Thursday, August 14, 2008

Life Expectancy in African-American Men: Improving, But Just Not Good Enough!

What is this mysterious killer with our black men in its sights? Disease that – for the most part – is preventable and treatable with great survivability. The recent untimely deaths of actor/comedian Bernard Jeffery McCullough, also know as Bernie Mac, and musician/singer Isaac Hayes, has re-focused attention to raising awareness and prevention of the premature deaths of African-American men.

Reports claim the life expectancy gap between men and women has decreased, but there are still significant disparities in health care among African American’s and ultimately our survival rates. According to the Centers for Disease Control the estimate of life expectancy at birth for the total United States population is 77.6 years. Men have a life expectancy of 74.8 years compared to 80.1 years for women. There has been an overall improvement in life expectancy for men, however, African-American men live approximately 6.2 years less than white men (69.2 years versus 75.4 years).

Why such a huge disparity?

African Americans make up approximately 13% of the U.S. population, but only about 2.5% of physicians and medical students. We are twice as likely as other ethnic groups to have a stroke; almost twice as likely as other Americans to have diabetes; we have the highest prevalence of high blood pressure in the world; and sadly, represent almost 50% of the new HIV/AIDS cases each year. Afircan-American men have one of the highest rates of prostate cancer in the United States, however a recent study published in the September 2008 issue of Cancer reports that we are less likely to be screened for the disease.

The American Medical Association’s (AMA) recent apology to African-American physicians for years of inequality plays a role in health disparities. Forty eight million people in this country are uninsured or under-insured. Even when health insurance and income differences are accounted for and the playing field is fair, AA men still receive fewer preventive services than white men such as flu shots and less aggressive procedures, like colonoscopy screening.

The AMA, however, is not completely to blame. As an African-American physician, I regularly see a general neglect for our health. Lack of exercise, poor eating habits, and the under-utilization of health care services are major pitfalls in our community.

“I have to go to work, Doc,” is a frequent excuse not to see the doctor, not realizing that once you have a heart attack or stroke, the disability associated with these medical problems could keep you from working forever.

In general, men tend to pay less attention to their health, smoke and drink more than women, and do not seek medical help as often as women. AA men frequently ignore symptoms and signs of disease, like chest pain (warning sign of heart disease), headaches (a stroke warning sign or brain tumor), and frequent urination (diabetes or enlarged prostate), and don’t seek care until there is a crisis. The end result is a late diagnosis of serious medical problems, which does not allow for aggressive treatment and potentially a poor overall outcome. Building a relationship with your physician and having family discussions regarding health are essential to better health.

Even in there early demise, Mac and Hayes have still found ways to inspire us. They will be missed, however, they have helped us to realize that we are not invincible and that regular checkups with our doctor, knowing our family history, eating healthy, and exercising are simple, but important ways to maintain good health.

(c)2008. Rani Whitfield, M.D.