The Washington PostDemocracy Dies in Darkness

Black men in D.C. are expected to die 17 years earlier than White men. Here’s why.

Activists stand with American flags at sunrise near the Washington Monument. (Tom Brenner/Reuters)

Samuel Mingle, 55, grew up in Ward 8. The closest grocery store to him was a 30-minute walk away.

Mingle, who is Black and has Type 2 diabetes, never questioned why he had to travel so far.

“When you’re living your life, you’re just living to the best of your ability,” he said. “You don’t know that you’re not in the know about a lot of things in the area.”

But the distance between home and a grocery store can lead to some people living longer than others. Heart disease, which can be caused by an unhealthy diet, was a major reason Black residents in the District died earlier than White residents in 2016, according to a new study published in Nature on Thursday.

 The study’s researchers set out to better understand the District’s life expectancy gap.

“Not only are we targeting specific causes of death that highlight disparities between Blacks and Whites in D.C., we’re also highlighting the stages of life, specifically, where those are being impacted most,” said Max Roberts, a PhD student at Utah State University and the lead author of the study.

Roberts and his two co-authors analyzed mortality data from 1999 to 2017. They found that, on average, Black men died 17 years earlier than their White counterparts in 2016. Heart disease, homicide, cancer and unintentional injuries such as accidental drug poisoning contributed most to the gap. Homicide contributed most to the gap from ages 15 to 39, while heart disease and cancer contributed most from ages 45 to 74.

Black women, on average, died 12 years earlier than their White counterparts in 2016, with heart disease, cancer and perinatal conditions contributing most to the gap. Heart disease and cancer among women contributed most from ages 40 to 74, while perinatal conditions contributed most before age 1.

Though the national life expectancy gap between Black and White people has narrowed since 1970 for a number of reasons, including increased access to health care and higher educational attainment, the gap has widened in the District, according to Roberts’s findings.

“Those findings are disappointing but not surprising,” said Dana Mueller, a physician and the director of adult and family medicine at Mary’s Center, a nonprofit community health center in the District. She pointed out that heart disease and cancer are the leading causes of death in the country. She also mentioned the lack of health care facilities east of the Anacostia River, where there is no trauma center and where many Black people in the District live.

The District’s only public hospital, United Medical Center, which is located in Ward 8, has been plagued by financial instability and scandal among its leaders. Health regulators closed UMC’s obstetrics ward in 2017 because of dangerous medical errors, and The Washington Post reported later that year on questionable deaths at the hospital, which is expected to close permanently in 2023.

Providence Hospital, another hospital that primarily served Black people in the District, ended many of its services in 2018.

Whitney Hewlett Noel, a research specialist at Georgetown University who studies Black maternal and infant mortality in the District, explained the troubles with access to care by pointing to gentrification and “the history of redlining and disinvestment from communities that are resulting in health inequities that affect people’s health.”

The coronavirus pandemic has only magnified those existing health disparities and will likely widen the life expectancy gap, health experts say. More than 13,000 people have tested positive for covid-19 in the District, and more than 600 people have died. Black people are more likely not only to contract the virus but also to die of it because they are overrepresented in jobs deemed essential and live in areas that lack health care facilities.

‘Legacy of inequality’ to blame for covid-19 deaths among Black D.C. residents, report says

The researchers decided to study D.C. after completing a similar study in Wisconsin, which has the largest gap among states. The District’s life expectancy gap, however, is twice as large as that of Wisconsin.

The researchers looked at 23 different causes of death to see how they contributed to the gap. Heart disease contributed 4.14 years to the gap between Black and White men. Homicide contributed 2.43 years, and cancer contributed 2.30 years. Unintentional injuries such as drug poisoning and motor vehicle accidents contributed 2.23 years.

“The most surprising finding that came with this was that homicide among Black males was actually contributing more to the gap than cancer, particularly at young ages, which is shocking,” Roberts said.

For women, heart disease contributed 3.24 years to the gap between Black and White women. Cancer contributed 2.36 years, and perinatal conditions contributed more than a half year.

Roberts and the team also looked at demographic changes that are widening the gap.

Between 2000 and 2017, the White population increased from 30 to 40 percent. The median income of White people jumped to $160,000 in 2017, an increase of $44,000 from 2007.

Meanwhile, the Black population declined by 16 percent during that time frame. The median income of Black people increased to $48,000 from $42,000.

The researchers suggest policymakers develop policies that target the causes of death. They encourage education about healthful diets, new walking and biking trails in Black neighborhoods and antismoking campaigns. They also called for more screening for early detection of breast, prostate and colorectal cancers. Community outreach, they suggested, could help lower the homicide rate.

While the District has a low percentage of uninsured residents, more than half of Black residents received public health insurance in 2018, compared with 13 percent of White residents.

“Different sources of healthcare coverage reflect unequal socioeconomic conditions for blacks and whites in Washington D.C.,” the authors wrote, “and they are likely indicative of differential access to the highest standards of care.”

Mingle recently moved to Ward 4. He said he now has “just about everything” at his fingertips. When asked about the inequities in the District, he said he did not know why things were the way they are. “I just improvised when I was there, and now I have things at ease,” Mingle said.

“As far as segregation and all, you can feel it,” Mingle said. “You can always sense it. I sensed it all my life.”

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