African Americans

 

 

Cancer - In 2001, the age-adjusted death rate for cancer was 25.4 percent higher for African-Americans (243.1 per 100,000 population) than for white Americans (193.9).

Diabetes - In 2001, the diabetes age-adjusted death rate for African-Americans was more than twice that for white Americans (49.2 vs. 23.0 per 100,000 population).

Adult Immunization - In 2002, influenza vaccination coverage among adults 65 years of age and older was 70.2 percent for whites and 52.0 percent for African-Americans. The gap for pneumococcal vaccination coverage among older adults was even wider at 60.6 percent for whites and 36.1 percent for African-Americans.

Infant Mortality - In 2001, the infant mortality rate among African-Americans was 13.3 per 1,000 live births -- more than twice the rate for white Americans (5.7 per 1,000 live births).

In 2003, African Americans had the highest age-adjusted all-causes rate of all races/ethnicities. In addition, African Americans had the highest age-adjusted death rate for heart disease, cancer, diabetes, and HIV/AIDS.

During 2001-2004, 68% of all women reported with AIDS were African American; among men, just under half (44%) of the new cases of HIV and AIDS were in African Americans.

In 2004, African Americans were more likely to be obese African American women are particularly impacted, with 39.0% of African American women obese in 2004.

Lupus is three times more common in African American women than in white women. African American women tend to develop symptoms at an earlier age than other women, and have more severe organ problems, especially with their kidneys.

Education was inversely associated with heart disease, hypertension, and stroke; as educational level increased, the percentages of adults with these conditions decreased.

Poverty level was inversely associated with heart disease (including coronary heart disease), hypertension, and stroke; adults in families that were poor and near poor were more likely to have never been told they had these conditions than were adults in families that were not poor.

A New England Journal of Medicine 322(1990) ):173-177 "Excess Mortality in Harlem." study reported that a 15-year-old black female in Harlem had a 65% chance of surviving to age 65, about the same as women in India.

Black males in Harlem, on the other hand, had a 37% chance of surviving to age 65, about the same as men in Angola.

Infectious diseases and diseases of the circulatory system were to blame, with a variety of contributing factors including the deep-fried foods traditional to the neighborhood, which may contribute to heart disease.

Church-Based Weight Plan Peels Off Pounds for Blacks

TUESDAY, March 10 (HealthDay News) -- A 12-week church-based weight loss program helped many overweight/obese blacks lose 5 percent or more of their body weight, and most of them maintained their weight loss for at least six months.

The study included 35 men and women, average age 46, with an average body mass index (BMI) of 36. They took part in a pilot program conducted by lay leaders at Gospel Water Branch Baptist Church near Augusta, Ga. The lay leaders had received two days of training to present the 12 modules of Fit Body and Soul, a faith-based diabetes prevention program adapted from the U.S. National Institutes of Health-sponsored Diabetes Prevention Program.

By the end of the program, 16 of the 35 (46 percent) participants had lost 5 percent or more of their starting weight, and about 26 percent had lost 7 percent of more. After the initial 12-week program, participants had six monthly "booster" sessions for six months. Eleven of the 16 participants (almost 69 percent) who lost weight in the initial program kept the weight off during the six months of follow-up sessions.

The findings were to be presented Tuesday at the American Heart Association's Annual Conference on Cardiovascular Disease Epidemiology and Prevention.

"This kind of result is remarkable in a faith-based program run by lay leaders when so many other community-based programs have failed," principal investigator Dr. Sunita Dodani, director of the Center for Outcome Research and Education, and associate professor, department of internal medicine, School of Medicine, Kansas University Medical Center in Kansas City, Kansas, said in an AHA news release.

A multi-year study will compare 10 congregations who use the Fit for Body and Soul program and 10 congregations who use a different health promotion program developed from the U.S. Centers for Disease Control and Prevention Community Guide. All the churches are in the Midwest.

Losing weight through healthy eating and exercise can reduce the risk of diabetes, which is a major risk factor for heart disease.

High Rate of Early Heart Failure Seen in Blacks Biggest risk factors were hypertension, obesity, study found By Ed Edelson HealthDay Reporter

WEDNESDAY, March 18 (HealthDay News) -- Blacks tend to develop heart failure 20 years earlier than whites, a long-running study shows.

"What we found is that [early] heart failure occurs almost exclusively among blacks, and it is not a rare occurrence," said Dr. Kirsten Bibbins-Domingo, lead author of a report in the March 19 issue of the New England Journal of Medicine. "It affects one in 100 in their 20s and 30s. What this means is that the incidence of heart failure among blacks in their 20s and 30s is that of whites in the 40s and 50s."

The study, which enrolled 5,115 then-healthy young people in four U.S. cities "was initiated by the National Heart, Lung, and Blood Institute to understand how heart disease develops in young people," said Bibbins-Domingo, an assistant professor of medicine at the University of California, San Francisco, and co-director of the Center for Vulnerable Populations at San Francisco General Hospital. The study is just entering its 25th year, she noted.

In the first 20 years, 27 participants developed heart failure, the progressive loss of the ability to pump blood. All but one were black. And while the study did not exclude such factors as genetics and socioeconomic status as potential causes of the difference, it clearly showed a higher incidence of two major risk factors, high blood pressure and obesity, among blacks.

"If you look at blacks and whites at the beginning of the study, they were remarkably similar in risk profiles," Bibbins-Domingo said. The higher incidence of the two major risk factors soon emerged.

"Those risk factors for heart failure were already present in young adults, and they made themselves felt 20 years later," she said.

Some association was found between lower education levels and the risk of future heart failure, Bibbins-Domingo said. But the overriding link was with high blood pressure and obesity.

"From other work, we know that young people are least likely to be aware that they have high blood pressure," she said. "If they do have high blood pressure, they are least likely to be in treatment, and if they are in treatment, they are least likely to have it under control."

Young people don't often go to doctors, and "physicians don't often treat high blood pressure in young people, because they think the consequences are far in the future," Bibbins-Domingo said.

The study "suggests that individual patients and their physicians should be aware of the future dangers of high blood pressure and obesity in young people," she said. "They should try for changes in lifestyle, and should put them on medications when lifestyle interventions don't work."

Those interventions are especially important in young blacks, she said, but the message is often ignored. "The high rate of teenage obesity in the black community suggests that we already are behind the curve," Bibbins-Domingo said.

Dr. Paul Underwood, former president of the Association of Black Cardiologists, was struck by "the interplay between high blood pressure and heart failure" shown by the study.

"Fully 40 percent of those in the study were not on hypertensive therapy at the time they were diagnosed," Underwood said.

The study points up the need to identify and control risk factors including obesity and diabetes, Underwood said. "If we don't get control of the situation, it's going to get much worse," he noted.

It's difficult to tell whether racism underlies the differences seen in the study, said Dr. Eric D. Peterson, a professor of medicine from Duke Clinical Research Institute in Durham, N.C., who wrote a commentary accompanying the report.

"That is hard to prove," Peterson said. "It is a diagnosis of exclusion. Patients don't notice a care differential, but when you look at the results, the care is different."

But doctors are human, and "dealing with people who are more similar to you can influence care," Peterson said. "The doctor-patient relationship can differ to the extent that you feel a commonality with that patient, and the patient feels a commonality with you."