scholarly journals Tuskegee and the Health of Black Men*

2017 ◽  
Vol 133 (1) ◽  
pp. 407-455 ◽  
Author(s):  
Marcella Alsan ◽  
Marianne Wanamaker
Keyword(s):  
Life Expectancy ◽  
Black Men ◽  
Medical Profession ◽  
White Men ◽  
Medical Mistrust ◽  
Difference In Differences ◽  
Men And Women ◽  
Demographic Groups ◽  
Black And White ◽  
Before And After

Abstract For 40 years, the Tuskegee Study of Untreated Syphilis in the Negro Male passively monitored hundreds of adult black men with syphilis despite the availability of effective treatment. The study’s methods have become synonymous with exploitation and mistreatment by the medical profession. To identify the study’s effects on the behavior and health of older black men, we use an interacted difference-in-difference-in-differences model, comparing older black men to other demographic groups, before and after the Tuskegee revelation, in varying proximity to the study’s victims. We find that the disclosure of the study in 1972 is correlated with increases in medical mistrust and mortality and decreases in both outpatient and inpatient physician interactions for older black men. Our estimates imply life expectancy at age 45 for black men fell by up to 1.5 years in response to the disclosure, accounting for approximately 35% of the 1980 life expectancy gap between black and white men and 25% of the gap between black men and women.

Abstract 15: Trends in Atrial Fibrillation-related Cardiovascular Mortality Rates in The United States: 1999-2017

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Yoshihiro Tanaka ◽  
Nilay Shah ◽  
Rod Passman ◽  
Philip Greenland ◽  
Sadiya Khan
Keyword(s):  
United States ◽  
Atrial Fibrillation ◽  
Black Men ◽  
Cause Of Death ◽  
Age Groups ◽  
White Men ◽  
The United States ◽  
Mortality Rates ◽  
Men And Women ◽  
Black And White

Background: Atrial fibrillation (AF) is the most common sustained arrhythmia in adults and the prevalence is increasing due to the aging of the population and the growing burden of vascular risk factors. Although deaths due to cardiovascular disease (CVD) death have dramatically decreased in recent years, trends in AF-related CVD death has not been previously investigated. Purpose: We sought to quantify trends in AF-related CVD death rates in the United States. Methods: AF-related CVD death was ascertained using the CDC WONDER online database. AF-related CVD deaths were identified by listing CVD (I00-I78) as underlying cause of death and AF (I48) as contributing cause of death among persons aged 35 to 84 years. We calculated age-adjusted mortality rates (AAMR) per 100,000 population, and examined trends over time estimating average annual percent change (AAPC) using Joinpoint Regression Program (National Cancer Institute). Subgroup analyses were performed to compare AAMRs by sex-race (black and white men and women) and across two age groups (younger: 35-64 years, older 65-84 years). Results: A total of 522,104 AF-related CVD deaths were identified between 1999 and 2017. AAMR increased from 16.0 to 22.2 per 100,000 from 1999 to 2017 with an acceleration following an inflection point in 2009. AAPC before 2009 was significantly lower than that after 2009 [0.4% (95% CI, 0.0 - 0.7) vs 3.5% (95% CI, 3.1 - 3.9), p < 0.001). The increase of AAMR was observed across black and white men and women overall and in both age groups (FIGURE), with a more pronounced increase in black men and white men. Black men had the highest AAMR among the younger decedents, whereas white men had the highest AAMR among the older decedents. Conclusion: This study revealed that death rate for AF-related CVD has increased over the last two decades and that there are greater black-white disparities in younger decedents (<65 years). Targeting equitable risk factor reduction that predisposes to AF and CVD mortality is needed to reduce observed health inequities.

Abstract MP73: Years of Potential Life Lost Due to Premature Cardiometabolic Mortality in The United States, 1999-2017

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Nilay S Shah ◽  
Donald M Lloyd-jones ◽  
Kiarri N Kershaw ◽  
Mercedes R Carnethon ◽  
Sadiya S Khan
Keyword(s):  
Black Men ◽  
White Women ◽  
Age Of Onset ◽  
Financial Burden ◽  
The United States ◽  
Cardiometabolic Health ◽  
Annual Percent Change ◽  
Men And Women ◽  
Black And White ◽  
Before And After

Introduction: Age of onset for heart disease (HD), cerebrovascular disease (CBD), and diabetes (DM) has shifted earlier, with increases in avoidable cardiometabolic deaths. We quantified total and trends in years of potential life lost (YPLL) before the age of 65 from HD, CBD, and DM, to describe population burden of premature preventable cardiometabolic mortality. Hypothesis: YPLL from premature cardiometabolic deaths in the U.S. have increased and are highest in black adults. Methods: Death certificates from the CDC’s Wide-Ranging Online Database for Epidemiologic Research (WONDER) were used to quantify mean age at death and proportion of deaths that were premature (<65 years) from HD, CBD, and DM as underlying cause of death. We then calculated age standardized premature YPLL (before age 65) per 100,000 people and mean annual percent change (APC) in YPLL, overall and in black and white women and men, before and after the previously published inflection in cardiometabolic death rates in 2011. Results: Between 1999-2017, 19% of HD deaths, 14% of CBD deaths, and 27% of DM deaths were premature. Overall, premature YPLL from HD decreased between 1999-2011 from 512 to 416 per 100,000 (APC -1.7%/year, 95% CI [-2.0, -1.5]), then remained unchanged from 2011-2017. For CBD, premature YPLL decreased 1.8%/year (-2.2, -1.5) to 70 per 100,000 in 2011, but remained unchanged through 2017. Premature YPLL from DM remained unchanged at 71 per 100,000 from 1999-2011, then increased 2.5%/year (1.8, 3.1) to 81 per 100,000 in 2017. Premature YPLL were higher in black men and women compared with white men and women, respectively (FIGURE). Conclusions: Premature YPLL from cardiometabolic causes plateaued or increased after 2011. Disparities in YPLL have persisted in the past decade with nearly half of cardiometabolic deaths in black men occurring before age 65. Equitable promotion of cardiometabolic health early in the lifespan may reduce population, health system, and financial burden of premature cardiometabolic mortality.

scholarly journals Age, sex, race, initial fitness, and response to training: the HERITAGE Family Study

2001 ◽  
Vol 90 (5) ◽  
pp. 1770-1776 ◽  
Author(s):  
James S. Skinner ◽  
Artur Jaskólski ◽  
Anna Jaskólska ◽  
Joanne Krasnoff ◽  
Jacques Gagnon ◽  
...  
Keyword(s):  
Age Groups ◽  
White Men ◽  
Cycle Ergometer ◽  
Men And Women ◽  
Black And White ◽  
Percent Change ◽  
Low Responders ◽  
Before And After ◽  
Blacks And Whites ◽  
Older Subjects

Effects of age, sex, race, and initial fitness on training responses of maximal O2 uptake (V˙o 2 max) are unclear. Data were available on 435 whites and 198 blacks (287 men and 346 women), aged 17–65 yr, before and after standardized cycle ergometer training. Individual responses varied widely, butV˙o 2 max increased significantly for all groups. Responses by men and women and by blacks and whites of all ages varied widely. There was no sex difference for change (Δ) inV˙o 2 max(ml · kg−1 · min−1); women had lower initial values and greater relative (%) increases. Blacks began with lower values but had similar responses. Older subjects had a lower Δ but a similar percent change. BaselineV˙o 2 max correlated nonsignificantly with ΔV˙o 2 max but significantly with percent change. There were high, medium, and low responders in all age groups, both sexes, both races, and all levels of initial fitness. Age, sex, race, and initial fitness have little influence onV˙o 2 max response to standardized training in a large heterogeneous sample of sedentary black and white men and women.

The Employment Effects of Wage Discrimination against Black Men

ILR Review ◽  
1996 ◽  
Vol 49 (2) ◽  
pp. 302-316 ◽  
Author(s):  
Marjorie L. Baldwin ◽  
William G. Johnson
Keyword(s):  
Black Men ◽  
Wage Differential ◽  
White Men ◽  
Wage Discrimination ◽  
Employment Rate ◽  
Employment Effects ◽  
Black And White ◽  
Relative Employment ◽  
The Difference ◽  
Employment Rates

When labor supply curves are upward-sloping, wage discrimination against black men reduces not only their relative wages, but also their relative employment rates. Using data from the 1984 Survey of Income and Program Participation, the authors estimate wage discrimination against black men and, for the first time, quantify the effects of that discrimination on the employment of black and white men. They find that 62% of the difference in offer wages to black and white men, and 67% of the difference in their observed wages, cannot be attributed to differences in productivity. Assuming that the unexplained wage differential is attributable entirely to employer discrimination, then the disincentive effects of wage discrimination reduced the relative employment rate of black men from 89% to 82% of white men's employment rate. Thus, wage discrimination and its employment effects resulted in a substantial transfer of resources from blacks to whites in 1984.

Abstract P001: Retirement Age And 20-year Cognitive Decline: The Atherosclerosis Risk In Communities Neurocognitive Study

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Albert Liu ◽  
Mehul D Patel ◽  
Alden L Gross ◽  
Thomas Mosley ◽  
Andreea Rawlings ◽  
...  
Keyword(s):  
Black Women ◽  
Cognitive Decline ◽  
Black Men ◽  
Occupational Status ◽  
White Men ◽  
Men And Women ◽  
Atherosclerosis Risk In Communities ◽  
Status Score ◽  
Lower Baseline ◽  
Atherosclerosis Risk

Background: The effect of retirement on cognitive functioning is not clear. We examined the association between age at retirement, midlife occupation, and cognitive decline in the large Atherosclerosis Risk in Communities (ARIC) biracial community-based cohort. Methods: Retirement status after ARIC visit 4 (1996-98) was reported in annual follow-up questionnaires administered in 1999-2007 (n= 8,426), and classified as occurring before or after age 70. Current or most recent occupation at visit 1 (1987-89) was categorized based on 1980 US census major occupation groups and tertiles of Nam-Powers-Boyd occupational status score (a measure of socioeconomic status of occupations, hereby used as a proxy for occupational complexity). Generalized estimating equation models were used to examine the associations of retirement with trajectories of a global cognitive factor score, assessed in 1990-92 (visit 2), 1996-98 (visit 4) and 2011-2013 (visit 5). Models were a priori stratified by race and sex and adjusted for demographics and comorbidities. To account for attrition, we also performed multiple imputation by chained equations. Results: Retirement before age 70 is associated with higher educational level and higher occupational status score in white men and women, and in black men. We observed associations between retirement before age 70 and lower baseline cognitive scores, as well as slower cognitive decline in white men and women, and in black men (Figure). The results did not change substantially after adjusting for the occupational status score or accounting for attrition. Conclusion: Retirement before age 70 was significantly associated with lower baseline cognitive scores and slower cognitive decline in whites and in black men. The lack of similar associations in black women and the investigation of reasons for the observed associations warrant further research.

Abstract 281: Contemporary Epidemiology of Atrial Fibrillation Among Medicare Beneficiaries, 2004-2013

2018 ◽  
Vol 11 (suppl_1) ◽  
Author(s):  
Joshua Parker ◽  
Rohan Khera ◽  
Ambarish Pandey ◽  
Daniel Cheeran ◽  
Colby Ayers ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Black Men ◽  
White Men ◽  
National Sample ◽  
Outpatient Setting ◽  
Relative Increase ◽  
Racial Groups ◽  
Fee For Service ◽  
Medicare Beneficiaries ◽  
Men And Women

Background: Atrial fibrillation (AF) is the most common dysrhythmia in clinical practice, and is a significant contributor to morbidity and mortality. Prior reports have projected a large increase in AF burden over time. A contemporary assessment of epidemiology is needed to assess if an emphasis of prevention strategies over the last decade has been effective in alleviating this risk. Methods: We used a 5% national sample of all Medicare beneficiaries in the US from 2002 through 2013 to construct a longitudinal cohort of 2.3 million fee-for-service Medicare beneficiaries administratively followed for ≥2 years using claims data. Trends in incident and prevalent AF were assessed for 2004 through 2013. Using ICD-9 codes, encounters with AF were identified from inpatient, outpatient, and physician claims. AF during the first 2 years of entry into the cohort was defined as pre-existing AF. Incident AF was defined as having either 1 inpatient claim with a diagnosis of AF or 2 outpatient or physician claims with AF. Calendar-year prevalence comprised pre-existing and incident AF for the respective years as well as those with incident AF in preceding years. Age-adjusted time trends were assessed using Poisson regression. Results: Between 2002 and 2013, 219,570 patients had incident AF. At incidence, mean age was 79 years, 55% were women, and 92% and 5% were white and black, respectively. Age-adjusted AF incidence decreased by 0.4/1000 per year between 2004 (20/1000) and 2013 (17/1000). While incidence declined for white men and women (P<.05), it has remained unchanged for black men and women (Figure). Proportion of incident events in the outpatient setting increased from 26% to 40%. One-year mortality was 9%, and remained unchanged throughout the study period. Over this period, the overall prevalence of AF decreased by 0.9/1000 per year (p<.05), however, there was a relative increase in AF prevalence among black men. Conclusions: Between years 2004 and 2013, the overall incidence and prevalence of AF among a 5% sample of Medicare beneficiaries stabilized. There were, however, differences across racial groups, with a slight decline in incidence among white men and women, which was not observed in black men and women.

Confronting Removal

2018 ◽  
pp. 83-100
Author(s):  
Amy Murrell Taylor
Keyword(s):  
Black Women ◽  
Black Men ◽  
Mississippi River ◽  
White Men ◽  
People Of Color ◽  
Men And Women ◽  
Racial Ideologies ◽  
The People ◽  
Competing Ideas ◽  
The Relationship

This chapter focuses on the relationship between race and space—between competing ideas for how people of different races should reside spatially—by looking at the Union army’s various attempts to remove refugees en masse. These removals attempted to resettle the people in places far removed from active combat, including northern states, islands in the Mississippi River, and even Haiti. Some of these efforts bore a great deal of resemblance to antebellum colonization plans, and, as in those cases, black men and women in the Civil War largely resisted being sent away. Most of the removals were justified by white officials in environmental terms, driven by racial ideologies that linked particular climates and landscapes to people of color. The chapter also argues that removals were sometimes triggered by concerns about gender and sex too—by beliefs that the physical proximity of black women and white men in military encampments had made rape inevitable.

scholarly journals Increasing Education-Based Disparities in Healthy Life Expectancy Among U.S. Non-Hispanic Whites, 2000–2010

2019 ◽  
Author(s):  
Phillip Cantu ◽  
Connor M Sheehan ◽  
Isaac Sasson ◽  
Mark D Hayward
Keyword(s):  
Life Expectancy ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
White Men ◽  
Mortality Rates ◽  
Healthy Life ◽  
Men And Women ◽  
Specific Mortality ◽  
Disability Prevalence ◽  
College Educated

Abstract Objectives To examine changes in Healthy Life Expectancy (HLE) against the backdrop of rising mortality among less educated white Americans during the first decade of the 21st century. Method This study documented changes in HLE by education among U.S. non-Hispanic whites, using data from the U.S. Multiple Cause of Death public-use files, the Integrated Public Use Microdata Sample (IPUMS) of the 2000 Census and the 2010 American Community Survey, and the Health and Retirement Study (HRS). Changes in HLE were decomposed into contributions from: (1) change in age-specific mortality rates; and (2) change in disability prevalence, measured via Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). Results Between 2000 and 2010, HLE significantly decreased for white men and women with less than 12 years of schooling. By contrast, HLE increased among college-educated white men and women. Declines or stagnation in HLE among less educated whites reflected increases in disability prevalence over the study period, whereas improvements among the college educated reflected decreases in both age-specific mortality rates and disability prevalence at older ages. Discussion Differences in HLE between education groups increased among non-Hispanic whites from 2000 to 2010. In fact, education-based differences in HLE were larger than differences in total life expectancy. Thus, the lives of less educated whites were not only shorter, on average, compared with their college-educated counterparts, but they were also more burdened with disability.

scholarly journals Dietary intake of Brazilian black and white men and its relationship to the bone mineral density of the femoral neck

2006 ◽  
Vol 124 (5) ◽  
pp. 267-270 ◽  
Author(s):  
Patrícia Constante Jaime ◽  
Maria do Rosário Dias de Oliveira Latorre ◽  
Alex Antonio Florindo ◽  
Tomoe Tanaka ◽  
Cristiano Augusto de Freitas Zerbini
Keyword(s):  
Bone Mineral Density ◽  
Femoral Neck ◽  
Black Men ◽  
Energy Intake ◽  
Bone Mineral ◽  
White Men ◽  
Racial Groups ◽  
Mineral Density ◽  
Black And White ◽  
The Relationship

CONTEXT AND OBJECTIVE: Osteoporosis and fragility fractures are an important public health problem. Although bone loss occurs with age universally, the incidence of bone loss fractures varies greatly between racial groups. The aim of this study was to examine the relationship between calcium, protein and energy intake and the bone mineral density of the femoral neck in Brazilian black and white men. DESIGN AND SETTING: This was a cross-sectional study, carried out in a teaching hospital in São Paulo. METHODS: The participants were 277 volunteer men, aged 50 years or older. The bone mineral density of the femoral neck (FNBMD) was measured by dual energy x-ray absorptiometry. The relationship between FNBMD and calcium, protein and energy intake, as assessed by a three-day food record, was analyzed using multiple linear regression models and was adjusted for age, height, physical activity and education level. The analysis was stratified by race (white and black). RESULTS: FNBMD presented similar means in the two racial groups (p = 0.538). Protein and energy intake did not show a significant correlation with FNBMD, either in the white or in the black population. Calcium intake showed a strong and independent correlation with FNBMD in the black men (partial r = 0.42). CONCLUSION: Calcium intake was a determinant of FNBMD for black men, aged 50 years or older, but not for the white ones.

scholarly journals Income and Marital Status Interact on Obesity Among Black and White Men

2019 ◽  
Vol 13 (1) ◽  
pp. 155798831982995 ◽  
Author(s):  
Caryn N. Bell ◽  
Roland J. Thorpe
Keyword(s):  
Marital Status ◽  
Black Men ◽  
Low Income ◽  
Positive Association ◽  
White Men ◽  
Poverty Line ◽  
High Income ◽  
Never Married ◽  
Black And White ◽  
Increased Risk

Racial disparities in obesity among men are accompanied by positive associations between income and obesity among Black men only. Race also moderates the positive association between marital status and obesity. This study sought to determine how race, income, and marital status interact on obesity among men. Using data from the 2007 to 2014 National Health and Nutrition Examination Survey, obesity was measured as body mass index ≥30 kg/m2 among 6,145 Black and White men. Income was measured by percentage of the federal poverty line and marital status was categorized as currently, formerly, or never married. Using logistic regression and interaction terms, the associations between income and obesity were assessed by race and marital status categories adjusted for covariates. Black compared to White (OR = 1.19, 95% CI [1.03, 1.38]), currently married compared to never married (OR = 1.45, 95% CI [1.24, 1.69]), and high-income men compared to low income men (OR = 1.26, 95% CI [1.06, 1.50]) had higher odds of obesity. A three-way interaction was significant and analyses identified that income was positively associated with obesity among currently married Black men and never married White men with the highest and lowest probabilities of obesity, respectively. High-income, currently married Black men had higher obesity rates and may be at increased risk for obesity-related morbidities.

Sign in / Sign up

Export Citation Format

Share Document