Study shows racial inequities apparent in premature deaths in Washington
People of color in Washington state die before the age of 65 at higher rates than white Washingtonians, a Washington State University analysis of recent premature deaths found.
Researchers analyzed nearly a quarter million death records of state residents who died prematurely, which included any death before the person reached age 65, in Washington from 2011 to 2015. Researchers were interested to find out if race and place affected the rate of premature death in the Evergreen State. The study analyzed not only a person’s race and age but also their address and cause of death.
It turns out race and place, studied together, can tell us a lot about life expectancy in the state, said Pablo Monsivais, lead author on the study.
“We know that race and place are both independently linked to your life expectancy,” Monsivais said. “And what we can add to that is looking at the combination of your racial identity and your community you’re coming from.”
Premature deaths occurred less frequently among white Washingtonians. Overall, 22% of white deaths occurred prematurely, while 43% of deaths among black Washingtonians were premature and half of American Indian deaths in the state were premature. Native Hawaiian and Pacific Islanders in Washington had the highest rate of premature death, at 55%.
The top two causes of premature deaths studied in Washington were heart disease and cancer. The data indicates health disparities and risks associated with a person’s race as well as where they were living when they died. The study is not predictive, however.
“We were interested in health disparities … we looked at it as the likelihood of dying prematurely, which is basically preventable,” Monsivais said. “Having the address and other demographic information allowed us to analyze how those factors were linked to whether someone died prematurely.”
The study used poverty, housing, employment and education statistics to measure socioeconomic disadvantages by neighborhood, categorizing census tracts on a scale from least to most deprived. Mirroring findings from national studies, the WSU analysis found that premature deaths occurred at higher rates in the more deprived neighborhoods in the state, although race was more strongly associated with premature mortality. In other words, white Washingtonians in poverty or the most deprived regions of the state still died early, however still at lower rates than people of color in similar situations.
Being a person of color and living in a “most deprived” area increased the chances that a person died before the age of 65.
“It’s the fact that people of color face discrimination and lack of opportunities and therefore have lower incomes, less access to education and less access to health care,” Monsivais said. “The race you happen to be born is going to have an impact on your life expectancy because it’s going to impact your social opportunities, and we know that that’s true.”
The WSU study presents the data in granular detail, down to individual census tracts, pinpointing exactly which communities have a high prevalence of premature deaths. Parts of downtown Spokane and Airway Heights have high rates of premature death. In most deprived communities, Spokane had high rates of premature deaths for residents of all races.
The study did not count Hispanic deaths for the five-year period due to low numbers, which Monsivais said is likely because fewer Hispanic people were living in Washington a half century ago. The premature mortality rate for Washingtonians of color points to other social and environmental factors that can impact a person’s health.
“African-Americans and other people of color are less likely to be able to get good quality schools as children, and that then has a long-term effect on their opportunities over their whole life course, not to mention things like discrimination and racism,” Monsivais said.
The stress that comes from living under economic distress – from not being able to pay bills or having access to healthy food – only compounds those issues.
“Those are chronic stressors that we know impact – in a small way – your health every day, but over your lifetime that can accumulate and have adverse affects on things like heart disease,” Monsivais said.
The WSU study localizes and echoes what national research says about how racial disparities and fewer economic opportunities can lead to adverse health outcomes.
“Premature deaths to a large extent are preventable, and they have a big social and economic cost,” Monsivais said.