The Study

Compared to their white peers, black men and women have a lower life expectancy in both duration and quality of life. Using nationally representative data, a recent analysis modeled what would happen to the differences in life expectancy if obesity and smoking—two of the leading factors in preventable disease and death in the US, including cardiovascular disease—were eliminated.

Our Take

These analyses are always subject to limitations, and the authors note them up front, but they still provide important clues as to what might be feasible with broad changes. The use of the approach in the study has some strengths. For example, it allows the investigators to examine the cumulative consequences of obesity over a lifetime, not just the impact of being obese at a single time point.

While every gender-race group benefited from the “never obese” and “never smoked” scenarios, the life expectancy gains were larger for blacks than whites. Black women would gain 1.7 years of life expectancy if obesity were eliminated, but the gains for white women were not statistically significant.  Black women would also experience greater gains in healthy-life expectancy (years without disability) than white women with the elimination of obesity in the model. Additional elimination of smoking makes the gains in total and healthy-life expectancy even greater.

What does this mean for minority health disparities?

Efforts to address obesity and smoking benefit the entire population, but this model suggests those efforts may have a particular benefit for racial/ethnic minority groups who face health disparities. It also proposes that the elimination of obesity and smoking could reduce the difference in total and healthy life expectancy between black and white women to be statistically no different.

Of course, the elimination of smoking and obesity is no minor feat. This study suggests that efforts in these two areas will have a particular benefit, especially if they are policy-related. The authors highlight a couple key factors on these policy-related efforts:

“Policies that blame the victim or point only to individualistic interventions are unlikely to succeed. The most successful interventions must attend to structural conditions that lead U.S. black men and women to have elevated risks of long-term smoking and obesity.”

Our Recommendations

While efforts to support employees who want to quit smoking or lose weight are beneficial, examining the social determinants of health and the context in which individuals try to make those changes are equally important in improving health outcomes.   For more insights into the link between social determinants of health data and health behaviors, check out our recent  Podcast.


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