By Jabari Asim
What does it say about our culture that African-American men living in the nation’s inner cities have a life expectancy roughly equal to that of people of similar age living in West Africa?
WASHINGTON—Back in my days as an aspiring poet in the Midwest, I frequented spoken-word gatherings and open-mike nights with a group of like-minded folks. One of them, Percy Wells, used to perform this attention-grabbing poem that began, “Where in the (expletive) is Bangladesh?’’ Whereas Percy often sang his lines in a charismatic, jazzy drawl, he would spit that poem out with all the force of a saxophone blast. It wasn’t an ode to geographic confusion: He knew where Bangladesh was.
Percy had heard about a 1990 article in the New England Journal of Medicine which concluded that a black man living in Harlem was less likely to reach 65 than a “comparable’’ man living in Bangladesh. He wanted to know why the odds of living a long and healthy life were so daunting for African-American men such as himself. His poem went on to ask how men living in the world’s wealthiest nation could somehow be worse off than men living in a nation where more than a third of the population lived on less than $1 a day.
More than a decade has passed since I first heard Percy recite that poem, but its central question still resonates. I found myself thinking of it while reading about a new longevity study published in PloS Medicine, the Public Library of Science’s online journal. The study found that middle-aged African-American men living in the nation’s inner cities have a life expectancy roughly equal to that of people of similar age living in West Africa. It’s hard to escape the feeling that black men’s health statistics are often compared to those of people in other countries because they’ve run out of analogies here in the United States.
The numbers only reinforce that suspicion. Of all the groups covered in the PloS report, black men in the inner cities had the shortest life expectancy, 66.7 years. Guess who fared just slightly better? Rural black men, who can expect to live 67.7 years. So it seems that for black men living anywhere in the United States—tenement, townhouse, mansion or farm—the bell will likely be tolling significantly sooner than it will for their countrymen. No surprise there, since the article in the New England Journal of Medicine said as much. What is surprising, however, is that 16 years have come and gone between the appearance of these two studies. And black men’s health prognosis remains mostly unchanged.
Blackness has always been an undefinable concept, despite frequent efforts over the centuries to pin it down. These and other studies suggest its meaning may soon derive less from a shared set of experiences, values and viewpoints than a common set of medical conditions. Instead of calling ourselves African-Americans we could opt for something ominous yet accurate, such as Short-Timers.
Meanwhile, undoubtedly critics will mount their soapboxes to denounce black men as victims of their own self-destructive behavior. Their accusations, as usual, will be partly true. Some black men engage in reckless pursuits such as unsafe sex, drug abuse and shooting up neighborhoods. It’s easy to condemn them if they bring about their own undoing, even as we reserve our compassion for their unfortunate victims. But the overwhelming majority of black men live upright lives—and their lives also tend to be shorter than those of their nonblack counterparts. For example, consider, as The Washington Post has reported, that “high mortality in urban black men persists even when homicide and AIDS are removed.’‘
That points to other ailments, such as heart disease, stroke and diabetes, and factors such as lack of access to quality healthcare. To be sure, irresponsible lifestyles can also be the cause of those maladies. But even when African-Americans make healthy choices and regularly consult doctors, their treatment may be less than thorough. A 2002 review by the Institute of Medicine found that blacks and other minorities often received poorer care despite having the same income and insurance coverage as whites.
Clearly, wholesale changes are necessary, and not least from the government. Black men between 45 and 64 are most likely to die before others in their age range, which happens to be the very part of the population least likely to be targeted for new, vital government health programs. Until healthcare spending expands to include investment in new options for that vulnerable group, the conclusion of a 2002 W.K. Kellogg Foundation report on the health of minority men still rings true. “From birth,’’ it noted, “a black male on average seems fated to a life so unhealthy that a white man can only imagine.’‘
Jabari Asim’s e-mail address is asimj(at symbol)washpost.com.