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Longevity Study Finds Wide Gaps Between Races, Classes

September 12, 2006 at 6:25 PM EDT
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GWEN IFILL: Why do some Americans live longer than others? Race, class, and gender have long been accepted as factors. Less clear has been why some groups are at greater risk than others.

In a new study, Harvard researchers reached some stark conclusions — among them, an Asian-American woman is expected to live nearly 21 years longer than an African-American male living in a major city.

For more on what these findings do and don’t tell us, I’m joined by “NewsHour” health correspondent Susan Dentzer.

Susan Dentzer, let’s — Susan, let’s take this point by point. Let’s walk through it.

That remarkable statistic I just read about Asian-American women, is that good news for Asian-American women?

SUSAN DENTZER: Well, it’s — it is astounding news, particularly when you look at Asian women in the U.S. vs. Asian women elsewhere.

There’s a difference, in terms of life expectancy, of three years, as over and against life expectancy for women, say, in Japan. Now, that’s the whole female population of Japan, just against the isolated pool of Asian-American women here in the U.S.

But it’s substantial. And it’s striking, and it’s a bigger magnitude of difference than we thought existed.

GWEN IFILL: And, yet, if you’re a — a black male living in the inner city, this is not good news.

SUSAN DENTZER: Absolutely not. Now, it’s not surprising news. We have known for a long time that that’s — you have a lot of risks growing up in the inner city as a — as a black male, in particular.

And what’s interesting about the study, though, is why. You could think of some reasons that you might think it might be especially dangerous, high homicide rates, high rates of HIV-AIDS. But the researchers looked at those things. And even when you strip out things like homicide, HIV-AIDS, you get very large differences in mortality.

And, interestingly, what they said that was largely due to was high rates of chronic disease. That’s what causes these high differences, these large differences in life expectancy around the U.S.

Demography and race

GWEN IFILL: Is that true as well among low-income whites, who also didn't fare so well in this study?

SUSAN DENTZER: Yes, very much so. Some viewers of our show may remember a piece we did several weeks back about a health fair in rural Virginia.

GWEN IFILL: Right.

SUSAN DENTZER: That's the population that this study speaks about, people in -- in Appalachian areas, again, very high rates of chronic disease, related to things that are preventable, in effect. It's tobacco use leading to lung cancer, emphysema, and so on. It's high rates of drinking.

It's a lot of obesity, related to things like diabetes and so forth. Those are the things that are driving up these differences in life expectancy, especially among middle-aged people, people between the ages of 18 and 64. Those are where the really striking differences in this study came clear.

GWEN IFILL: Now, these researchers decided to look at this question, which we have -- we have talked about before, but through a kind of a -- demographic lens that was driven by geography, as well as race.

How did they do that?

SUSAN DENTZER: Well, what they did was, they wanted to answer the question. We know that there are differences that are based on race and income, but we know that those differences -- the differences in life expectancy are so big, that just race and income don't explain that.

So, the question they asked is, how do we slice up the population, that we could tease out the answer to what's really driving the differences? And, so, they ended up grouping populations into eight groups around the country, some of them were very recognizable and understandable, Western Indians, the roughly one million people they found who live in or near Native American reservations.

Other groups are very large and amorphous. Two hundred and fourteen million people in this scheme end up in a big block called Middle America. And this doesn't mean the middle of the country. These could be people from California to New York. But, in effect, it's people in the vast middle who are, in one instance, white. And, then, in another group, they looked at black middle-class people.

So, they aggregated all the people into these different categories. And they said, what is really driving these differences in life expectancy? And that's where they came to the conclusion that the biggest difference is chronic disease, and, to a lesser degree, injuries that people suffer, sometimes linked to unhealthy behaviors, like getting into a car accident because you were drinking and driving.

Ambiguous racial divisions

GWEN IFILL: So, if you are a member of one of these groups, it's not just that if you are born, if you have the misfortune to be born a black male living in the inner city, you automatically have a lower life expectancy. These are behaviors that you can change or that an individual can change to drive these numbers up.

SUSAN DENTZER: Yes. And that was actually one of the criticisms of this study, which is that it doesn't -- by design, really -- doesn't get at the social processes that drive these things. It doesn't tell you, for example, why an obese person in North Dakota is obese and has diabetes, vs., say, an obese person in Virginia.

And, so, the question that really comes out of this study for many people is, now that we see all of these disparities, what do we do about it? What is the policy recipe that you use to address that? And that is where the study, the researchers, I think, presented a very hopeful scenario, hopeful against a very bleak picture, which is that, through public health interventions that we know work -- for example, we manage to get very high-income Americans in this country mainly to quit smoking.

We know those things work. What we have to really do is develop those public health strategies to reach the whole of the population. It's not built into people's genes. It's not wired into where they live. It's really a question of addressing these in a public health fashion.

GWEN IFILL: I have to say, looking at just a quick read of these findings, you wonder where are Latino Americans in this. You hear about Asian-Americans. You hear about Native Americans, black Americans, and this great middle, which -- America -- 90 percent of it, apparently, are white.

Where are Latinos, who are the biggest demographic group?

SUSAN DENTZER: They're actually in this study -- they're actually in this study. But the way data is collected, it's collected by race -- data relative to deaths and mortalities connected -- is collected by race, not by ethnicity.

So, actually, Hispanics show up in this study as either being listed as blacks or whites, depending on whether, frankly, they're light or fair-skinned. It's basically up to the funeral director in many states to decide what race you are when you're dead, and then report that to statisticians. So, they're here. They just show up as being part of white Middle America or other parts of white America vs. black America.

GWEN IFILL: OK, Susan Dentzer, thanks a lot.

SUSAN DENTZER: Thanks, Gwen.