COVID-19 as of December 2022, the third highest COVID mortality rate, behind Indigenous people (the highest) and Pacific Islanders (APM Research Lab). However, Black and Indigenous people have the lowest vaccination rate (CDC, APM). Though multiple factors may contribute to this rate, this shows how access to medical care is not dictated by actual need; instead, it is a matter of privilege, leaving Black and Brown Americans to scramble for resources that should be readily available. 

Differences in life expectancy between racial groups have gradually grown less severe; however, the economic inequality that has plagued communities of color since this nation’s origins ultimately leads to health inequality, perpetuating the gap (NY Mag). Black and Brown communities are too often barred from receiving quality care because of financial setbacks, discriminatory legislation, and practices that keep conveniently-located hospitals and healthcare facilities out of Black and Hispanic neighborhoods(TCF). Adequate healthcare requires ample funding, and Medicaid patients, who already “experience increased barriers to care,” are rarely prioritized over wealthy ones (Inquiry). The United States continually shirks the possibility of socialized healthcare in favor of maintaining privatized, for-profit institutions, making it exceedingly difficult for low-income patients to receive proper care. 

Sickle cell disease sheds light on the deeply entrenched prejudice that plagues the U.S. healthcare system. The disease predominantly affects Black individuals, occurring in 1 in 365 Black births (CDC). The disease is inherited, causes a lower life expectancy, and requires intensive, regular care to be treated properly. In this way, it is similar to cystic fibrosis, a disease that occurs most commonly among white Americans, one in 2,500 white births (Medline). However, cystic fibrosis receives significantly more funding, national attention, and specialty clinics, with new treatments being approved regularly over the past decade (JAMA Network, KHN). Adults with sickle cell disease often rely more on ER care since fewer specialized physicians are available or affordable or don’t accept Medicaid (KHN). They also report their pain is not taken seriously and are waiting 50% longer for care. 

Quality healthcare is a luxury reserved for those with money and access, meaning communities of color seeking decent healthcare will be consigned to the bottom of the waitlist. Legislation like the Affordable Care Act has made a noteworthy stride towards equality by extending coverage to over 20 million Americans, 2.8 million of whom are Black (AJPH). While this shows a step toward improved medical access regardless of race or class, it is only one minor victory. Major changes are required for society to represent and protect us all. If left unchanged, the U.S. system will continue to steal Black and Brown lives in staggering numbers. Privilege should not determine one’s right to survival, but in America, it certainly seems to be the case. 

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KEY TAKEAWAYS

• The life expectancy gap between BIPOC and white Americans is a result of the social and economic policies that have oppressed non-white citizens for centuries. This gap, contrary to popular belief, cannot be shrunk by the determination of working class individuals alone. 

• In order to wage a social contract that protects people of every race and economic standing, the existing institutions that govern American society should be deconstructed and purged of their racist tactics. 

• A healthcare system that benefits all people equally will not be implemented without major political action.

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*This piece was originally published on 3/12/2021. It was updated and edited by The ARD on 1/24/23.