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African-Americans

Approximately 13% of Americans, making them the second largest minority ethnic group after Hispanic in the U.S.

Black Americans hold just 3% of the country‘s wealth.

The health sector is the largest US employer and the largest employer of Black Americans, but Black staff members are often the lowest paid employees and have the worst health outcomes.

Mortality of hypertension, and risk of coronary artery disease, stroke and heart failure increased compared to the White population in the U.S.

In the years 1999 through 2020 the Black population in the US experienced more than 1.63 million excess deaths and more than 80 million excess years of life lost when compared with the white population: the differences between the Black population and the White population healthcare disparities nave recently increased.

Incidence of syphilis rates are higher among Black people.

Black Americans are exposed to higher annual levels of air pollution, containing fine particulate matter than White Americans, and may be more susceptible to its health effects.

There is some evidence that headaches may be more common in certain racial groups, such as African Americans and Hispanics.

Older Black Americans are much more likely to have good hearing than white Americans, and the difference is especially notable among men.

The incidence of squamous cell carcinoma of the skin in Black persons is estimated to be 3 cases for 100,000, as compared with 150 to 360 per hundred thousand among White persons in the US.

In the US, the incidence of gastric cancer is highest in Blacks, individuals of Asian and Pacific island descent, and Hispanic and Latino individuals.

There is overall poorer health and greater prevalence of heart disease, obesity, diabetes, and cancer among black American men.

Cardiovascular mortality related to obesity in the US population over the past 2 decades has been increasing: in contrast to general cardiovascular mortality trends, which have steadily declined over the same time period. 

Black individuals, in particular women, have been  disproportionately impacted. In the US peripartum cardiomyopathy is four times as likely to develop in Black women as it is in White women.

Blacks have the highest incidence and mortality from most cancers.

In the US the risk of intracerebral hemorrhage is approximately 1.6 times as high among Black persons and Hispanic persons as among white persons.

Black individuals develop non-small lung cancer five years earlier than their European American count parts.

Blacks have higher history of renal cancers.

Blacks have one and a half times the incidence  of dementia than Whites.

Differences in neonatal morbidity and mortality exist regardless of gestational age of birth, with infants of Black individuals dying at a higher rate of 11.1 versus 5.1 per 1000 live births, a risk ratio of 2.2, than those of similarly aged White individuals.

Neonates born to a mother who identified as Black or Hispanic account for 66% of periviable neonates.

Black women have a higher rate of trichomonis infection than white women.

Glaucoma is the leading cause of blindness in African-Americans.

The highest prevalence of open angle glaucoma can be found in African-American patient populations.

African-American children are least likely to develop acute lymphoblastic leukemia, but they tend to fare worse in survival compared with those of European and Asian discent.

Blacks experienced the highest rates of tobacco related disease and death, and black men have the highest lung cancer death rate of any group despite having similar smoking rates as white individuals.

With the same age and smoking history, a black person has a higher risk for lung cancer than a white person.

The major carcinogenic compounds in highway exhaust are small PM2.5 and nitrogen oxides, both of which exist at higher levels in black communities, and both of which are associated with increased lung cancer incidence and mortality.

Alcohol consumption has the highest prevalence among White individuals, the highest prevalence of abuse/dependence in Native Americans, and the highest vulnerability to alcohol related health consequences in Black individuals and Native Americans.

Women of racial/ethnic minorities demonstrate disproportionately higher obesity levels than non-Hispanic white women.

American Blacks are more likely to develop obesity hypoventilation syndrome. 

Black adults report consuming lower amounts of fruit and vegetables than white adults.

In the US neuromyelitis optica spectrum disorder has a higher prevalence for Blacks than for Whites by greater than three times.

African Americans have a lower incidence of hyperuricemia and gout.

There is a lower prevalence of isomaltase and sucrase  reported in African Americans and compared to Caucasians.

Approximately 1/3 of all patients on end-stage renal disease dialysis are black.

The unintended pregnancy rate for black women is more than doubled thst of white women (79 verses 33 per 1000).

African American women in general may have higher postpartum cardio-metabolic risk and more excess gestational weight gain than Latina women, who in turn have more than white women.

Black women are more likely to have postpartum cardiomyopathy by a ratio of 4 to 1 to White women.

 

Degenerative spondylolithesis disproportionately affects females, particularly black women.

 

Blacks are 30% more likely to have premature ventricular contractions than whites.

Black women have higher rates of uterine cancer associated with increased use of hair straighteners.

Black women who have hip fractures are more likely to die within six months, less likely to gain independence, have timely surgery and rehab than white women who have hip fractures.

Hip dysplasia has a low risk in African Americans.

Higher incidence of hypertension in black patients versus white patients and is most prevalent in black men, at 59%. 

Black men suffer higher rates of hypertension complications, including death caused by uncontrolled blood pressure.

Blacks have an increase sensitivity to sodium and therefore respond with increased blood pressure with increased salt intake.

Black adults have more hospitalizations and worse COPD related quality of life compared with White adults, despite having lower prevalence of COPD than White adults.

African Americans have lower rates of bladder cancer than Whites.

The average age of thelarche for African American females in the United States is between 8.9 and 9.5 years, the average for Causasians is 10-10.4 years, and the average age of thelarche for Hispanic females is approximately 9.8 years.

Hypertension associated death rates in black men are more than 2.5 fold higher than in white men,  and  almost 1.5 fold higher than nonblack women.

Nearly one in every three young black adults and one in every five young Mexican Americans adults have hypertension: Control of hypertension among these individuals is approximately one in 10 young adults.

Potassium supplementation has a greater effect in reducing blood pressure in Blacks compared with Caucasians.

In the US AAs bear a disproportionate share of the cancer burdens, having the highest death rate and lowest survival rate of any racial or ethnic group for most cancers and other leading causes of death, including heart diseases, stroke, and diabetes.

30% higher mortality for African-Americans than for overall US population and nearly double stroke mortality.

In the US the highest drowning mortality rates are among American Indians and Alaskan natives, and Black persons.

Black males have a lifetime risk of firearm deaths of 2.61%, indicating that one out of 38 black males will die from firearms.

Firearm homicide rates are 10 times greater in black individuals than white individuals (29 per hundred thousand versus 2.9 400,000, respectively).

In Black males, ages 15 to 34, homicide deaths is the leading cause of death, the majority of which are due to firearms.

Cardiovascular disease, including stroke is the largest contributed to the mortality difference between the black and white populations in the US, accounting for 34% of the difference in years of life lost.

 

Stroke is 4 times as common in Black middle-aged adults than in White middle-aged adults.

 

Coronary Artery Risk Development in Young Adults study: Stroke is 4 times as common in Black middle-aged adults than in White middle-aged adults.

 

The  incidence rate for stroke was 29 per 100,000 person-years for White adults and 120 per 100,000 person-years for Black adults.

Studies have shown that black American males have the shortest lifespans of any group of people in the US, averaging only 69 years.

Blacks have a lower incidence of spina bifida than do whites or Hispanics.

African Americans have a higher prevalence of Hereditary Non -polyposis colorectal cancer than whites.

Hypertension is the single largest contributor accounting for 15% of the disparity in white versus black mortality.

The rates of peripheral artery disease reported to be twice is high in African-Americans.

The prevalence of abdominal aortic aneurysm is lower among black than among white persons.

More prevalent and severe hypertension compared with whites.

Black patients have chronic pancreatitis more commonly than do white patients.

Systemic lupus erythematosus disproportionately affects and causes increased mortality among persons of African dissent, particularly young black women.

In the United States there is a higher prevalence for Blacks with 13 cases per hundred thousand persons than  for whites,  at 4 per hundred thousand of neuritis optica spectrum disorder.

Rates of gonorrhea are highest among black individuals.

Ectopic pregnancy-Mortality ratios are 6.8 times higher for black pregnant individuals compared with white pregnant individuals.

Keloid scars are especially likely to develop in patients of African descent. 

Prevalence of heavy sugar consumption of greater than 25% of daily calories is disproportionately high among Blacks.

Pulse oximetry measurements systematically overestimate arterial oxygen saturation in patients with darker skin colors, potentially leading to inappropriate medical decisions for Black patients.

Asthma disproportionately affects women, Blacks, or Puerto Ricans, and people with low household income.

Severe and poorly controlled asthma disproportionately affects black children and asthma mortality is four times higher among Puerto Ricans and Blacks as among whites.

Black children have 2 to 3 times the prevalence of asthma as White children, and among those with asthma, have more than twice the risk for emergency department visits and hospitalizations compared with White children.

One in three Black men have a lifetime risk of imprisonment, and there is a Black to White disparity of imprisonment of more than 9 to 1 in seven states.

About one third of African American adolescent females report encountering some form of sexual assault including rape.

Cutaneous T-cell lymphomas are more common in black patients.

T-cell acute  lymphoblastic leukemia disproportionally affects black children.

While they’re much less likely to develop chronic lymphocytic leukemia (CLL) than are White patients, African-American patients with this blood cancer are detected later and die sooner from the disease.

Black patients and those with non-private insurance are more likely to be non-adherent to medical advice.

Anemia or evalence higher in elderly African-American men and women compared to Caucasian men and women.

 

As many as 46% of black MSM (men having sex with men) have HIV while the HIV rate is estimated at 21% for white MSM and 17% for Hispanic MSM.

Black mothers are three times as likely as white mothers to die from pregnancy related causes.

Rates of cervical cancer are highest among Black and Hispanic women,

Chronic hypertension in pregnancy disproportionately affects black women and is associated with 3 to 5 times the risk of preeclampsia, placental abruption, preterm birth, or small for gestational age birthweight, or perinatal death.

Black women are at greater risk for developing preeclampsia than other women, and experience higher rates of maternal and infant morbidity and perinatal mortality than other racial and ethnic groups.

The maternal mortality rate among black women has climbed to 69.9 deaths per hundred thousand, 2.6 times that of white women, a disparity that has persisted for decades.

Black infants are more than twice as likely as white infants to die in their first year of life. 

The incidence of Wilms tumor is highest among African American children.

The rate of chlamydia infections are approximately five times higher in the Black population compared to White people.

Many African Americans are descendants of people of West African nations and have a high prevalence of APOL1 risk alleles as well as APOL1 associated kidney diseases. 

The rate of premature death before 75 years of age is 30% higher among black Americans than among white Americans.

Black Americans die about four years earlier, on average, than white Americans.

Multiple myeloma is twice as common in blacks compared with whites and this is due to a higher prevalence of monoclonal gammopathy of undetermined significance in blacks.

African-Americans have a higher incidence of smoldering multiple myeloma.

Blacks have an incidence of multiple myeloma 2 to 3 times higher than Whites, and makes it the most common hematologic malignancy in African Americans.

Blacks have higher incidence of peripheral neuropathy from bortezomib therapy in myeloma.

African-Americans have approximately 25% higher incidence of pancreatic cancer than whites.

The rates of peripheral artery disease reported to be twice is high in African-Americans.

Transthyretin amyloidosis responsible for about 3% of cardiac failure cases in black patients 60 years and above.

Val1421 genetic variant occurs in 3 to 4% of persons in the US who identify as African-American or Black.

Black Americans are almost three times more likely to be more vegan and vegetarian than all other Americans.

African-American girls are especially prone to early puberty. 

Children with autism spectrum disorder who are Black tend to present at older ages than those who are White, and more often present with intellectual disability, suggesting racial disparities in access to care.

 

Black individuals in the US or 2-4 times more likely than others to progressed to kidney failure and are less likely to receive optimal therapies, including kidney transplants.

 

Measured GFR for Black Americans is, on average, 15.9% higher than that for non-Black persons with the same creatinine level, sex, and age.

Blacks have a 3 to 4 full greater risk of kidney failure and higher mortality compared with individuals of other races and ethnicities with approximately 16% to 21% better estimated glomerular filtration rate compared with other individuals.

Chronic kidney disease and its most severe form, end-stage kidney failure,  leads to dialysis or transplantation, limits lifespan, and quality of life and has disproportionately affects persons in of African descent at four times radio among White persons.

Rates of graft loss and acute rejection of renal transplants are higher in blacks than in white recipients, especially among younger patients.

Access to organ transplantation is systematically lower for Black patients with end-stage renal disease than for their White counterparts.

People without health insurance or more likely to be diagnosed with advanced cancer had to have a higher risk of cancer death compared to the insured.

In 2017 11% of blacks were uninsured compare with 6% of whites.

Black men in the US, have a higher mortality rate after surgery than Black women, as well as White women and White men, based on the outcomes of more than 1.8 million black and white patients age 65 years old covered by Medicare: after undergoing elective surgery, 1.3% of black men died within 30 days compared with 0.85% of white men.

Have the highest risk for the development of heart failure and have the highest proportion of incident heart failure not preceded by clinical myocardial infarction at 75%.

African Americans have a twofold higher incidence, earlier onset, greater severity at the time of diagnosis, more likely nonischemic in etiology, with pathophysiology attributed to hypertension, greater morbidity, younger ages, and

Within 5 years after a first myocardial infarction, at 45-64 years of age, death occurs in 11% of white males, 16% of African American males, 17% of white females and 28% of African American females (Benjamin EJ).

The African-American race is an independent risk factor for post operative morbidity and mortality after coronary artery bypass grafting and heart transplantation.

Blacks have a higher stroke incidence and mortality than do whites in the US.

Black men at higher risk for mortality from sleep apnea.

Black individuals have a higher level of urinary albumin excretion than whites, and may contribute to racial disparities in cardiovascular outcomes.

In Blacks chlorthalidone was not associated with a significant blood pressure lowering benefits over hydrochlorothiazide, while it was associated with a greater risk of metabolic adverse effects.

In the US, Black women with endometrial cancer have a 90% higher five-year mortality rate after diagnosis, compared with white women.

Black women in the US are diagnosed with more advanced endometrial cancer stage of disease independent of insurance coverage and healthcare access.

Because of the high prevalence of fibroids and non-endometrioid histology types among black women,  in comparison with white women, transvaginal ultrasound screening guidelines for postmenopausal bleeding have worse performance for black women contributing to racial inequality in endometrial cancer outcomes.

Cumulative incidence of fibroids by 50 years of age is approximately 50% among white women and 80% among Black women.

Black women develop fibroids at younger ages than white women.

Prostate cancer is more than twice as common among Black men as among White men.

Black patients, compared with white patients: the onset of prostate cancer is earlier and tumor volumes are greater even among men with low risk disease.

Black patients with low risk prostate cancer who underwent radical prostatectomy are more likely to harbor more aggressive disease on surgical pathology review than white patients.

Among black patients under surveillance for prostate cancer, the black cohort exhibited higher rates of cancer progression than White patients and remained on active surveillance for relatively shorter periods, 31.2 months vs not reached.

Black patients have a twofold higher prostate cancer mortality compared with white patients, even with a Gleason score 6 cancer.

Black men have 67% higher rate of diagnosis of prostate cancer and this percentage continues to rise.

Black men are more likely to be diagnosed with higher grades of prostate cancer presentation including a 2 to 3 times higher rate of mortality compared with European American men.

Observational data suggest prostate cancer may exhibit a biologically distinct, more aggressive behavior in blacks.

Single nucleotide polymorphism in numerous metabolic genes are linked with prostate cancer and blacks, but not in their European American counterparts.

 

8q24 variants that may partially explain increased prostate-cancer incidence among Black men

Blacks have the highest prevalence rate among Americans at 14% having Alzheimer’s disease.

Blacks have a lower cardiorespiratory fitness than whites.

Black and Hispanic people are disproportionately affected by Alzheimer’s disease.

It is  estimated that black Adults have twice the risk of developing Alzheimer’s disease than whites.

The risk of sarcoidosis is greater among Black people as opposed to white people.

 

About 20% of African Americans with sarcoidosis have a family member with the condition, 

Black individuals typically present with more advanced x-ray disease compared with white individuals, stage for stage in pulmonary sarcoidosis.

The incidence of sarcoidosis per 100,000 each year is three among Asian individuals, four among Hispanic individuals, eight among white individuals and 18 among black individuals.

There is a higher sarcoidosis related mortality in Black individuals (females: 10 deaths per 1,000,000 individuals; males: 3 deaths per 1,000,000 individuals) than for White individuals (one death per 1 million individuals).

Levels increase minutes after eating.

Circulating levels decrease rapidly because of enzymatic inactivation mainly by dipeptyl peptidase-4 (DDP-4) and renal clearance.

 

The lowest susceptibility to NAFD is observed in black individuals.

Black individuals have about half the risk of development of herpes zoster as white individuals.

Blacks have the highest level of seroprevalence at 34.6% of herpes simplex virus –2 (HSV-2).

African-Americans have a higher risk for gout and hyperuricemia compared with Caucasians (4.8-4%).

The prevalence of G6PD deficiency is high among black men.

The incidence rate of ESRD among blacks in the United States is nearly 4 times that for whites.

By 2010 African Americans have a life expectancy four years less than white populations.

Black populations have lower life expectancy attribute to higher death rates from heart disease, cancer, homicide, diabetes, and perinatal conditions.

Black patients have a higher hemoglobin A1c level than white patients for the same average glucose level, potentially contributing to observed disparities in diabetes management, outcomes, and hypoglycemia.

Black patients with diabetes, have a 1.7 higher rate of severe hypoglycemia versus White patients.

Diabetic foot ulcers and amputations are more common among Blacks and Hispanics.

Blacks and Hispanics have more advanced diabetic foot ulcers and peripheral artery, disease at presentation and are more likely to undergo lower extremity amputation.

Normal hemoglobin levels in women and Black men are 1-2 g/dL less than in Caucasian men.

Black populations have lower death rates from suicide, unintentional injuries, and chronic lower respiratory tract diseases

Drug induced immunoallergic hepatitis is more common among black individuals

Asian people are nine times and Black people are 2.5 times more likely to die from hepatitis B related complications than white persons.

There is a higher prevalence of hepatitis C in Black people.

There is a significantly higher mortality due to hepatitis C in Black people compared with white people in the US – 5/100,000 versus 2.98 per hundred thousand.

Have 2-3 times risk of Caucasians to have chronic renal disease.

African-Americans have higher levels of clinical pain and have lower pain tolerance based on clinical studies.

The incidence of venous thromboembolism, comprising deep vein thrombosis and pulmonary embolism are 30-100 percent higher in black Americans than white Americans.

Pulmonary hypertension is most common in  black individuals.

Compared with white individuals, blacks generally have higher levels of plasma biomarkers associated with Venous thromboembolism: D-dimer, factor VIII, factor IX. and a higher prevalence of many medical conditions leading to provoked venous thromboembolism.

The incidence of thrombotic thrombocytopenic purpura is seven times as high among Black people than other races.

Higher incidence of lung cancer in males.

Black Americans have poorer survival than white Americans for all cancers.

African Americans have a significantly higher rate of corns and calluses compared with non-Hispanic white and Puerto Rican participants (70% vs 58% vs 34.1%).

African-American females are more likely than white woman to die of breast cancer, although they have a lower incidence rate of this disease than white women.

Black women have a twofold higher rate of advanced stage breast cancer, than white women among regular breast cancer screenings.

Black women with breast cancer who undergo ancillary lymph node dissection are four times more likely to develop lymphedema than White women, regardless of other risk factors.

Cancer is the second most common cancer among African-American women with one in nine African-American women compared with one and eight White women will be diagnosed with breast cancer.

Incidence rated of breast cancer under the age of 45 years are 16% higher among African American women then among white women.

Black women are more likely to be diagnosed with breast cancer before age 50 years or with estrogen receptor negative and triple negative breast cancer than white women.

Triple negative breast cancer patients have the lowest five-year survival rate among receptor expression defined subtypes, and since it is more prevalent in African-American women, and  it contributes to the disparate outcomes for this population.

TAILORx trial showed that with equivalent treatments in women with hormone positive, HER2 neg, breast cancer, black women has significantly higher breast cancer recurrence and increased overall mortality compared to white women.

Black women with early hormone receptor positive breast cancer experience shorter relapse free intervals and overall survival compared with white women independent of insurance and neighborhood deprivation.

Breast cancer death rate in black women remains 40% higher than that in white women overall and is two times higher among young women.

Black women are 14% more likely to die from breast cancer.

Black women in the US are more likely to have a high risk recurrence score and to die of axillary node-negative breast cancer compared with white women with comparable recurrence scores (Hoskins).

Male African Americans have a high incidence of colon cancer of 72 per 100,000, while Native Africans in South Africa have a low incidence rate of colon cancer of less than 1 per 100,000, a more than 72-fold difference in rates of colon cancer due to disparity of fat in diet.

Blacks are younger at diagnosis and have poorer colorectal cancer outcomes regarding stage and mortality than white Americans.

The median age among Blacks at diagnosis of colon cancer is 64 years compared with 68 years in European Americans.

Colorectal cancer incidence rates were 20% higher in those in whites and 50% higher than those of Asian pacific islanders.

Death rates among Blacks with colorectal cancer are 40% higher than white Americans in twice that of Asian pacific

The socioecologic determinants in health such as poverty and socioeconomic deprivation has a negative impact on colorectal cancer biology and mortality.

 

There is  lower average measures of normal lung function observed in non-White groups.

Black and Hispanic patients are less likely to receive opioid analgesics than  white patients. 

 

When black and Hispanic patients do receive opioids they commonly receive a lower dose an White counterparts.

 

African Americans appeared to be at a heightened risk for developing type II diabetes mellitus with exposure to some antipsychotic drugs.

Rates of overdose deaths are rising faster in black than white populations.

Blacks are experiencing the highest increases in drug overdose death rates.

African American patients have more medical mistrust than white patients, and were less likely to undergo a recommended surgery as a result.

Younger black women with cervical cancer are at risk for presenting with higher stage disease and have worse overall survival.
Black women experience significantly higher cervical cancer mortality rates than white women.
 
Black patients with head and neck cancer have a worse survival than white patients.
The preterm birth rate is more than 50% higher among Black women, than  among White women.
The rate of childhood asthma among black children is more than double than among White children.
Black children have a higher rate of pediatric emergency department visits for mental health than White children.
Blacks have a higher frequency of rare variants of CFTR in cystic fibrosis.

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