Race Can Create Some Big Health Gaps

I've written before about some of the reasons why men have shorter lifespans than women, so I enjoyed listening to a panel on this topic hosted by the University of North Carolina this week. Study after study has shown that numerous illnesses, ranging from cancer to heart disease to autism, strike men in greater numbers, more swiftly, and with greater force than they do women. Indeed, the lifespan gap between the genders, though narrowing, is still about 5.2 years.

The panel looked beyond the differences between men and women to the particular situation of nonwhite men. While the average life expectancy for men as a group is about 75.2, the average is just 69.8 for black men. That's more than a decade less than the average for white women. The stats for nonwhite Hispanics, Native Americans, and Pacific Islanders are more encouraging: Life expectancy for those groups appears to be higher than whites, although the National Center for Health Statistics does not published official life expectancy estimates for these groups because of the limitations of the existing data.

Clearly, the complex interplay of genetics and culture—captured in medical studies as race—has a strong impact on which diseases men get and how those diseases progress. Take prostate cancer, for example. The incidence rate is 60 percent higher among blacks than whites, and blacks are twice as likely as other racial groups to die of the disease. In my book, that's useful information: If I were a black man, I'd want to be doubly sure to get regular PSA screens to detect the cancer early. However, if I were Asian, a group significantly less vulnerable to prostate cancer, I'd be less concerned about missing the occasional PSA screen.

I'll be the first to point out that using race to anticipate disease is, at best, a limited and imprecise tool. (What do any of the categories mean, for example, for people who are biracial?). And, most certainly, race will eventually fall to the wayside as we advance into an era of personalized medicine in which tests and treatments will be tailored to each person's unique genetic makeup. But we're not quite there yet.

After culling through the statistics on race and health put out by the Department of Health and Human Services' Office of Minority Health and the Center for Disease Control and Prevention's Office of Minority Health and Health Disparities, I know that I'll be paying closer attention to the diseases—such as skin and testicular cancer—that I'm at especially high risk of getting. Though certainly not comprehensive, I've included a few stats below that jumped out at me for some common diseases. Click on the links to find out how to take action to prevent them.

Cancer. Black men have more cancers of the lung, prostate, colon, and rectum than do white men; they have more malignant tumors and are less likely to survive. Prostate cancer is particularly common and deadly among black men; their death rate is twice that of other groups. Asians and Hispanics had a significantly lower risk of developing prostate cancer than whites, but a higher risk of developing stomach and liver cancer. White men have the highest rates of skin cancer and fives times the risk of black men of getting testicular cancer.

Heart disease. Blacks are 30 percent more likely to die of heart disease than whites, but whites are at higher risk than Hispanics and Asians. American Indians have a slightly higher rate of heart disease than whites.

Diabetes. Hispanics, blacks, and Asians are approximately twice as likely as whites to get diabetes. Among people younger than 20, American Indians ages 10 to 19 have the highest prevalence of

Suicide. Blacks are more likely to experience mental disorders, but whites are twice as likely to commit suicide. Asians are 25 percent less likely than whites and 50 percent less likely than blacks and Hispanics to seek outpatient care for mental health problems. The suicide rate for Indians is 1.5 times the national rate.

HIV/AIDS. The virus is hitting black and Hispanic communities with particular force. Although black and Hispanic people represent about one quarter of the country's population, more than half of new AIDS cases are among these populations.

Others. Black Americans suffer disproportionately from hypertension and tuberculosis; Asian- Americans from hepatitis B and chronic obstructive pulmonary diseases; Hispanics from asthma and obesity; and Indians from substance abuse and SIDS.

As a men's health movement emerges, there are signs that gender and racial disparities will command some real attention. Research centers at universities and hospitals devoted to gender-specific medicine and men's health concerns are popping up; there's a push to create a Men's Health Office; a new scientific journal, one of the first devoted exclusively to men's health, has added rigor to the field; and conferences like this one that highlight men's unique health vulnerabilities are making us all take note.