How Race and Poverty Can Affect Early Death

Study after study has identified being a racial minority and living below the poverty line as key factors that can contribute to higher mortality for many reasons. While the causes can vary — including diet, limited access to quality health care, smoking status and being more vulnerable to violent crime — most of the research has looked at race and poverty together.

But in a new study published in JAMA Internal Medicine, scientists at the National Institute on Aging (NIA) decided to look at the effects of race and economic status on mortality separately. They divided African-American men and women who were above and below the federal poverty line, and did the same for whites. They then compared their death rates over six years.

They found that African-American men who lived below the poverty line had nearly three times higher risk of dying early during the study period than those who were not poor. Among whites, the death rates were about the same for both economic groups. Among women, both African-American and white women living in poverty had a nearly two-fold greater risk of dying early than their counterparts living above the poverty line.

Those results suggest that African-American men are especially vulnerable to early death. Whether that has to do with biology, lifestyle or other factors is not clear from this study. But Dr. Michele Evans, deputy scientific director of NIA and one of the co-authors, says the team will continue to study the population to isolate these factors.

“We are trying to understand what social determinants turn biologic processes in different directions and lead to differential longevity,” she says. “As well as understand how they contribute to higher incidences of chronic diseases that occur much earlier in lower socioeconomic populations, particularly among minority Americans.”

For now, she says, she hopes the data start to highlight the fact that policymakers should re-examine how they set the federal poverty level. She says that they compared people who were 125% above and 125% below the federal poverty line, and while there were certainly more people below the poverty line at risk of early death, those above poverty also showed concerning rates of dying early. That suggests that perhaps even those people aren’t able to access government programs to improve their health or give them access to health care to treat chronic disease because they don’t qualify since they are above the poverty line.

“Poverty is bad for everybody and their health,” she says. “Particular people may be more vulnerable to the effects of poverty, and poverty may play a more specific role in certain disease processes. So we really need to re-look at what we are considering the poverty threshold. That’s the decision point in opening the doors for people to participate in federal government programs that could have an effect on their health and well being.”