What ails Black women 2: Health and life

The employment and wage disparities now widening between Black and White women appear alongside substantial – and possibly increasing – health disparities. As the recent concern over breast cancer advice shows, Black and White women often inhabit different worlds in our healthcare system.

Consider the infant mortality rate, a good measure of women’s health and healthcare. The Black infant mortality rate (13.63) is 2.4-times the White rate overall of 5.76 (a shade worse than 10 years ago). Teen motherhood doesn’t explain this, as the race gap is actually smallest for mothers under age 20 – if there were more Black teen mothers, the overall gap would be smaller.

Source: National Vital Statistics Report (2005 data).

Even controlling for income, education, obesity, smoking, and some diseases, Black infant mortality is significantly higher. This presumably indicates worse healthcare, although some suspect the “physiologic effects of experiencing lifelong racism.”

The most striking of the recent reports was a scary analysis released earlier this year showing that Black women have been getting shorter: absolutely and relative to White women, and the same is not true of Black men.

Height within a group varies according to genetics, but height differences between groups indicate health and nutrition inequalities during childhood. Black women born in 1965 reached an average height of 5’4-1/2” (Michelle Obama is about 5’11”). Each cohort since then has been shorter, and the average for those born in 1980 is less than 5’4”. Black men and White men and women all grew taller during this period. Black men and White men are now separated by less than a quarter inch, but White women have opened up a gap of three-quarters of an inch.

The author of the analysis, John Komlos, believes obesity is the main factor driving the disparity, compounded by inequities in health care access and quality. He concludes:

The decline in [Black women’s] height is most likely related to the obesity epidemic caused by inadequate dietary balance. Black women in the age range 20-39 weigh some 9.5 kg (21.0 lb) more than their white counterparts. It appears that black females are experiencing a double jeopardy in the sense that both their increasing weight and the diminution of their physical stature are both substantial and are both probably associated with negative health consequences.

In some urban areas, the disparities between Black and White women are especially stark. That is the case in Washington, D.C., which pairs a disproportionately poor Black population with an above-average-income White population. There, Black women are more than 3-times more likely to be overweight or obese than Latina or Asian women, 5-times more likely than White women.

Obesity doesn’t explain everything, of course, and neither does other health behavior such as smoking. At just 17.3%, Black women have lower smoking rates than White women (21.5%).

Racism and discrimination are the hard-to-measure elephants in the room on both employment and health matters. That’s coming in the next entry.

Before: Work and wages

Today: Health and life

Next: Discrimination and repercussions