Doctors May Miss African-American Patient Risk Factors for Some Diseases

On May 2, 2017, the CDC published a report that found that African-Americans (blacks) in their 20s, 30s, and 40s are more likely to live with or die from conditions that typically occur at older ages in whites, including heart disease, stroke, and diabetes. Risk factors for some diseases, such as high blood pressure, may go unnoticed and untreated during these early years.


The study found the death rate for blacks declined 25 percent between 1999 and 2015. But disparities still persist between blacks and whites. Although blacks as a group are living longer, their life expectancy is still four years less than that of whites.


Notably, the death rates for homicide among blacks did not change over the 17 years of the study. While the rate remained stable, it was high. The report found that blacks ages 18 to 34 years and 35 to 49 years are nine times and five times, respectively, as likely to die from homicide as whites in the same age groups.


Disparities in all age groups are narrowing because death rates are declining faster among blacks than among whites. The overall disparity in death rates between these two races for all causes of death in all age groups was 33 percent in 1999, but fell to 16 percent in 2015. The racial death rate gap closed completely for deaths from heart disease and for all causes of death among those 65 years and older.


The report also described improvements in other causes of death, such as a dramatic decrease of approximately 80 percent in HIV deaths among 18 to 49-year-olds from 1999-2015. Dramatic drops in HIV deaths were also seen among whites. Still, a wide disparity remains with blacks seven to nine times more likely to die from HIV.


“We have seen some remarkable improvements in death rates for the black population in these past 17 years. Important gaps are narrowing due to improvements in the health of the black population overall. However, we still have a long way to go,” said Leandris Liburd, Ph.D., M.P.H., M.A., associate director of the CDC’s Office of Minority Health and Health Equity. “Early health interventions can lead to longer, healthier lives. In particular, diagnosing and treating the leading diseases that cause death at earlier stages is an important step for saving lives.”


Social and economic conditions, such as poverty, contribute to gaps in health differences between blacks and whites, according to the report. In all age groups, the analysis showed that blacks had lower educational attainment and home ownership and nearly twice the rate of poverty and unemployment as whites. These risk factors may limit blacks’ access to prevention and treatment of disease. Other risk factors that affect health outcomes for blacks include obesity and less physical activity.


Regarding the need for doctors to look for warning signs of disease at an earlier age, the study made a series of key findings. Blacks ages 18 to 64 are at higher risk of early death than whites. Disparities in the leading causes of death for blacks compared with whites are pronounced by early and middle adulthood, including homicide and chronic diseases such as heart disease and diabetes. Blacks ages 35-64 are 50 percent more likely to have high blood pressure than whites. Blacks ages 18-49 years, are two times more likely to die from heart disease than whites. Blacks have the highest death rate for all cancers combined compared with whites.


“It is important that we continue to create opportunities for all Americans to pursue a healthy lifestyle,” said Timothy Cunningham, Sc.D., lead author and epidemiologist with the CDC’s Division of Population Health. “Public health professionals must work across all sectors to promote health at early ages.”


Public health agencies and community organizations should continue to implement programs proven to reduce health disparities, and partner with other sectors, including education, business, transportation, and housing, to create social and economic conditions that promote health starting in childhood to continue to close the gap in health outcomes. Proven prevention measures such as healthy eating, physical activity, tobacco cessation, disease screenings, and medication adherence remain important to reduce disease and early death.


See the CDC Announcement


See the CDC Report


See also Medical Risk Law, February 2015 Report: Mending a Broken Heart: Malpractice Risks in Diagnosing and Treating Heart Disease


See also Medical Risk Law, November 2014 Report: More Than Skin Deep: Skin Cancer Misdiagnosis and Other Liability Issues


See also Medical Risk Law, May 2014 Report: Diabetes and Its Complications: Malpractice and Other Liability Issues


See also Medical Risk Law, October 2012 Report: Mistakes in Diagnosing Cancer: Liability Concerns for Misdiagnosis, Failure to Diagnose, and Delayed Diagnosis