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Life Expectancy Gap Due
to Smoking, HIV, Diabetes
Excerpt
By Charnicia E. Huggins, Reuter's Health
NEW YORK (Reuters
Health) - Blacks and the less educated
in the US have life expectancies about 6 years shorter than their
white and better-educated counterparts, respectively. Now a new
report suggests that smoking-related diseases are largely to blame
when it comes to cutting the life expectancy of people with lower
levels of education.
And high blood pressure, HIV, diabetes
and homicide appear to be the greatest contributors to the discrepancy
in death rates among blacks versus whites, according to a team
of California researchers.
"Previous studies have found that
African Americans and those less educated have worse health outcomes
for a diverse array of diseases, thus, it has been difficult to
know where to focus our public health resources," lead study author
Dr. Mitchell D. Wong, of the University of California at Los Angeles
told Reuters Health.
"The study has important implications
for redirecting public health efforts and the allocation of future
research funding," he said.
Wong and his colleagues analyzed data
from the 1986 to 1994 National Health Interview Survey and estimated
death rates from various diseases, based on a life expectancy
of 75 years.
Overall, people without a high school
education were at risk of dying an average 9 years earlier than
high school graduates, while blacks were at risk of dying almost
2 years earlier than their white counterparts, the investigators
report in this week's issue of The New England Journal of Medicine.
These findings remained true when
the researchers took into account the study participants' age,
gender and race or educational level, the report indicates.
The diseases that most accounted for
the educational disparity in death rates were heart disease, lung
cancer, stroke, congestive heart failure, pneumonia and lung disease--all
smoking-related diseases.
In fact, eliminating heart disease--which
accounted for nearly 12% of the potential years of life lost--would
lead to a nearly 10-month gain in life expectancy, study findings
show. Similarly, eliminating lung disease--the second greatest
contributor to the educational disparity--would add about 6 months
to the life expectancy of less-educated individuals.
On the other hand, the discrepancy
in death rates among blacks, in comparison to whites, was largely
due to deaths from high blood pressure (hypertension)--which accounted
for 15% of the disparity, followed by deaths from HIV, diabetes
and homicide.
Eliminating the number one contributor to racial disparities--high
blood pressure--would lead to an almost 3-month gain in life expectancy
among blacks, and getting rid of HIV deaths would lead to a roughly
2-month gain in life expectancy, the report indicates.
In many studies on eliminating
racial disparities, researchers have focused on heart attacks
and cancer--the leading causes of death among African Americans
and whites, and differences in treatment, according to Wong. The
present study findings, however, "suggest that we need to pay
more attention to hypertension, HIV and diabetes, as well as homicide,"
he said.
The study did not investigate whether
health insurance, access to care or related factors might explain
the disparities in death rates, but the fact that smoking-related
diseases accounted for the top six contributors to the educational
disparity in life expectancy suggests "that interventions to prevent
smoking could have an enormous impact," the authors write.
"In addition, we know that African
Americans are more likely to get hypertension, HIV and diabetes,
and also tend to have more severe disease," Wong said. "Thus,
it is important to find out what the impact would be of improved
screening, prevention and treatment of these diseases on racial
disparities in life expectancy."
SOURCE: The New England Journal
of Medicine 2002;347:1585-1592.
Reference
Source 89
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