Life expectancy: How can we address uneven declines?
Not so long ago, during the pre-pandemic 2019 period, the reported life expectancy at birth for non-Hispanic black, white non-Hispanic, and Hispanic populations was approximately 75, 79, and 82, respectively. . The higher life expectancy of Hispanics compared to others in the United States may come as a surprise to some.
This phenomenon, known as the “Hispanic Paradox,” was first noticed in the 1980s, and its legitimacy has been debated since. A host of explanations have been offered, including assumptions about “the healthy immigrant” (people who migrate to the United States are healthier than those who stay in their country of origin) and the “healthy immigrant” bias. salmon ”(less healthy American immigrants are more likely to return to their countries of origin). Other experts note that Hispanic communities have lower smoking rates and higher levels of social cohesion, which can certainly contribute to their presumed higher life expectancy. Ultimately, this difference remains poorly understood and is further complicated by research indicating that US-born Hispanics may have lower life expectancies than their foreign-born counterparts.
Now, recent life expectancy estimates from the Centers for Disease Control and Prevention (CDC) show an alarming change that highlights the disproportionate impact of COVID-19 on communities of color. Between 2019 and 2020, life expectancy fell more sharply among black and Hispanic populations compared to their white counterparts, by three years, two years and one year, respectively. In fact, the life expectancy gap between black and white populations has widened from four to six years, the largest gap since 1998. And the life expectancy advantage once held by populations Hispanics over whites went from three to two. In other words, the COVID-19 pandemic has resulted in a decrease in the life expectancy of all individuals in the United States, but this impact has been felt mostly by communities of color.
Many reasons for greater vulnerability to COVID-19
Many factors have contributed to this uneven decline in life expectancy. But these remarkable numbers remind us of the vulnerability of Blacks, Indigenous Peoples and People of Color (BIPOC) in the United States, a result of long-standing unequal access to health care and the resources necessary to achieve upward economic mobility. . Many populations of BIPOC in the United States are living on the brink of collapse. With little health or financial reserves, these communities are increasingly vulnerable to sudden events, such as the financial collapse of the early 2000s or a global pandemic.
Racism operates largely through structural barriers that benefit some groups and disadvantage others. Rather than causing new disparities, the COVID-19 pandemic has simply exposed the chronic failings of our social policies and health care delivery for our BIPOC communities. Recently, the CDC recognized this and declared racism a public health threat that harms the health and well-being of the BIPOC populations.
Long-standing systemic failures lead to overall poor health
Abnormally high and sustained exposure to stress during pregnancy and infancy leads to a sustained release of inflammatory and stress-related hormones such as cortisol, resulting in toxic levels of chronic stress. Racism causes chronic stress, which affects the development and well-being of BIPOC children. In addition, many BIPOC children are generally less likely to thrive. They live in neighborhoods plagued by widespread poverty caused by long-standing discriminatory policies such as redlining and residential segregation. These factors worsen, ultimately leading to higher levels of cardiovascular disease, mental illness and risky health behaviors. Known as aging, it contributes to both a decrease in lifespan and lifespan (the period of a lifetime that a person is healthy).
In addition, people at BIPOC in the United States constantly face barriers to accessing quality health care. Examples include higher rates of uninsured and underinsured, and lower health care literacy. Ubiquitous biases and discriminatory policies run deep in our health care delivery infrastructure. The CDC report’s findings should therefore come as no surprise: A population chronically deprived of accessible prevention services would be expected to fare badly during a pandemic.
Moving Forward: What Changes Could Help?
We can all raise our voices to persuade and support the efforts of government officials at all levels and health officials to address the immediate disparities related to the ongoing pandemic and chronic loopholes that make BIPOC communities more and more vulnerable. Below are several steps that could move our system in the right direction.
Ordinary citizens can
- Vote in all elections – especially local elections. Local officials, such as the mayor, city manager, members of city council and the county sheriff, can affect the lives of citizens even more personally than state or federal officials. Local media and websites may have information on political opinions and background to help you choose candidates.
- Beware of fake news spread on social media. Social media puts a wealth of information at our fingertips, but also offers ways to spread false information that can greatly affect our decisions. Try to maintain a good level of skepticism. Check the information with reliable sources. These common sense tips can save you from falling victim to fake news.
- Support local organizations. Local nonprofits and community organizations play a major role in helping to address COVID-19 disparities affecting BIPOC communities and in fighting for vaccine testing and equity. If you are financially able, consider donating to local nonprofits, food banks, and community organizations so they can continue to help when needed.
Policy makers and government leaders can
- Fix unemployment insurance. Inject federal funds into renovating the unemployment insurance infrastructure of crumbling states and pass legislation requiring standard minimum benefits to be provided by all states.
- Make universal health a reality. Ensure that universal health insurance is achieved, whether through a public option, a single payer, or a host of other alternatives. Americans deserve equitable access to quality health care, especially preventive care.
- Eliminate historically racist and discriminatory policies. Eliminate discriminatory practices like gerrymandering that contribute to the continued disempowerment of voters, residential segregation and pervasive poverty, leaving communities of color in needy circumstances speechless.
Editor’s Note: At Dr. Perez’s request, terms used to describe all races and / or ethnicities are capitalized in this article, to reflect his view on racial identity and fairness.
Life expectancy afterwards: how to deal with uneven declines? first appeared on the Harvard Health Blog.
Our sincere thanks to