Elizabeth B Pathak1. 1. Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, USA. dr.elizabeth.pathak@gmail.com.
Abstract
IMPORTANCE: Black men have the lowest life expectancy of all major ethnic-sex populations in the USA, yet no recent studies have comprehensively examined black male mortality. OBJECTIVE: The purpose of this study was to analyze recent mortality trends for black men, including black to white (B to W) disparities. DESIGN: The study design was national mortality surveillance for 2000 to 2014. SETTING: The setting was the USA. POPULATION: All black non-Hispanic males aged ≥15 years old in the USA, including institutionalized persons, were included. EXPOSURE: The 15 leading causes of death were analyzed. MAIN OUTCOMES AND MEASURES: Linear regression of log-transformed annual age-adjusted death rates was used to calculate average annual percent change (AAPC) in mortality. Black to white (B to W) disparity rate ratios (RR) and 95% confidence intervals (CI) were compared for 2000 and 2014. The most recent available social and economic profile data were obtained from the U.S. Census of Population. RESULTS: The top five causes of death for black men in 2014, with percentage of total deaths, were (1) heart disease (24.8%), (2) cancer (23.0%), (3) unintentional injuries (5.8%), (4) stroke (5.1%), and (5) homicide (4.3%). Significant mortality declines for 12 of the 15 leading causes occurred through 2014, with the strongest decline for HIV/AIDS (AAPC -8.0, 95% CI -8.8 to -7.1). Only Alzheimer's disease, ranked #15, significantly increased (AAPC +2.5, 95% CI +1.4 to +3.7). Significant black disadvantage persisted for 10 of the 15 leading causes in 2014, including homicide (RR = 10.43, 95% CI 9.98 to 10.89), HIV/AIDS (RR = 8.01, 95% CI 7.50 to 8.54), diabetes (RR = 1.88, 95% CI 1.82 to 1.93), and stroke (RR = 1.61, 95% CI 1.57 to 1.65). The B to W disparity did not improve for heart disease (RR 1.24 in 2000 vs. RR 1.23 in 2014), but did improve for cancer (RR 1.39 in 2000 vs. 1.20 in 2014). Death rates were significantly lower in black men for five causes, including unintentional injuries (RR = 0.83, 95% CI 0.80 to 0.84), chronic lower respiratory diseases (RR = 0.75, 95% CI 0.73 to 0.78), and suicide (RR = 0.37, 95% CI 0.35 to 0.39). CONCLUSIONS AND RELEVANCE: Total mortality significantly declined for black men from 2000 to 2014, and the overall B to W disparity narrowed to RR = 1.21 (95% CI 1.20 to 1.23) in 2014. However, significant black disadvantages relative to white men persisted for 10 leading causes of death.
IMPORTANCE: Black men have the lowest life expectancy of all major ethnic-sex populations in the USA, yet no recent studies have comprehensively examined black male mortality. OBJECTIVE: The purpose of this study was to analyze recent mortality trends for black men, including black to white (B to W) disparities. DESIGN: The study design was national mortality surveillance for 2000 to 2014. SETTING: The setting was the USA. POPULATION: All black non-Hispanic males aged ≥15 years old in the USA, including institutionalized persons, were included. EXPOSURE: The 15 leading causes of death were analyzed. MAIN OUTCOMES AND MEASURES: Linear regression of log-transformed annual age-adjusted death rates was used to calculate average annual percent change (AAPC) in mortality. Black to white (B to W) disparity rate ratios (RR) and 95% confidence intervals (CI) were compared for 2000 and 2014. The most recent available social and economic profile data were obtained from the U.S. Census of Population. RESULTS: The top five causes of death for black men in 2014, with percentage of total deaths, were (1) heart disease (24.8%), (2) cancer (23.0%), (3) unintentional injuries (5.8%), (4) stroke (5.1%), and (5) homicide (4.3%). Significant mortality declines for 12 of the 15 leading causes occurred through 2014, with the strongest decline for HIV/AIDS (AAPC -8.0, 95% CI -8.8 to -7.1). Only Alzheimer's disease, ranked #15, significantly increased (AAPC +2.5, 95% CI +1.4 to +3.7). Significant black disadvantage persisted for 10 of the 15 leading causes in 2014, including homicide (RR = 10.43, 95% CI 9.98 to 10.89), HIV/AIDS (RR = 8.01, 95% CI 7.50 to 8.54), diabetes (RR = 1.88, 95% CI 1.82 to 1.93), and stroke (RR = 1.61, 95% CI 1.57 to 1.65). The B to W disparity did not improve for heart disease (RR 1.24 in 2000 vs. RR 1.23 in 2014), but did improve for cancer (RR 1.39 in 2000 vs. 1.20 in 2014). Death rates were significantly lower in black men for five causes, including unintentional injuries (RR = 0.83, 95% CI 0.80 to 0.84), chronic lower respiratory diseases (RR = 0.75, 95% CI 0.73 to 0.78), and suicide (RR = 0.37, 95% CI 0.35 to 0.39). CONCLUSIONS AND RELEVANCE: Total mortality significantly declined for black men from 2000 to 2014, and the overall B to W disparity narrowed to RR = 1.21 (95% CI 1.20 to 1.23) in 2014. However, significant black disadvantages relative to white men persisted for 10 leading causes of death.
Authors: Suma Prakash; Rudolph A Rodriguez; Peter C Austin; Refik Saskin; Alicia Fernandez; Louise M Moist; Ann M O'Hare Journal: J Am Soc Nephrol Date: 2010-06-17 Impact factor: 10.121
Authors: Nancy Krieger; Anna Kosheleva; Pamela D Waterman; Jarvis T Chen; Karestan Koenen Journal: Am J Public Health Date: 2011-07-21 Impact factor: 9.308
Authors: Kari-Lyn Kobayakawa Sakuma; Jamie Felicitas; Pebbles Fagan; Charles L Gruder; Lyzette Blanco; Christopher Cappelli; Dennis R Trinidad Journal: Nicotine Tob Res Date: 2015-02-08 Impact factor: 4.244
Authors: Katriina Heikkilä; Eleonor I Fransson; Solja T Nyberg; Marie Zins; Hugo Westerlund; Peter Westerholm; Marianna Virtanen; Jussi Vahtera; Sakari Suominen; Andrew Steptoe; Paula Salo; Jaana Pentti; Tuula Oksanen; Maria Nordin; Michael G Marmot; Thorsten Lunau; Karl-Heinz Ladwig; Markku Koskenvuo; Anders Knutsson; France Kittel; Karl-Heinz Jöckel; Marcel Goldberg; Raimund Erbel; Nico Dragano; Dirk DeBacquer; Els Clays; Annalisa Casini; Lars Alfredsson; Jane E Ferrie; Archana Singh-Manoux; G David Batty; Mika Kivimäki Journal: Am J Public Health Date: 2013-05-16 Impact factor: 9.308
Authors: Gregorio A Millett; John L Peterson; Stephen A Flores; Trevor A Hart; William L Jeffries; Patrick A Wilson; Sean B Rourke; Charles M Heilig; Jonathan Elford; Kevin A Fenton; Robert S Remis Journal: Lancet Date: 2012-07-20 Impact factor: 79.321
Authors: Derrick D Matthews; A L Herrick; Robert W S Coulter; M Reuel Friedman; Thomas C Mills; Lisa A Eaton; Patrick A Wilson; Ron D Stall Journal: AIDS Behav Date: 2016-01
Authors: Richard G Watt; Anja Heilmann; Wael Sabbah; Tim Newton; Tarani Chandola; Jun Aida; Aubrey Sheiham; Michael Marmot; Ichiro Kawachi; Georgios Tsakos Journal: BMC Public Health Date: 2014-05-30 Impact factor: 3.295
Authors: Kameron J Sheats; Shalon M Irving; Jim A Mercy; Thomas R Simon; Alex E Crosby; Derek C Ford; Melissa T Merrick; Francis B Annor; Rachel E Morgan Journal: Am J Prev Med Date: 2018-08-20 Impact factor: 5.043
Authors: Karyn A Stewart; Stephen Ristvedt; Katherine M Brown; Erika A Waters; Kathryn Trinkaus; Natasan McCray; Aimee S James Journal: Am J Mens Health Date: 2019 May-Jun