The wide racial gap in health is growing in Chicago, a major new study has found. Already lagging far behind whites on most key measures of health, blacks in Chicago have fallen even further behind in 11 of 15 areas reviewed by Chicago's Sinai Urban Health Institute between 1990 and 2005 -- including infant mortality, heart-disease deaths and diabetes.
There's a stark, human cost in that: In all, the researchers estimated that the toll of the black-white health disparity is an additional 3,200 deaths of African Americans in Chicago every year.
It isn't that blacks' health is declining. In fact, overall, the health of both African Americans and whites in Chicago and across the United States has improved on most of the measures studied between 1990 and 2005. But whites showed gains at a sharply higher rate, resulting in a wider gap, according to the Sinai institute, which is part of Chicago's Sinai Health System and which works to find "approaches that improve the health of urban communities."
Nationally, the racial gap in health between blacks and whites in the United States has remained fairly constant over the same 15-year period, according to the new analysis, which was abased largely on communicable disease reports and birth and death records and was published online Thursday in the American Journal of Public Health.
In Chicago, areas where the divide between blacks and whites in Chicago worsened significantly included: the death rates from heart disease and breast cancer, rates of prenatal care during the first trimester of pregnancy and the number of cases of tuberculosis.
The death rate from all causes for black Chicagoans was 36 percent higher than whites in 1990. By 2005, the difference had grown to 42 percent. In contrast, at the national level the racial gap in death rates shrank, going from 35 percent to 29 percent.
The researchers attributed the growing racial gap largely to whites' greater ability to benefit from health care advances because of "racism and poverty."
"What's happening is that, as advances become available for these different diseases, white people are able to gain access to advances, and black people are not," said Steven Whitman, director of the Sinai Urban Health Institute. "It's absolutely essential to understand the underlying structural issues that are causing these disparities: those are racism and poverty."
Whitman said the segregated nature of Chicago puts minorities at a disadvantage for accessing high-quality health care. He also noted that blacks in Chicago often live in poorer neighborhoods with underperforming schools, fewer parks and recreation areas and more "food deserts" -- areas that don't have supermarkets and the array of healthy foods they carry.
What isn't clear and needs to be studied, according to Whitman, is whether the disparities seen in Chicago are worse than in other cities.
Romana Hasnain-Wynia, director of the Center for Healthcare Equity at Northwestern University's Feinberg School of Medicine, said the racial health gulf isn't helped by "one size fits all" public health messages aimed at lowering death rates from heart disease, cancer and other illnesses.
"We have to be targeted in our interventions," said Hasnain-Wynia, who was not involved in the study.
James Randell recently was diagnosed with heart disease at Mount Sinai Hospital after coming in with chest pain. The Chicago man said he was troubled -- but not surprised -- to learn that African Americans aren't seeing the same level of improvement in their health as whites. His layman's take? It's the result of a lack of health literacy among minorities.
"A lot of us, we don't know what we should be doing to be healthy," said Randell, 47. "If I had taken better care of myself, I wouldn't be here."
