Nearly 60,000 black Americans die each year because the nation has failed to push their disease and death rates down to the same level as those for whites in six categories -- heart disease, homicide, cancer, low birthweight, cirrhosis and diabetes -- the Department of Health and Human Services reported yesterday.
The report, based on a year-long study of minority health problems, calculated that from 1979 to 1981, an annual average of 138,635 blacks below the age of 70 died from all causes. If black death rates from diseases, homicides and accidents had been the same as for whites, the number of black deaths would have been 79,693 annually -- meaning 58,942 "excess" deaths a year due to poorer health conditions.
Homicide is viewed as a health problem because 10 percent of homicides are related to drug abuse and 50 percent to alcohol abuse. Moreover, family quarrels and prior assaults often precede homicide.
The report also found about 2,000 "excess" deaths annually among American Indians and other native Americans. Persons of Hispanic origin also had a higher death rate than that for whites.
The report also found that persons of Asian and Pacific Island origin are "healthier than all racial/ethnic groups in the United States, including whites," and have a greater life expectancy, possibly in part because most of them appear to drink and smoke less.
The study is the first systematic effort to quantify "excess" deaths caused by the disparity between health conditions for minorities and whites, and to identify the major diseases and conditions involved.
Secretary Margaret M. Heckler, in releasing the seven-volume study by a task force headed by Dr. Thomas E. Malone, deputy director of the National Institutes of Health, called the continued health disparity between whites and minority groups "an affront to our ideals and to the genius of American medicine."
But while the report identified poverty, lack of health insurance and poorer prenatal care for minorities as major contributors to health problems (about a quarter of blacks and Hispanics lack year-round health-insurance coverage, almost twice the rate for whites), Heckler said she is not proposing any major new funds or health programs to deal with these issues.
Instead, she is focusing on new initiatives that can be achieved with existing resources through added education, research and "outreach" programs. She said she is allocating $3 million to the Public Health Service to monitor an effort withinHomicide is viewed as a health problem because 10 percent of homicides are related to drug abuse and 50 percent to alcohol abuse. the department to make sure that "an appropriate share of our funds" in various programs is devoted to minority health problems.
The report said four-fifths of the 58,942 "excess" black deaths resulted from six groups of conditions: heart disease and stroke (18,181), homicide and accidents (10,909, about four-fifths from homicide), cancer (8,118), infant mortality (6,178), cirrhosis (2,154) and diabetes (1,850).
Homicide was thus roughly tied with cancer as the second-leading cause of "excess" deaths among blacks under 70. For those between 15 and 44, "homicide is the leading cause of death for black males." It is the leading cause of "excess" deaths among all blacks under 45, ahead of infant mortality and accounting for one-third of "excess" deaths in the under-45 group.
"Much of the health gap suffered by minority Americans -- perhaps even most of it -- is related to knowledge and life style," Heckler said. "Smoking, alcohol, diet and obesity are clearly linked to the higher cancer, cirrhosis, cardiovascular, infant mortality and other disease rates afflicting our minorities."
She said the homicide rate among Indians and other native Americans was 70 percent higher than for the general population; for black males 25 to 34 "the homicide rate was 7.6 times greater than for white males in the same age group . . . . The chance of becoming a homicide victim for white persons is 1 in 240 -- for blacks and other nonwhites, the lifetime chance is 1 in 47."
Black infant mortality rates are double those for whites. Liver disease death rates for black males are double those of whites; for native American males, the rate is triple. Death rates from homicidefor males under 45 are about seven times as high for blacks and over twice as high for native Americans as for whites.