Race and Death

The concept of race is used to differentiate among groups based on criteria such as physical characteristics (e.g., skin color and hair texture) and sociocultural heritage. Ethnicity is a concept that focuses primarily on sociocultural heritage. In the study of health status, including death rates, race tends to be emphasized in order to compare differences between racial/ethnic minorities and the white majority group in society. Although there have been significant declines in overall death rates in the United States, health disparities persist across racial/ethnic groups. This review first identifies the major racial/ethnic groups in the United States. Second, the interaction between race, poverty, and death rate disparities is discussed. Finally, there is a call for further research to better understand factors that contribute to the large and persistent gap in mortality between racial/ethnic minorities and the white majority population.

U.S. Major Racial and Ethnic Groups

According to the 2000 U.S. Census, the racial/ethnic makeup of the American population was 12#x0025; African Americans, 3.6#x0025; Asians, 0.1#x0025; Native Hawaiians and Other Pacific Islanders, 0.9#x0025; American Indians and Alaska Natives, 13.3#x0025; Hispanics, and 70#x0025; non-Hispanic whites. Most blacks have ancestors who were African natives brought to the Americas as slaves. Other blacks belong to newer immigrant African groups from the Caribbean, Haiti, or other areas in the West Indies and South America. Asian immigrants came from more than 30 countries of origin in the Far East, Southeast Asia, or the Indian subcontinent. Native Hawaiians and Other Pacific Islander populations are from Hawaii, Guam, Samoa, or other Pacific Islands, while Hispanic or Latino Americans are people of mixed racial heritage who come from Cuba, Puerto Rico, Mexico, or other countries of Central and South America. American Indians and Alaska Natives are a relatively small but growing segment of the U.S. population and are native to North, South, and Central America. Non-Hispanic whites are people who immigrated to the United States from Europe, the Middle East, or North Africa. Currently, white Americans form the numerical majority in the United States, and collectively are better educated and economically situated than other racial/ethnic minorities, with the exception of Asian Americans.

Health Disparities by Race

It was long thought that racial health disparities were due to genetic differences in human populations. However, recent developments in the fields of genomics and medicine have shown that racial groups are more alike than different. Therefore, a focus on biology to explain health disparities underestimates the role that social, political, and environmental structures contribute to health outcomes. The life expectancy of most racial/ethnic minorities is shortened by social and economic inequalities and injustices that make for harsh [Page 838]living conditions and exposure to racism, prejudice, discrimination, violence, and poverty.

The Interaction of Race, Poverty, and Mortality

Research has indicated that health care and health status in the United States are stratified by income, race/ethnicity, education, and occupational status. Educational attainment and high socioeconomic status are positively correlated with health and mortality advantage, whereas low socioeconomic status and poverty are linked to health disadvantage. Poverty is strongly associated with mortality among racial/ethnic minorities, who are often living in substandard housing; experiencing high rates of unemployment or underemployment, often with inadequate or no health insurance; and are often victims of violent acts, drug use, and other threats to personal health and well-being. Area-of-residence studies consistently link high mortality with high-crime areas, high crime being more likely to occur in low-income communities.

...