Morbidity

All ethnic populations are prone disproportionately to some conditions rather than others in comparison to other ethnic groups. The causes for this are multiple and include ethnicity, culture, education, income, and barriers encountered when accessing health care. Cultural differences regarding diet and exercise may combine to predispose individuals to some of these conditions.

For African Americans, these conditions include (Mouton, 1997):

hypertension
coronary artery disease
stroke
end stage renal disease
diabetes
certain cancers

Hypertension, Coronary Artery Disease and Stroke

These have been recognized for decades as major risks for African American older adults. In the 1980s, 37% of Black males and 64% of females age 65 and over were reported to have hypertension. There is an inverse relationship between socioeconomic status and blood pressure, so that those in poverty have a higher risk. Also, African Americans between the ages of 45-64 are 2-5 times more likely to die from heart failure than Caucasians in the same age group (Duster, 2007).

Cancer

Prostate

A major type of cancer affecting older African American men is prostate cancer, in which they have a 60% excess incidence (Richardson, 1996). Black non-Hispanic males have been found to have twice the risk of prostate cancer as Black Hispanic men (Manton, 1997).

Breast

Breast cancer incidence seems to be about the same or lower for African American women as other women, but the survival rate is lower. The survival rates appear to be improving, but the stage at which the tumor is diagnosed is still later for Black women.

Factors associated with the late stage diagnosis are:

limited access to care
care in public rather than private clinics
higher body mass index
lower rates of mammography

Cervical

Cervical cancer risk is higher among African American women (Manton, 1997). Incidence and mortality for multiple myeloma cancer among Blacks are twice that among Whites, and the risk increases with age. (For complete discussion of causes of racial differences in cancers see Manton and Stallard, 1997).

Survival Rates

Figure 2 shows a comparison of cancer survival rates between Black and White patients. With the exception of Mesothelioma, Blacks tend to have a lower survival rate than Whites. Sizable disparities are seen in Breast, Corpus & Uterus, NOS, Larynx, Non-Hodgkin Lymphoma, Oral Cavity & Pharynx and Kaposi Sarcoma.