Usually, more education leads to better health, even though black men in the U.S. don’t get the same benefit as other groups, the research suggests.
The reasons for the gap are annoying, experts said, but they can provide an important window into the unique challenges black men face as they try to gain not only good health but also a level of equality in the world. United States.
In general, higher education means better paid jobs and health insurance, healthier behaviors and a longer life. This is true in many demographic groups. And studies show that life expectancy is higher for educated black men (those with a college or higher education) compared to those who have not finished high school.
But the increase is not as great as it is for whites. This adds to the many health barriers that black men already face. They are more likely to die from chronic diseases such as cardiovascular disease, diabetes and cancer than white men, and their average life expectancy is lower. Experts point to several factors that could play a role, but many said racism is the most widespread.
Researchers point out that black women face many of the same challenges as black men, but black women tend to have a longer life expectancy than black men. (They also point out that it is difficult to draw conclusions about Hispanic residents due to the lack of studies on the problems.) As a result, many experts said the health problems stem from a persistent devaluation of black men in society. American.
“At all levels of income and education, there is still a race effect,” said David Williams, a public health professor at Harvard University who developed a scale nearly 30 years ago that quantified the connection between racism and health.
The precise difference in health gains between educated white men and educated black men is difficult to pinpoint because of differences in study designs. Some studies, for example, look at life expectancy, while others look at the burden of illness or depression.
Experts said, however, that the evidence is strong and compelling that these gaps have persisted for many years. A 2012 study published in Health Affairs, for example, found that the life expectancy of white men with more education was 12.9 years longer than in white men with less education. For black men, the difference was 9.7 years.
In addition, other research shows how this gap develops. A 2019 study examined years of “lost life” (years cut short by health problems) between groups. According to the study, published in the Journal of Health and Social Behavior, educated black men lost 12.09 years, while educated white men lost 8.34 years.
Racism affects the health of black men and is persistent, experts said.
“No matter how far you go to school, whatever you do, you’re still a black man,” said Derek Novacek, who holds a doctorate in clinical psychology from Emory University and is researching black-and-white health differences in at UCLA.
S. Jay Olshansky, a professor of epidemiology and biostatistics at the University of Illinois at Chicago and lead author of the 2012 study, said potential risk factors for various diseases and environmental problems could also play a role: ” “I would be very surprised if this was not part of the equation. The risk of diabetes and obesity is much higher in the black population, even in those with a high education.”
Other possible causes investigated by researchers include stress and depression.
“When you follow other groups, with more education decreases depression,” said Dr. Shervin Assari, an associate professor of medicine at Charles R. Drew University of Medicine and Science in Los Angeles County, California, who studies race, the gender and health. “But when you look at black men, you guess what? Depression is on the rise. “
Depression is often an indicator of physical well-being and a contributing factor to many chronic diseases, such as hypertension, obesity, and diabetes.
Researchers who study the health of various ethnic and racial groups, as well as the social factors that influence health outcomes, see cause for concern. The findings suggest that the power of discrimination to harm the lives of black men may be more persistent than previously understood. And they could mean that improving the health of black men can be more complicated than previously thought.
“What has surprised me is how powerfully and consistently discrimination predicts ill health,” Williams said.
COVID-19 has highlighted the problem. As early as last April, researchers noticed higher mortality and hospitalization rates for blacks. Patterns have persisted, with black patients almost twice as likely as whites to die from the virus and black men having the highest death rates from COVID.
The results of COVID, Williams and others suggested, helped to point out that the health and well-being of middle-class, educated black men has been overlooked.
Higher education has not brought about the health equity that many experts had hoped for. Although black men are in worse health than other groups if they are not educated, they cannot catch up with their white peers even if they are.
“What society has done to black men is to corner them,” Assari said.
Black men, even with educational backgrounds, have a lower social and financial safety net than white men. This promotes stress, experts said. Also, while black men climb a corporate, academic, or managerial ladder, many feel isolated. And social isolation harms health.
Thomas LaVeist, a sociologist and dean of Tulane University School of Public Health, said that in a white-dominated society, black men are less likely to have high-income relatives or social and business connections that can open doors for them. . And once hired in the workplace, they are less likely to have mentors, LaVeist said, and the lack of connections is associated with stress, depression and other factors that can lead to worse health.
“There needs to be a designated effort to offer a ramp” to black men, he said.
And they may have experienced more accumulated adversity and continued racism.
“Your high socioeconomic status does not protect you from the impact or incidence” of racism, Dr. Adrian Tyndall, associate vice president of strategic and academic affairs at the University of Florida Health.
“That’s hard,” added Tyndall, who is black. “If I came out of this institution into the community, where people don’t know me, they could say the word N. And yes, that’s pretty depressing.”
The cumulative effect of discrimination has a psychological and physiological weight, but so does anticipation.
“It’s not just the actual exposure in dealing with these kinds of experiences, it’s“ What do you do before you leave home? “You take care of your dress, your behavior, your way of looking because of the threat of discrimination, and that’s how you react,” said Williams, a Harvard professor.
For example, when Williams, who is black, became a professor at Yale University for the first time, he wore a coat and tie every day. No one else in his department did that. And yet, he said, he kept practicing for years.
LaVeist recalls getting on an elevator at an academic medical center around 1990, shortly after earning his doctorate, and a passenger wearing a white robe (presumably a doctor) assumed LaVeist was working in the cleanup. The man asked LaVeist, who was wearing a suit, to clean up a spill on the sixth floor.
“When I told him I was a teacher, he wasn’t talking,” LaVeist said. “He just didn’t talk.”
Greg Pennington, 67, of Atlanta, holds a doctorate in clinical psychology from the University of North Carolina and a bachelor’s degree from Harvard, owns a professional consulting firm and has worked with hundreds of men individually. as well as with dozens of Fortune 500 companies. “It’s not so much that [Black men] they experience discrimination and depression “even after” they have advanced degrees, “he said.” It’s more descriptive to say ‘throughout the process.’
Despite their academic credentials, black men said, they often feel the need to prove themselves, which adds another layer of stress.
“It’s almost as if I couldn’t fail; I am a representative of other black men, “said Woodrow W. Winchester III, director of professional engineering programs at the University of Maryland-Baltimore County.” Your courage and success are to advance the collective. “.
The conclusion, according to experts, is that discrimination has a persistent effect on health.
Dana Goldman, director of the USC Schaeffer Center for Health Policy and Economics, co-authored the 2012 study on health issues on these chasms. Goldman said he agrees that the underlying cause is racism and added that he believes one solution is to improve education. He and others suggested that schools, starting in lower grades, should provide black students with more culturally appropriate curricula that reinforce their own image and help build social relationships between black and white youth. These efforts must continue as students move toward higher education.
“The political remedy is not just less racism, but improving the quality of our schools, job security and public health,” Goldman said.
Others agree that the results suggest the need to reconsider general changes in education, housing, and the judicial system, so that black men feel safe and supported in their search for better education and jobs.
It will be a long-term project, said Williams, a Harvard professor.
“We need a Marshall Plan for all unauthorized Americans,” he said, but one that specifically addresses the implicit biases and how American society sees and treats black men.