Minnesota’s racial equity gaps are part of the problem
In Minnesota, racial disparities in life expectancy for Black men and other men of color are fueled in part by gaps in socioeconomic status and educational inequalities. The state’s racial wealth gap is one of the worst in the nation. The income inequality gap between Blacks and Whites is only worse in Washington, D.C. Minnesota also ranks worst of all 50 states for racial disparities in high school graduation rates.
As educational attainment and wealth remain significant predictors of life expectancy, these racial disparities spell disastrous consequences for Black longevity. The impact of these gaps on life expectancy is especially evident for Black men, who live an average of just under 67 years in Minnesota.
Beyond the institutional factors at play in life expectancy gaps, healthcare-related habits passed down through generations may further complicate Black men’s health.
Dr. James Hill is a community internal medicine doctor with the Mayo Clinic in Rochester, Minnesota. Principles of human learning and behavior, including modeling, impact the Black community’s complex relationship with healthcare providers, Hill said.
Mistrust of medical community
“From my experience, skepticism and mistrust of doctors and the healthcare system have a role to play in not seeking care, and in avoiding recommended care,” Hill said. “This mistrust has roots in very real atrocities. But the past should not completely affect us today.”
Hill noted that the top 10 causes of death for Black men and White men don’t differ significantly: heart disease, cancer, stroke and diabetes are top killers of men in both groups. Proper management of these chronic diseases is crucial, but they may be impacted by personal healthcare habits.
“These diseases require regular follow up, which can help one avoid heart attacks, strokes, dialysis, and even erectile dysfunction,” Hill said. “Blood pressure control is important. Cancer screening is important. Managing stress is important, even if it means considering medication,” he added.
Black men face other barriers to accessing medical care. They are, for example, far less likely than White men to have health insurance.
In terms of the top causes of mortality, one significant difference between Black and White men stands out. Homicide is the fifth-leading cause of death for Black men according to the Centers for Disease Control, but it does not appear at all among the top 10 causes of death for White men.
Racism and Black longevity
Homicide and poor management of chronic diseases both have an adverse impact on Black longevity and could be tied to levels of self-worth.
“Self-worth comes into play when we think about the effects of racism in all its forms,” Hill said. “Unlike structural racism and interpersonal racism, internalized racism affects how one views their own race and personhood. This affects self-worth. We have adopted this slogan ‘Black Lives Matter.’ We need to ensure that we also believe it.”
A growing threat to Black men’s longevity is the increasing rate of suicide over the past decade. Suicide rates for Black men have historically been low but are increasing. For Black male teens and young adults between the ages of 15 and 24, suicide is the third-leading cause of death, according to the U.S. Department of Health and Human Services. In 2018, the rate of suicide among Black men was four times greater than among Black women.
The Black Men’s Health Project is a national initiative aimed at gaining a greater understanding of the unique health challenges of Black men in order to develop solutions that improve their health outcomes.
Dr. Roland Thorpe is the founding director of the Program for Research on Men’s Health at Johns Hopkins University. There is a lack of available research specific to the health of Black men, Thorpe explains in a video on the project’s website. “There is no national dataset that focuses exclusively on Black men,” he says. “We found things such as discrimination, microaggressions and medical mistrust. Those are the few things that we’ve found so far that are linked to the health of Black men.”
Fortunately, families and individuals can take steps on a household level to improve health outcomes for Black men. “Start the conversation about the value of health and longevity,” Hill said.
“Model good behavior by going to a primary care provider for an evaluation. Ask friends about trusted providers if you are uncertain. Be open to adapting the food you eat to a healthier option.”
Hill also encourages people to learn about the diseases that run in their family, and to be more proactive about screening and preventative measures.
“We need to speak about the diseases in our family so that our loved ones have a better chance at addressing issues before it is too late,” he said.