The study found that the mortality risk for poor black men, relative to similar white men, persisted even when taking factors like education, employment, and marital status into account.
Being poor more than doubles the risk of early death among black men, according to data reported in a research letter in JAMA Internal Medicine. These men live in social and environmental conditions that create a toxic stew, leading to unhealthy behavior, and at the same time limiting healthcare access.
“African American males are feared and marginalized in American society,” said the letter, signed by Alan B. Zonderman, PhD; Nicolle A. Mode, MS; Ngozi Ejiogu, MD; and Michele R. Evans, MD. “This lifelong ostracism facilitates cascading negative outcomes in education, employment, and interaction with the criminal justice system. The resultant poverty is a virulent health risk factor,” for these men.
Cardiovascular disease and cancer—especially lung cancer—are higher among the poor regardless of race and gender, but the results are particularly profound for black men, the study finds.
Researchers examined how gender, race, and socioeconomic factors affected overall mortality in the Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) study. In HANDLS, researchers recruited 3720 participants based on a several factors, and paid close attention to the differences above and below 125% of the federal poverty level.
They matched data to the National Death Index to obtain death rates and causes for participants, who enrolled between 2004 and 2009 and were followed through the end of 2013. They found black men below poverty status had a 2.66 times higher risk of mortality than black men living above the line. Black women and white women also had higher mortality risks if they lived in poverty, but the risk was smaller (for black women, the risk increased 1.77 and for white women, it rose 1.85).
Researchers found that the mortality risk among poor black men persists, compared with white men, even when adjusting for education, employment, and marital status, which the authors said should concern policymakers.
“Our findings at 125% of the poverty line suggest that revision of poverty threshold triggering eligibility for federal programs that influence quality of life, health, and equal opportunity should take into account premature mortality driven by poverty as a first step to address the vulnerability” of black men, the authors said.
Before the Affordable Care Act, men in this group might have very limited access to healthcare, depending on where they live. The expansion of Medicaid offers the chance for those who live in the 31 states that have expanded the program to gain healthcare access.
The study was funded by the National Institutes of Health.
Zonderman AB, Mode NA, Ejiogu N, Evans MK. Race and poverty status as a risk for overall mortality in community-dwelling middle-aged adults [published online July 18, 2016]. JAMA Intern Med. 2016; doi: 10.1001/jamainternmed.2016.3649.