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Black people in the United States are more likely to develop certain conditions or have worse outcomes from those conditions. The reasons for this are often some combination of genetic, social, and economic factors.
Several conditions impact Black communities more strongly than other racial groups. Some of these conditions are more common among Black people. In others, Black people may have worse outcomes or develop conditions earlier.
The reasons for these disparities are complex and often intertwined. In this article, we’ll review conditions that disproportionately affect Black people in the United States and the reasons behind the disparities. We’ll also address what Black people can do to close the health gap for these conditions.
Before we delve into the conditions, it’s important to understand why some of these disparities exist. In some cases, it can be a matter of biology and genetics. But in most cases, the disparities are rooted in several systemic issues.
Known as social determinants of health (SDOHs), these nonmedical factors can influence health outcomes. Experts group SDOHs into
- Economic stability: Lack of income or employment can be a significant barrier to stable housing, as well as access to medical care and nutritious foods.
- Education access and quality: Not only is your level of education often tied to your income, but
education can play a role in helping you live a longer and healthier life. - Healthcare access and quality: Black people in the United States are more likely to be uninsured or underinsured than their white counterparts. They also report receiving a lower standard of care.
- Neighborhood and environment: Living in an area with high rates of violence or pollution can significantly affect your health. You might work in a job that exposes you to greater health risks.
- Social and community context: Mistrust of the medical community may be deeply entrenched in some pockets of the Black communities.
An underlying theme throughout all the SDOHs is the impact of systemic racism. Historically racist attitudes and policies have led to the disparities mentioned above.
Now let’s look at how these factors can influence Black people’s experiences with certain health conditions.
Despite having lower rates than white people, Black people in the United States are 30% more likely to die from heart disease. It’s also more likely to affect Black adults at a
As for many of the conditions where health disparities exist, the reasons are complex. But it’s worth noting that Black Americans have higher rates of the major risk factors for heart disease — hypertension, obesity, diabetes, and smoking.
While genetics and SDOHs may affect your ability to control these risk factors, they are modifiable and offer an opportunity to close the health gap.
Black adults in the United States are 30% more likely to have obesity than white adults. This disparity is even greater for children and teens (50%) and women (50%). Obesity is a risk factor for several conditions on this list and can contribute to worse outcomes for other conditions.
This disparity often has economic and geographic causes. Disparities in income affect people’s ability to buy healthy food options. Some people may live in food deserts or spaces where physical activity is challenging or unsafe.
Black adults in the United States are
Complications from diabetes, like kidney disease, are also more common among Black people. Efforts to control risk factors like obesity and a sedentary lifestyle are of utmost importance.
According to the American Heart Association (AHA),
The AHA lists obesity and diabetes as two major contributing factors. But stress and racial discrimination might also play a role in this disparity.
The same steps you take to control other risk factors related to heart health can help reduce your risk of hypertension or control your blood pressure if it’s already high.
A stroke occurs when enough blood can’t get to your brain, usually due to a blockage in an artery. As with other conditions relating to cardiovascular health, Black adults in the United States are
High blood pressure and diabetes are major risk factors for stroke. But so are high cholesterol, stress, and smoking. A heart-healthy lifestyle can also help reduce your risk of stroke, even if you have a family history of it.
Sickle cell anemia (SCA) is a rare genetic disease that affects hemoglobin in your red blood cells. It affects how much oxygen your red blood cells can deliver to your organs and tissues.
While only 1 in every 16,300 Hispanic American babies is born with SCA, the condition affects
But disparities in healthcare access and quality can also affect people with SCA. Many have trouble obtaining the pain medications they need to manage their conditions because of racist beliefs about Black people’s perception of pain or concerns over opioid misuse.
SCA is a lifelong condition with symptoms starting in childhood. Finding a culturally competent doctor who understands the impact of the disease on Black families can make a big difference.
According to the
The ACS also acknowledges that these disparities are more due to socioeconomic factors and access to care than to any biological reason.
Some of these cancers include:
- Breast cancer: Black women are 41% more likely to die from breast cancer than white women.
- Prostate cancer: Black men are 73% more likely to develop prostate cancer than white men and are twice as likely to die of it.
- Colorectal cancer: Largely due to disparities in screening, Black people are 20% more likely to develop colorectal cancer. This disparity only developed in the last 30 years.
- Lung cancer: Black men are 12% more likely to be diagnosed with lung cancer than white men. Both Black men and women are more likely to be diagnosed younger.
- Multiple myeloma: This blood cancer is twice as common in Black people than in white people.
According to the National Kidney Foundation (NKF), Black people in the United States are more than three times as likely as white people to have kidney failure. They attribute this to higher rates of risk factors in People of Color. Such risk factors include diabetes, obesity, and high blood pressure.
Doctors use a test called the estimated glomerular filtration rate (eGFR) test to assess your kidney function. But this test often estimates Black people as having higher kidney function than they actually do. This can delay detection and treatment.
The NKF has eliminated this calculation and is working to ensure that labs across the country follow suit.
The key to management is early detection. But because a higher percentage of People of Color are uninsured or lack quality healthcare access, many do not detect kidney disease until its late stages.
Asthma occurs when the airways in your lungs narrow, making it difficult to breathe.
Not surprisingly, this condition disproportionately affects children in communities with poor air quality. Black communities have been the target of environmental racism, resulting in exposure to higher levels of air pollution.
According to the Asthma and Allergy Foundation of America, asthma is 50% more common in Black people in the United States than in white people. They’re also five times more likely to visit the emergency department due to asthma and three times more likely to die from it.
But these rates have been declining since the introduction of the Affordable Care Act when many more people gained insurance and access to health services.
African Americans felt the brunt of the HIV and AIDS epidemic in the 1980s. That disparity is even more pronounced today, with Black people making up
According to the Kaiser Family Foundation, the impact is felt greatest among women, young people, and men who have sex with men. About two-thirds of Black U.S. adults and adolescents living with HIV live in southern states.
HIV treatment options have improved significantly since the 80s. Antiretroviral therapy can decrease the amount of virus in your body to where it’s almost undetectable. This lowers the risk of passing the virus on to another person.
The early months of the COVID-19 pandemic highlighted the impact of racial disparities in our healthcare system and our country as a whole.
In May 2020, Black people were more than three times more likely to be admitted to the hospital for COVID-19 than white people. They also died at almost twice the rate.
Many of the conditions that are more prevalent in the Black community, like obesity and sickle cell disease, can increase your risk of
A year into the pandemic, Black Americans were still less likely to be vaccinated than white Americans. This vaccine hesitancy was in part fueled by medical mistrust rooted in historic injustices involving vaccines. It took until 2 years into the pandemic for Black Americans to be vaccinated at the same rate.
In a 2022 report from the Pew Research Center, 79% of Black U.S. adults surveyed thought they were less likely to receive advanced care from medical professionals. Respondents reported feeling rushed, disrespected, or not having their pain taken seriously.
It can help to find a healthcare professional who understands the unique health concerns of Black people in America.
Many healthcare systems are working to provide better cultural competency. And many healthcare professionals have the background and expertise necessary to understand your unique health needs and offer you the care you deserve.
Still, you might just prefer a Black doctor — and that’s okay.
A 2019 study found that Black men had improved outcomes when they saw Black doctors. The men were more likely to discuss other health issues and undergo preventive screenings. The doctors were more likely to take detailed notes.
But according to the Association of American Medical Colleges, Black doctors account for only 5.0% of all active physicians. This can make finding someone with lived experience a bit challenging. It can be even harder if you’re uninsured or on a public plan like Medicaid.
Thankfully, there are organizations and websites that can help you make a connection.
The reasons why some health conditions are more common among Black people are complex and interconnected. We need overarching changes in our political, social, economic, and medical systems before we can really close the gap.
But until then, there’s much we can do on our own to take control of our personal health. That means understanding our risk, making healthy life choices, and taking appropriate actions to prevent or manage these conditions.
And remember — it’s always okay to advocate for the care you need and deserve.
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