Within the past two months, I have given the keynote speech at a health disparities conference in Chattanooga, Tenn. sponsored by the Tennessee Department of Health, moderated a panel in D.C. on the same subject for the National Medical Association and moderated a panel at yet another conference in Virginia organized by Hampton University’s Health Disparities Reduction Project.

At each event, the same point was made: Of the 15 leading causes of death in the United States, Blacks had higher death rates than Whites in 11 areas: heart disease, cancer, stroke, accidents, diabetes, flu and pneumonia, kidney diseases, septicemia, homicide, cirrhosis of the liver and hypertension. African-Americans had lower death rates than Whites as a result of respiratory diseases, Alzheimer’s, suicide and aortic aneurysm.

Professor David R. Williams, a senior research scientist at the University of Michigan’s Institute for Social Research, has done significant research in this area. He presented many of his findings to the audience at Hampton and has written about them in the National Urban League’s “State of Back America 2004.”

One of the most stunning points made by Williams was that although overall health has improved in the U.S. over the past 50 years, racial differences in health are unchanged or widened.

“The age-adjusted overall death rate for African-Americans was 20 percent higher than that of Whites in 1950 but 30 percent higher in 2000,” Williams says. “Similarly, a Black baby born in the U.S.A. was 1.6 times as likely to die before his/her birthday than a White infant in 1950, but is 2.5 times as likely in 2000.”

To show the significance of the gap, in 1985 the Department of Health and Human Services began using the term “excess deaths,” defined as the number of African-Americans who would not die each year if Blacks and Whites had the same mortality rates. According to the National Center for Health Statistics, there were 66,900 excess Black deaths in 1940; 50,900 in 1960; 80,600 in 1980 and 96,800 in 1998. From 1940 to 1998, according to the center, 4.27 million African-Americans died prematurely.

Whites in the U.S. are hardly a model.

Williams says that when the infant mortality and life expectancy figures are calculated for Whites alone, Caucasians fared poorly when measured against other industrialized nations. If Whites made up their own country, they would rank 24th in infant mortality deaths. At 5.8 deaths per 1,000 births, Whites would trail top-ranked Hong Kong (3.1), Japan (3.4), Sweden (3.4), Singapore (3.5), Finland (3.7) and seven other countries (Norway, Denmark, France, Austria, Ireland, New Zealand and Portugal).

When looking at international life expectancy rates, White women, averaging 80 years, would rank 19th and White men (74.5 years) would rank 20th. Men in Hong Kong live an average of 77.4 years, longer than males anywhere else. They are followed by Japan (77.2), Sweden (76) and Switzerland (76.3). Women live longest in Japan (84 years), followed by Hong Kong (83 years).

As a country, Blacks would rank 36th in infant mortality deaths (14.6 per 1,000 births). In life expectancy, Black men would rank 34th if measured against other men in the world (67.6 years). Black women would rank 35th among feamles (74.8 years).

“The subjective experience of discrimination is a neglected but important source of stress,” Williams points out. “Research indicates that acute and chronic experiences of discrimination are stressful incidents that are adversely related to physical and mental health.”

He adds, “A small but growing body of research indicates the health of African-Americans is adversely affected when they buy into the larger society’s negative characterization of Blacks.”

Even with the clear health disparities, Williams argues that race is less of a health factor than education and economic status.

“The differences in life expectancy by education, within each race and gender group (with the exception of White women) are larger than the racial differences,” he states.

However, that does not mean race can be ignored.

“The most disadvantaged White group (women who have not completed high school) has a lower infant mortality rate than the most advantaged Black group (college graduates),” he observes.

Because income, education and even where one lives help determine a person’s life expectancy, Williams argues that in order to eliminate these disparities, efforts should made to end housing discrimination, racism and unequal access to health care.