Data shows massive disparity in excess deaths among Black Americans

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• Amna Nawaz:

  A pair of new studies from "The Journal of the American Medical Association" find that the toll of racial disparities in health for Black Americans is even starker than we knew.

  That's true both in lives lost and in enormous economic cost as well. From 1999 to 2020, Black Americans experienced 1.63 million excess deaths compared to white Americans. This resulted in 80 million years of life lost. COVID widened that gap in deaths even further, and the loss was felt especially among infants and older adults.

  In terms of economic cost, the "JAMA" study found that, in 2018, racial health inequities cost the U.S. an estimated $421 billion. Around two-thirds of that cost came from premature deaths.

  To explain the significance of this data, I'm joined by Dr. Lisa Cooper, director of the Johns Hopkins Center for Health Equity and the Bloomberg distinguished professor at Johns Hopkins University School of Medicine

  Dr. Cooper, welcome, and thank you for joining us.

  Dr. Lisa Cooper, Director, Johns Hopkins Center for Health Equity: Thank you for having me.

• Amna Nawaz:

  These numbers are absolutely staggering when laid out this way.

  You have long studied these issues. Were you surprised by these figures when you saw them?

• Dr. Lisa Cooper:

  Unfortunately, I wasn't surprised, although I have to say, though, I was disappointed, because I was hoping that we would have seen some improvement over what we saw in the last century. And it seems like the trends are looking pretty much the same.

• Amna Nawaz:

  It is now well-documented the systemic racism that exists specifically in our health care system in America. How much of these numbers is attributable to that?

• Dr. Lisa Cooper:

  So, I think it's important for us to note that structural racism is something that impacts all of our institutions. And so I think racism in health care contributes substantially to these statistics.

  But I think that racism throughout all of our institutions, and through our all of our policies is contributing to these disparities, because, really, those are the policies and practices that determine where people live, whether or not they have gainful employment, whether they can get a good education, whether they have access to healthy food, and access to health care.

  So all of these things shape up people's opportunities to live healthy lives and determine whether or not they die prematurely.

• Amna Nawaz:

  Dr. Cooper, these numbers are staggering when you look at them. But you still see a number of patients in your clinic.

  How do these numbers show up day to day in those patients?

• Dr. Lisa Cooper:

  Well, they show up in the young people I see. I see young adults, people as young as 30, 35 or 40, who already have hypertension, who already are obese, who already have had a stroke.

  I see people who are in middle age who have diabetes and have suffered amputations and can no longer work. And a lot of these people are from communities that have low income or they are African Americans, people who are Hispanics.

  I see people at very young ages with diseases that normally you would see in older people. So, it's very — it's painful and it's hard to see. And there are a few people that actually beat the odds, but the odds are definitely not stacked in their favor.

• Amna Nawaz:

  There is an economic component to this study as well, as we mentioned, the hundreds of billions of dollars in cost of those racial health inequities.

  Why, to you, is that an important part of this argument?

• Dr. Lisa Cooper:

  Well, I think it's an important part because I think, in lots of ways, our economy and our businesses, they respond to things like this.

  I think people don't realize the interconnection between health and productivity. Oftentimes, they see them as separate things. And if we can see that it's — that our health is connected to everything we do — we cannot work, we cannot innovate, we cannot compete successfully with other countries if we have poor health.

  And if we have poor health in certain groups of people in our country, that actually puts our entire country at a disadvantage. So I think it's important for people to understand the scope of the problem, that it's human suffering, and it impacts society in so many, many different ways.

  But economically is something that a lot of people really understand.

• Amna Nawaz:

  So, Dr. Cooper, what does it take to turn these numbers around?

• Dr. Lisa Cooper:

  Well, it's going to take a lot of work.

  But I think that one thing we need to do is to understand that we actually have science to inform a lot of the solutions. And what we need to do is to use what we know. As we generate more information and more science, we need to use what we know already. We know that early childhood education improves our health later in life.

  So we should support policies and practices that do that. We know a higher living wage, a higher income, or a minimum wage will improve economic opportunities and the health of people in their adulthood. We know that changing the life circumstances, the living conditions in neighborhoods and housing quality and access to food, we know all those things work to shape health.

  And we know that providing universal access to health care improves health care outcomes, and especially for those who can't afford it based on who they work for. So we — we just know a lot that we aren't implementing, because we need to generate stronger political will.

  And doing that means engaging with people in communities that are impacted by health disparities and making sure that they are civically engaged and that they have the know-how and the involvement and the input at the decision-making tables.

  And I think, in so doing, we will — we will achieve the goal, but it's something that everyone needs to understand that it impacts us all.

• Amna Nawaz:

  That is Dr. Lisa Cooper, director of the Johns Hopkins Center for Health Equity, joining us tonight.

  Dr. Cooper, thank you.

• Dr. Lisa Cooper:

  Thank you for having me.