Because so many Black people die young — with many years of life ahead of them — their higher mortality rate from 1999 to 2020 resulted in a cumulative loss of more than 80 million years of life compared with the white population, the study showed.

Although the nation made progress in closing the gap between white and Black mortality rates from 1999 to 2011, that advance stalled from 2011 to 2019. In 2020, the enormous number of deaths from covid-19 — which hit Black Americans particularly hard — erased two decades of progress.

Authors of the study describe it as a call to action to improve the health of Black Americans, whose early deaths are fueled by higher rates of heart disease, cancer, and infant mortality.

“The study is hugely important for about 1.63 million reasons,” said Herman Taylor, an author of the study and director of the cardiovascular research institute at the Morehouse School of Medicine.

“Real lives are being lost. Real families are missing parents and grandparents,” Taylor said. “Babies and their mothers are dying. We have been screaming this message for decades.”

High mortality rates among Black people have less to do with genetics than with the country’s long history of discrimination, which has undermined educational, housing, and job opportunities for generations of Black people, said Clyde Yancy, an author of the study and chief of cardiology at Northwestern University’s Feinberg School of Medicine.

Black neighborhoods that were redlined in the 1930s — designated too “high risk” for mortgages and other investments — remain poorer and sicker today, Yancy said. Formerly redlined ZIP codes also had higher rates of covid infection and death. “It’s very clear that we have an uneven distribution of health,” Yancy said. “We’re talking about the freedom to be healthy.”

A companion study estimates that racial and ethnic inequities cost the U.S. at least $421 billion in 2018, based on medical expenses, lost productivity, and premature death.

In 2021, non-Hispanic white Americans had a life expectancy at birth of 76 years, while non-Hispanic Black Americans could expect to live only to 71. Much of that disparity is explained by the fact that non-Hispanic Black newborns are 2½ times as likely to die before their 1st birthdays as non-Hispanic whites. Non-Hispanic Black mothers are more than 3 times as likely as non-Hispanic white mothers to die from a pregnancy-related complication. (Hispanic people can be of any race or combination of races.)

Racial disparities in health are so entrenched that even education and wealth don’t fully erase them, said Tonia Branche, a neonatal-perinatal medicine fellow at Lurie Children’s Hospital of Chicago who was not involved in the JAMA study.

Black women with a college degree are more likely to die from pregnancy complications than white women without a high school diploma. Although researchers can’t fully explain this disparity, Branche said it’s possible that stress, including from systemic racism, takes a greater toll on the health of Black mothers than previously recognized.

Death creates ripples of grief throughout communities. Research has found that every death leaves an average of nine people in mourning.

Black people shoulder a great burden of grief, which can undermine their mental and physical health, said Khaliah Johnson, chief of pediatric palliative care at Children’s Healthcare of Atlanta. Given the high mortality rates throughout the life span, Black people are more likely than white people to be grieving the death of a close family member at any point in their lives.

“We as Black people all have some legacy of unjust, unwarranted loss and death that compounds with each new loss,” said Johnson, who was not involved with the new study. “It affects not only how we move through the world, but how we live in relationship with others and how we endure future losses.”

Johnson’s parents lost two sons — one who died a few days after birth and another who died as a toddler. In an essay published last year, Johnson recalled, “My parents asked themselves on numerous occasions, ‘Would the outcomes for our sons have been different, might they have received different care and lived, had they not been Black?’”

Johnson said she hopes the new study gives people greater understanding of all that’s lost when Black people die prematurely. “When we lose these lives young, when we lose that potential, that has an impact on all of society,” she said.

And in the Black community, “our pain is real and deep and profound, and it deserves attention and validation,” Johnson said. “It often feels like people just pass it over, telling you to stop complaining. But the expectation can’t be that we just endure these things and bounce back.”

Teleah Scott-Moore said she struggles with the death of her 16-year-old son, Timothy, an athlete who hoped to attend Boston College and study sports medicine. He died of sudden cardiac arrest in 2011, a rare condition that kills about 100 young athletes a year. Research shows that an underlying heart condition that can lead to sudden cardiac death, hypertrophic cardiomyopathy, often goes unrecognized in Black patients.

Scott-Moore still wonders if she should have recognized warning signs. She also has blamed herself for failing to protect her two younger sons, who found Timothy’s body after he collapsed.

At times, Scott-Moore said, she wanted to give up.

Instead, she said, the family created a foundation to promote education and health screenings to prevent such deaths. She hears from families all over the world, and supporting them has helped heal her pain.

“My grief comes back in waves, it comes back when I least expect it,” said Scott-Moore, of Baltimore County, Maryland. “Life goes on, but it’s a pain that never goes away.”

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Racial bias prevents many people from attending adequate schools, entering promising careers, and accessing adequate healthcare. This bias also affects where they can find suitable housing, and that housing may contribute to health difficulties brought on by pollution or vermin infestation. The situation, undeniably, is untenable, and anyone who believes in human rights will find each of these impediments anathema.

All the above is clear, but taking the situation two steps further will reveal the hidden extent of the potential damage raining down on anyone who is a victim of this bias. And, most disturbing, this further damage to health happens in the medical realm.

Socioeconomic factors lead to health risks such as asthma, and the need for ongoing, accurate treatment for asthma is mostly with inhalers. The condition is so severe that frequent emergency treatment is sought. Compared with white people with asthma, African American people with asthma are five times more likely to visit the emergency room for symptoms.

One of the inhalers of choice for asthma is albuterol, and here, again, there is a problem with treatment. A study of over 1,400 children revealed a genetic lack of appropriate response to this drug in some patients. And problems in sampling were apparent. We and others have documented the implications and challenges posed by the lack of non-European study populations in biomedical research. Sampling bias is at the heart of one major problem in device engineering.

Once asthma treatment is sought, there still needs to be a resolution to the underlying measurement problem. While in the ER, how is the oxygen level of these patients determined? The usual initial route is to get a quick level using an oximeter slipped on a finger. It’s a rapid and supposedly accurate measure of how much oxygen the patient has in their blood; vital information.

Who questions the oximeter readings? The assumption is that the task is accurate because the device is FDA approved, made by a reputable company, and has been used for years in hospitals. But that conclusion is patently false.

The validity of the readings was made primarily on persons of European descent. How accurate would they be on anyone who did not meet that criterion? The answer would seem obvious.

Studies dating back to 2005 show pulse oximeters tend to overestimate the amount of oxygen a patient with darker skin may actually have in their blood. It’s simple physics: Melanin in skin absorbs some of the light the devices analyze to make their readings. The darker the skin, the more melanin there is, and the less light passes through.

If the readings are wrong, how does that have an impact on treatment? Again, no question that there is a bias in oxygen levels leading to changes in medical care.

The FDA issued an alert on oximeters, but did everyone dispose of their older, inaccurate devices in healthcare and the home? Other factors affect these readings, including poor circulation, skin pigmentation, skin thickness, skin temperature, current tobacco use, and use of fingernail polish.

NASA had developed guidelines and devices for more accurately measuring blood oxygen, but the corporation involved in it changed its marketing direction and the device was dropped.

We know that the disturbing use of oximeters tested in Japan (with a relatively homogenous population) may lead to delays in treatment in persons with darker skin. How is this permissible? It’s not, and the NASA devices should be considered again.

The post The Medical Device That May Lead to Harm in People of Color appeared first on Medika Life.

Improving cultural and racial education

Some insights from Diversity and Discrimination in Healthcare note that healthcare practitioners should learn to be aware of their biases to modify existing perceptions and behaviors. Healthcare providers must be willing to learn and self-reflect in an ongoing manner. Here, diversity education could work.

This is training to recognize their personal and institutional biases, then learning how to employ an attitude of curiosity with how patients’ unique contexts shape their health views or behaviors. Diversity education is more than a handful of classes, as it requires a cultural shift against stereotyping and microaggressions. It would help to introduce healthcare workers to diverse populations early on in their careers, maybe through internships or mentoring programs.

Investing in research diversity

Data gaps in current research indicate many disparities. For instance, findings on skincare issues are often skewed towards treatment of white communities; we commonly see symptoms photographed on white skin. Or, research connected to reproductive health may not consider perspectives from the transgender population. When populations are neglected in studies, this can drive poor health outcomes for entire communities.

In an article on inclusive research for Wheel, Ashwini Zenooz, MD highlighted two ways to diversify research: expanding participant pools for studies and clinical trials, and ensuring equitable funding for minority researchers. We need to recruit and engage with patients who truly represent the general population through strategies like remote trial capabilities, which can expand our reach. Next, we have to make sure that a diverse mix of researchers receive better funding; when subjects and patients encounter professionals who look like them, speak their language, and share their culture, they are more likely to cooperate — contributing to accurate findings.

Integrating community in leadership practices

A call to action from the University of Göttingen asked the global scientific community to pay more attention to researchers belonging to disadvantaged social groups in the wake of the pandemic. The crisis, they pointed out, will negatively impact early career researchers — particularly minorities of all genders, women, researchers from the Global South, and persons with disabilities. The university recommended that leadership in workplaces, institutions, and offices should actively strive to improve gender equality measures, targeted funding, and increased state aid.

Indeed, systemic change requires a top-down approach. Hospital leaders should exert effort to learn about the populations they serve and work with, so they can come up with institutionalized solutions and meet specific community needs. Conducting interviews and surveys with their stakeholders can activate real change, like decisions to invest in interpreters, provide Halal dietary options, or change their hiring practices. This commitment within policies and procedures will set the tone for the rest of the organization to follow.

The post Healthcare is Becoming More Inclusive — Here’s How appeared first on Medika Life.

First, a quick look at the scope of the problem. Worldwide, there are over 1.4 million men with prostate cancer. Prostate cancer represents about seven percent of all cancer cases.

Each year, over 375 000 will die from prostate cancer. This mortality number is nearly four percent of all deaths related to cancer.

Such statistics haunt me, driving me to continue to explore how we can work harder on the front end — risk-reduction — to reduce the probability of being diagnosed with, or dying from, prostate cancer.

Prostate cancer — risk factors (fixed)

Like all types of cancer, the exact cause of this male cancer isn’t easy to determine. Multiple factors may be involved in many cases, including genetics and exposure to environmental toxins, like certain chemicals or radiation.

Anything that can raise your risk of a disease (such as cancer) is a risk factor. Some of the risk factors for being diagnosed with prostate cancer include:

• Age. Prostate cancer risk rises with age. For whites with no family history of prostate cancer, the chances rise significantly after age 50. The risk increases for blacks or those with a close relative with prostate cancer at age 40. Approximately two-thirds of cases are among men 65 and older. However, the older a man with prostate cancer is, the less aggressive the disease tends to be, especially after age 70.
• Inherited genetics (family history). For most men with prostate cancer, the genetic changes associated with prostate cancer are acquired during life and are present only in specific prostate cells. These somatic variants are not inherited. The American Cancer Society offers that inherited mutations cause up to ten percent of prostate cancer cases.
• Race. The risk of prostate cancer is 1.8-times higher for African-American men (compared with white Americans). In addition, some studies indicate that prostate cancer tends to be more advanced among African-Americans. Interestingly, the risk is low in Africa and Japan but rises sharply for immigrants to higher-risk countries like the USA. We don’t know why.
• Geography. Prostate cancer is more common in the Caribbean, North America, northwestern Europe, and Australia. Rates are lower in Asia, Africa, Central America, and South America.

Prostate cancer — risk factors (changeable)

Here are some potentially modifiable risk factors:

• Vitamin D. Did you know that in the USA, men living north of 40 degrees latitude have a higher risk of dying from prostate cancer than those who live more south. The Prostate Cancer Foundation explains that this may be secondary to lower levels of sunlight (and therefore vitamin D). Whether getting more vitamin D reduces prostate cancer risk remains unknown.
• Smoking. Please don’t do it.
• Diet. Some studies suggest dietary fat is associated with prostate cancer. Those in countries with a high-fat diet also are more likely to eat fewer fruits and vegetables. There is speculation that meat and dietary products play a role, given places where people consume many of them have a higher risk (compared with places where diet centers on rice, vegetables, and soy products). Is there high-level evidence of a diet: prostate cancer relationship, in my view? In a word, no. Here are some thoughts from the University of California, San Francisco (USA).
• Obesity. While being obese may not raise one’s risk of prostate cancer, the extra pounds may increase your risk of getting more aggressive prostate cancer. That’s the conclusion of some, but not all, research.
• Sedentary behavior. Here’s the take of the Seattle Cancer Care Alliance: Studies have found that men who get regular physical activity have a slightly lower risk of prostate cancer. Vigorous activity may have a more significant effect, especially on the risk of advanced prostate cancer. Also, physical activity is associated with better survival in men with prostate cancer. About three hours a week of modestly vigorous activity may substantially improve prostate cancer survival.
• Ejaculate frequently. Men who ejaculate frequently have a lower chance of being diagnosed with prostate cancer. Perhaps they are clearing irritants out of the prostate.

Prostate cancer risk reduction — Action

Thank you for joining me today. The takeaway? Watch your weight, get some physical activity, and consider vitamin D (with K2). Frequent ejaculation may lower risk, too.

Thank you for joining me.

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