scholarly journals Racism as a Leading Cause of Death: Measuring Excess Deaths in the US

2021 ◽  
Author(s):  
Daisy Massey ◽  
Jeremy Faust ◽  
Karen Dorsey ◽  
Yuan Lu ◽  
Harlan Krumholz
Keyword(s):  
Black Women ◽  
Mortality Rate ◽  
Black Men ◽  
Cause Of Death ◽  
White Women ◽  
Black People ◽  
Mortality Rates ◽  
White People ◽  
The Us ◽  
Excess Deaths

Background: Excess death for Black people compared with White people is a measure of health equity. We sought to determine the excess deaths under the age of 65 (<65) for Black people in the United States (US) over the most recent 20-year period. We also compared the excess deaths for Black people with a cause of death that is traditionally reported. Methods: We used the Multiple Cause of Death 1999-2019 dataset from the Center of Disease Control (CDC) WONDER to report age-adjusted mortality rates among non-Hispanic Black (Black) and non-Hispanic White (White) people and to calculate annual age-adjusted <65 excess deaths for Black people from 1999-2019. We measured the difference in mortality rates between Black and White people and the 20-year and 5-year trends using linear regression. We compared age-adjusted <65 excess deaths for Black people to the primary causes of death among <65 Black people in the US. Results: From 1999 to 2019, the age-adjusted mortality rate for Black men was 1,186 per 100,000 and for White men was 921 per 100,000, for a difference of 265 per 100,000. The age-adjusted mortality rate for Black women was 802 per 100,000 and for White women was 664 per 100,000, for a difference of 138 per 100,000. While the gap for men and women is less than it was in 1999, it has been increasing among men since 2014. These differences have led to many Black people dying before age 65. In 1999, there were 22,945 age-adjusted excess deaths among Black women <65 and in 2019 there were 14,444, deaths that would not have occurred had their risks been the same as those of White women. Among Black men, 38,882 age-adjusted excess <65 deaths occurred in 1999 and 25,850 in 2019. When compared to the top 5 causes of deaths among <65 Black people, death related to disparities would be the highest mortality rate among both <65 Black men and women. Comment: In the US, over the recent 20-year period, disparities in mortality rates resulted in between 61,827 excess deaths in 1999 and 40,294 excess deaths in 2019 among <65 Black people. The race-based disparity in the US was the leading cause of death among <65 Black people. Societal commitment and investment in eliminating disparities should be on par with those focused on other leading causes of death such as heart disease and cancer.

scholarly journals Opioid-Related Mortality for Individuals with Sickle Cell Disease Remains Low with No Significant Increase during 2013-2019

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 124-124
Author(s):  
Lana Mucalo ◽  
Amanda M. Brandow ◽  
Ashima Singh
Keyword(s):  
Cause Of Death ◽  
Black People ◽  
Opioid Analgesics ◽  
Mortality Rates ◽  
Cell Disease ◽  
White People ◽  
Mortality Trends ◽  
The Us ◽  
Over Time ◽  
Related Mortality

Abstract In 2017, the United States (US) Department of Health and Human Services declared the opioid epidemic a public health emergency due to rising opioid-related deaths. Since then, there has been increasing pressure to implement policies that regulate the use and prescribing of opioid medications. These new policies that include limiting the amount of prescribed opioids can adversely affect individuals with chronic pain conditions, such as sickle cell disease (SCD), who require opioid analgesics to manage acute and chronic pain. Individuals with SCD are also affected by racial disparities in healthcare which further exacerbate the withholding of opioid medication for these individuals when needed. Opioid-related mortality trends have not been quantified specifically for individuals with SCD. Therefore, the objective of this report is to describe opioid-related mortality trends in individuals with SCD. We hypothesize that there has been no significant increase in mortality rates due to opioids during the years 2013-2019 in individuals with SCD. Secondarily, we hypothesize that individuals with SCD do not have a higher rate of death due to opioids, compared to both Black people without SCD and White people. To determine the number of deaths and population at risk during the years 2013-2019, we used data from the Center of Disease Control and Prevention (CDC) Wide-ranging Online Data for Epidemiologic Research (WONDER) Multiple Cause of Death database. The opioid-related overdose deaths were identified using the underlying cause of death ICD-10 codes of 'X40', 'X41', 'X42', 'X43', 'X44', 'X60', 'X61', 'X62', 'X63', 'X64', 'X85', 'Y10', 'Y11', 'Y12', 'Y13', 'Y14' and multiple cause of death codes were used to identify specific drug type: 'T40.0', 'T40.1', 'T40.2', 'T40.3', 'T40.4', 'T40.6'. The deaths were determined to be among individuals with SCD if the multiple cause of death included codes for SCD 'D57.0', 'D57.1', 'D57.2', 'D57.4', 'D57.8'. Since there are no direct estimates of the SCD population in the US, we extrapolated the SCD population at risk by assuming that 1 in 365 Black people in the US have SCD. The mortality rates among Black people with SCD, Black people without SCD and White people were calculated as the crude rate per 100,000 people. The trends for death rates during 2013-2019 were evaluated using Joinpoint regression. These models fit the rates on a logarithmic scale using a series of permutation tests. We compared overall deaths over the years 2013-2019 between Black people with SCD, Black people without SCD and White people using the chi-square test in SPSS. A p-value of &lt;0.05 was considered significant. Between 2013 and 2019 there were 273,301 recorded deaths due to opioids in the US. Of these, 236,982 (87.29%) occurred among White people, 31,316 (10.87%) among Black people without SCD, and 77 (0.03% of total opioid deaths) among Black people with SCD. Figure 1 represents mortality trends over time and Table 1 shows regression analysis and annual percentage changes in cohorts. We identified no statistically significant changes in the trend during the years 2013-2019 for Black people with SCD (annual percent change-APC=8.9%, p=0.217). However, we observe significant increasing opioid-related mortality rates for Black people without SCD (APC=24.9%, p&lt;0.001). The mortality rates for White people increased significantly until 2017 (APC=16.0%, p=0.011) and then flattened over the years 2017-19. Overall mortality rates between the 2013-2019 period for Black people with SCD were significantly lower compared to White people (62.1 vs 93.8 per 100,000, p&lt;0.001), but the difference was not significant in comparison to Black people without SCD (62.1 vs 69.4 per 100,000, p=0.33). Opioid-related mortality in Black people with SCD has not significantly increased over time despite overall increased opioid-related mortality in Black people without SCD and White people. Further, Black people with SCD have significantly lower opioid-related mortality rates compared to White people. These data support continued efforts are needed to ensure access to opioid analgesics for individuals with SCD and promote SCD pain treatment as per evidence-based guidelines. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

scholarly journals Is there race/color differential on femicide in Brazil? The inequality of mortality rates for violent causes among white and black women

2021 ◽  
Vol 31 (2) ◽  
pp. 358-366
Author(s):  
Mario Francisco Giani Monteiro ◽  
Jackeline Aparecida Ferreira Romio ◽  
Jefferson Drezett
Keyword(s):  
Black Women ◽  
Mortality Rate ◽  
White Women ◽  
Public Health Problem ◽  
Secondary Data ◽  
Mortality Rates ◽  
Gender Violence ◽  
Chi Square ◽  
Significance Level ◽  
Health Council

Introduction: Femicide is considered the extreme expression of gender violence. The Brazilian scenario points to a complex public health problem, with evidence of a more severe social phenomenon for black women. Objective: To compare mortality rates due to violent causes in white and black women. Methods: Ecological study of temporal series with secondary data obtained from the Mortality Information System of DATASUS. We estimated the mortality rate from 2016-2018 about suicides, aggressions, and undetermined death by violence in the range of ages 15-29 and 30-59 years among white and non-white women. Femicide cases were compared using firearms or other means. Statistical analysis employed the chi-square test, with a significance level of p<0.05, Confidence Interval of 95%. According to resolution 510/2016 of the National Health Council, the study is exempted from Research Ethics Committee´s evaluation. Results: Between 15 and 29 years, the mortality rate due to aggression was higher for black, 10.5/100,000, than for white women, 4.9/100,000. The same occurred between 30 and 59 years, with 12.5/100,000 deaths among black and 5.9/100,000 deaths among white women. Suicide rates were lower for black than for white women aged 15 to 29 years (1.2/100,000 versus 2.8/100,000) and between 30-59 years (2.0/100,000 versus 5.2/100,000). Among non-white women, the use of firearms was higher and, among white women, hanging was used the most. Conclusion: Violent deaths of women by aggression affect more forcefully Brazilian black women, regardless of age. Firearms remain the aggressor's main resource for practicing femicide, especially against non-white women.

scholarly journals Woman in the Mirror: Reflections

2015 ◽  
pp. 92
Author(s):  
Laura Fish
Keyword(s):  
Black Women ◽  
Black Men ◽  
Virginia Woolf ◽  
Black People ◽  
White People ◽  
Black British ◽  
Mary Prince ◽  
Political Views ◽  
History Of ◽  
Joan Riley

In A Room of One’s Own (1929) Virginia Woolf asserts: “Women have served all these centuries as looking-glasses possessing the magic and delicious power of reflecting the figure of man at twice its natural size”. (34) The use of the mirror is key to Woolf’s arguments about the position of women in general and in particular that of women writers. Complicating Woolf’s view less than a century later, I examine how black women function as looking-glasses in a dual way: as blacks, we shared the past (and now share the current) fate of black people reflecting the “darker” side of white people, as many whites projected onto blacks the unacknowledgeable traits of their own nature. The mirror is also key then to the way in which racial oppression has been analysed in literature. My paper offers an account, by way of selected examples from the history of our literature, of indicating how the mirror has been essential to how black British women are viewed and reflected back. I suggest that the misshapen image in the looking glass created by white people and also black men, allows them to see an inflated reflection of themselves, to assume false feelings of superiority, and to perpetuate oppression against us. I focus on Mary Prince, Mary Seacole, Una Marson, Joan Riley and Helen Oeyemi–authors whose work either anticipates or relates to Woolf’s notion of mirroring, by seeking ways to addressor overcome the situation in which we are placed. The texts explored not only trace the development of the tradition of our writing - the shift from being represented to representing ourselves– but also present a range of cultural and political views and identify three recurring themes: firstly, the denigration in our portrayal; secondly, the assumed superiority white people and black men adopt over us; and thirdly our resistance in remonstrating against such treatment and exposure.

scholarly journals BLACK–WHITE MARITAL MATCHING: RACE, ANTHROPOMETRICS, AND SOCIOECONOMICS

2016 ◽  
Vol 82 (4) ◽  
pp. 399-421 ◽  
Author(s):  
Pierre-André Chiappori ◽  
Sonia Oreffice ◽  
Climent Quintana-Domeque
Keyword(s):  
Black Women ◽  
Black Men ◽  
White Women ◽  
Panel Study ◽  
Marriage Market ◽  
White Men ◽  
Socioeconomic Characteristics ◽  
The Us ◽  
Using Data ◽  
Exchange Hypothesis

Abstract:We analyze the interaction of black–white race with physical and socioeconomic characteristics in the US marriage market, using data from the Panel Study of Income Dynamics. We estimatewho inter-racially marries whomalong anthropometric and socioeconomic characteristics dimensions. The black women who inter-marry are the thinner and more educated in their group; instead, white women are the fatter and less educated; black or white men who inter-marry are poorer and thinner. While women in “mixed” couples find a spouse who is poorer but thinner than if they intra-married, black men match with a white woman who is more educated than if they intra-married, and a white man finds a thinner spouse in a black woman. Our general findings are consistent with the “social status exchange” hypothesis, but the finding that black men who marry white women tend to be poorer than black men who marry black women isnot.

Gender Theory in Philosophy of Race

2017 ◽  
Author(s):  
Naomi Zack
Keyword(s):  
Black Women ◽  
Critical Race Theory ◽  
Critical Theory ◽  
Black Men ◽  
Women Of Color ◽  
White Women ◽  
Main Idea ◽  
Race Theory ◽  
Philosophy Of Race ◽  
The Subject

The subject of critical race theory is implicitly black men, and the main idea is race. The subject of feminism is implicitly white women, and the main idea is gender. When the main idea is race, gender loses its importance and when the main idea is gender, race loses its importance. In both cases, women of color, especially black women, are left out. Needed is a new critical theory to address the oppression of nonwhite, especially black, women. Critical plunder theory would begin with the facts of uncompensated appropriation of the biological products of women of color, such as sexuality and children.

Abstract MP050: Race and Gender Group Specific Trends in Length of Stay for Acute Myocardial Infarction: The Atherosclerosis Risk in Communities (ARIC) study, 1987–2008

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Laura R Loehr ◽  
Xiaoxi Liu ◽  
C. Baggett ◽  
Cameron Guild ◽  
Erin D Michos ◽  
...  
Keyword(s):  
Black Women ◽  
Length Of Stay ◽  
Black Men ◽  
White Women ◽  
White Men ◽  
Quadratic Term ◽  
Race And Gender ◽  
Insurance Type ◽  
And Gender ◽  
Aric Study

Introduction: Since the 1980’s, length of stay (LOS) for acute MI (AMI) has declined in the US. However, little is known about trends in LOS for non-white racial groups and whether change in LOS is related to insurance type or hospital complications. Methods: We determined 22 year trends in LOS for nonfatal (definite or probable) AMI among black and white residents age 35–74 in 4 US communities (N=396,514 in 2008 population) under surveillance in the ARIC Study. Events were randomly sampled and independently validated using a standardized algorithm. All analyses accounted for sampling scheme. We excluded MI events which started after admission (n=1,677), events within 28 days for the same person (n=3,817), hospital transfers (n=571), and those with LOS=0 or LOS >66 (top 0.5% of distribution, N= 144) leaving 22,258 weighted events for analysis. The average annual change in log LOS was modeled using weighted linear regression with year as a quadratic term. All models adjusted for age and secondary models adjusted for insurance type (Medicare, Medicaid, private, or other), and complications during admission (cardiac arrest, cardiogenic shock, or heart failure). Results: The average age-adjusted LOS from 1987 to 2008 was reduced by 5 days in black men (9.5 to 4.5 days); 4.6 days in white women (9.4 to 4.8 days); 4 days in white men (8.3 to 4.3 days) and 3.6 days in black women (9.0 to 5.4 days). Between 1987 and 2008, the age-adjusted average annual percent change (with 95% CI) in LOS was largest for white men at −4.40 percent per year (−4.91, −3.89) followed by −3.89 percent (−4.52, −3.26) for white women, −3.72 percent (−4.46, −2.89) for black men, and −2.94 percent (−3.92, −1.96) for black women (see Figure). Adjustment for insurance type, and complications did not change the pattern by race and gender. Conclusions: Between 1987 and 2008, LOS for AMI declined significantly and similarly in men and women, blacks and whites. These changes appear independent of differences in insurance type and hospital complications among race-gender groups.

Abstract MP32: Race-sex differences in hyperlipidemia awareness, treatment and control in the Reasons for Geographic And Racial Differences in Stroke (REGARDS) study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Monika M Safford ◽  
Paul Muntner ◽  
Raegan Durant ◽  
Stephen Glasser ◽  
Christopher Gamboa ◽  
...  
Keyword(s):  
Sex Differences ◽  
Black Women ◽  
Black Men ◽  
Racial Differences ◽  
White Women ◽  
White Men ◽  
Risk Category ◽  
Chd Risk ◽  
And Control ◽  
Risk Categories

Introduction: To identify potential targets for eliminating disparities in cardiovascular disease outcomes, we examined race-sex differences in awareness, treatment and control of hyperlipidemia in the REGARDS cohort. Methods: REGARDS recruited 30,239 blacks and whites aged ≥45 residing in the 48 continental US between 2003-7. Baseline data were collected via telephone interviews followed by in-home visits. We categorized participants into coronary heart disease (CHD) risk groups (CHD or risk equivalent [highest risk]; Framingham Coronary Risk Score [FRS] >20%; FRS 10-20%; FRS <10%) following the 3 rd Adult Treatment Panel. Prevalence, awareness, treatment and control of hyperlipidemia were described across risk categories and race-sex groups. Multivariable models examined associations for hyperlipidemia awareness, treatment and control between race-sex groups compared with white men, adjusting for predisposing, enabling and need factors. Results: There were 11,677 individuals at highest risk, 847 with FRS >20%, 5791 with FRS 10-20%, and 10,900 with FRS<10%; 43% of white men, 29% of white women, 49% of black men and 43% of black women were in the highest risk category. More high risk whites than blacks were aware of their hyperlipidemia but treatment was 10-17% less common and control was 5-49% less common among race-sex groups compared with white men across risk categories. After multivariable adjustment, all race-sex groups relative to white men were significantly less likely to be treated or controlled, with the greatest differences for black women vs. white men (Table). Results were similar when stratified on CHD risk and area-level poverty tertile. Conclusion: Compared to white men at similar CHD risk, fewer white women, black men and especially black women who were aware of their hyperlipidemia were treated and when treated, they were less likely to achieve control, even after adjusting for factors that influence health services utilization.

Gendered racism : the lived experiences of black undergraduate women at an HPWI : microaggressions, space and culture

2018 ◽  
Author(s):  
◽  
Veronica A. Newton
Keyword(s):  
Black Women ◽  
Black Men ◽  
Emotional Labor ◽  
Lived Experiences ◽  
White Women ◽  
Racial Microaggressions ◽  
Critical Race ◽  
Critical Race Feminism ◽  
Gendered Racism ◽  
Undergraduate Women

[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT AUTHOR'S REQUEST.] This current study examined how Black undergraduate women experience gendered racism at a historically, predominately white university in the South. With a lack of studies on Black women's college experiences, I took a critical intersectional approach to interrogate the role of racism and patriarchy together by utilizing a Critical Race Feminism perspective. With the approach I was able to explore and examine the lived experiences of gendered racism, gendered racial microaggressions in white-maled spaces on campus, Black-maled spaces on campus, as well as white women's spaces on campus. Using a critical race feminism theoretical, conceptual and methodological framework, I interviewed 25 Black undergraduate women who attended a state-flagship university in the Mid-Southern region of the US. I also conducted ethnographic fieldwork by shadowing 5-8 different participants from June of 2015 to January 2017 on campus and off campus. The findings of this study show that Black women received gendered racial microaggressions from white men, Black men, white women students and professors on campus. Black women also receive these microaggressions in white-maled spaces and Black-maled spaces. Furthermore, Black women experience challenges that prevents their acquirement of social capital based on the way their raced and gendered bodies are read. Lastly, Black women have no spaces on campus that serve both their raced and gendered identity together and participate in emotional labor that white students and Black men students do not experience.

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.

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