NEW YORK (Reuters Health) - Blacks and the less educated in the US have life expectancies about 6 years shorter than their white and better-educated counterparts, respectively. Now a new report suggests that smoking-related diseases are largely to blame w

And high blood pressure, HIV (news - web sites), diabetes and homicide appear to be the greatest contributors to the discrepancy in death rates among blacks versus whites, according to a team of California researchers. "Previous studies have found that African Americans and those less educated have worse health outcomes for a diverse array of diseases, thus, it has been difficult to know where to focus our public health resources," lead study author Dr. Mitchell D. Wong, of the University of California at Los Angeles told Reuters Health. "The study has important implications for redirecting public health efforts and the allocation of future research funding," he said. Wong and his colleagues analyzed data from the 1986 to 1994 National Health Interview Survey and estimated death rates from various diseases, based on a life expectancy of 75 years. Overall, people without a high school education were at risk of dying an average 9 years earlier than high school graduates, while blacks were at risk of dying almost 2 years earlier than their white counterparts, the investigators report in this week's issue of The New England Journal of Medicine (news - web sites). These findings remained true when the researchers took into account the study participants' age, gender and race or educational level, the report indicates. The diseases that most accounted for the educational disparity in death rates were heart disease, lung cancer, stroke, congestive heart failure, pneumonia and lung disease--all smoking-related diseases. In fact, eliminating heart disease--which accounted for nearly 12% of the potential years of life lost--would lead to a nearly 10-month gain in life expectancy, study findings show. Similarly, eliminating lung disease--the second greatest contributor to the educational disparity--would add about 6 months to the life expectancy of less-educated individuals. On the other hand, the discrepancy in death rates among blacks, in comparison to whites, was largely due to deaths from high blood pressure (hypertension)--which accounted for 15% of the disparity, followed by deaths from HIV, diabetes and homicide. Eliminating the number one contributor to racial disparities--high blood pressure--would lead to an almost 3-month gain in life expectancy among blacks, and getting rid of HIV deaths would lead to a roughly 2-month gain in life expectancy, the report indicates. In many studies on eliminating racial disparities, researchers have focused on heart attacks and cancer--the leading causes of death among African Americans and whites, and differences in treatment, according to Wong. The present study findings, however, "suggest that we need to pay more attention to hypertension, HIV and diabetes, as well as homicide," he said. The study did not investigate whether health insurance, access to care or related factors might explain the disparities in death rates, but the fact that smoking-related diseases accounted for the top six contributors to the educational disparity in life expectancy suggests "that interventions to prevent smoking could have an enormous impact," the authors write. "In addition, we know that African Americans are more likely to get hypertension, HIV and diabetes, and also tend to have more severe disease," Wong said. "Thus, it is important to find out what the impact would be of improved screening, prevention and treatment of these diseases on racial disparities in life expectancy."

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