Researchers May Have Found A Way To Improve Black Men's Life Expectancy
Researchers May Have Found A Way To Improve Black Men's Life Expectancy
Black men have the lowest life expectancy of any major demographic group in the U.S. Researchers say the solution appears to be pairing black men with black physicians.
NOEL KING, HOST:
Black men in America live, on average, 72 years. That is four years less than white men. Now a growing body of research suggests there may be a way to change that, but the solution raises difficult questions for a society that dreams of being colorblind. NPR's Shankar Vedantam reports.
SHANKAR VEDANTAM, BYLINE: Every so often, Marland Wade likes to head over to his local barbershop Wrist Action. He doesn't come for a cut.
MARLAND WADE: No hair. No hair. I just wear the bald head. (Laughter).
VEDANTAM: He comes to shoot the breeze.
UNIDENTIFIED PERSON: Yeah. Yeah.
VEDANTAM: Wade likes to hang out with people who know and understand him. Some years ago, when he was in the market for a new doctor, he looked for that same feeling of connection.
WADE: I had various choices. I had, like - I had over 20 doctors to choose from.
VEDANTAM: But one stood out. She was, like him, black and, like him, a practicing Muslim.
WADE: She gets me. I get her. We talk about life. We talk about our religion. You know, if somethin' wrong with me, she going to let me let know.
VEDANTAM: While Wade has a trusting relationship with his doctor, many black men in America do not. Their reluctance to seek out preventative health care lowers the odds they will survive diseases like prostate cancer.
OWEN GARRICK: It's not just prostate cancer. It's cardiovascular disease. It's stroke. It's diabetes. Most of the death is due to preventable or chronic conditions.
VEDANTAM: Owen Garrick is a doctor and researcher. He wondered what it would take to persuade black men to accept preventative care. He and his colleagues Marcella Alsan and Grant Graziani had a hunch that the race of the doctor might be a factor. So they ran a field study to try to answer one simple question.
GARRICK: Will black men take more preventative care services if they're randomly assigned to a black doctor?
VEDANTAM: The researchers randomly assigned 600 black men to see a black or a nonblack doctor at a clinic. All the doctors recommended several health screenings.
GARRICK: The black doctors were able to convince more effectively the patients to take more of the preventative services.
VEDANTAM: And not by a little. By a lot. Black doctors were about 50% more effective than nonblack doctors at getting black men to get a flu shot and have a blood test for diabetes. They were even more successful at convincing patients to get blood drawn for a cholesterol screening.
GARRICK: There was a 72% difference in the ability of the black doctor to recommend and have the black male patient take cholesterol screening compared to the nonblack doctor.
VEDANTAM: If all African American men were to respond like those in the study, Garrick says racial gaps in cardiovascular disease outcomes might shrink by nearly 20%. Why were the black doctors more effective? Garrick thinks the data offer a clue.
GARRICK: We found that the black doctors actually wrote more notes compared to the nonblack doctors about their patients, and often those notes talked about their non-health care issues - a wedding is coming up, will the Warriors repeat as NBA champions? Like, so nonmedical issues.
VEDANTAM: In other words, these doctors were making a connection with patients. It's like what Marland Wade from the barbershop said about his doctor. They talk about life, about religion. He gets her, she gets him. All this might be true for more than just black patients. In a follow-up study, Garrick found that large majorities of black and white patients said they'd be better understood by a physician of the same race.
The research is part of a growing body of work that asks whether matching people by race, gender or religion makes a difference. In another study, researchers found that Florida patients assigned to physicians of their own race were 13% less likely to die while in the hospital. The results were driven almost entirely by black patients matched with black physicians. Studies in other fields echo the same results. Education researcher Constance Lindsay and her colleagues reviewed data from 11,000 students in Tennessee. They found that when black students had early interactions with black teachers, there was a lasting effect.
CONSTANCE LINDSAY: Black students who were matched to a black teacher were less likely to drop out of high school, more likely to sit for a college entrance exam - so think, you know, SAT, ACT - and then more likely to enroll in college.
VEDANTAM: These studies present a difficult quandary for policymakers, particularly given our painful history of racial segregation. I raised this issue with Constance Lindsay.
Let's say you're the principal of a school, and you have one black teacher in second grade, and you have, let's say, 15 black students spread across five sections of second grade. Would you assign all those 15 students to the black teacher?
LINDSAY: I probably would not do that. If I had students that, in that particular set of 15 that were particularly disadvantaged, I might. I might also explore ways in which teachers could co-teach. But I definitely wouldn't advocate sort of segregating them into one class.
VEDANTAM: I guess what I'm asking you is, you know, if you looked at the data and said that you are improving the odds of students by 10, 15, maybe 20%, and you did not do that thing that could improve their odds by 10, 15, 20%, I mean, that is immoral.
LINDSAY: You could say that. I mean, if I were a parent of a black boy and there was one black male teacher in the school, I would go tell the principal to assign my child to him.
VEDANTAM: There are three lessons from this work. The first is that we really need doctors and teachers from different races and different backgrounds. The second lesson is that if we want to be understood by people who are different from us in some way, it's going to take work. You can't just assume that your job begins and ends with teaching a course or diagnosing a patient. You have to make a connection with the person across from you.
The final lesson has to do with the seemingly contradictory effects of diversity. Other research has shown that diversity boosts creativity and innovation. Here we've looked at how connecting with people who are like us can produce better outcomes. One explanation for this seeming contradiction lies in what you are trying to achieve. Novelty and creativity might flourish from bringing together different perspectives. But trust might come a little easier when we have things in common. Shankar Vedantam, NPR News.
KING: You can hear more of Shankar's reporting on this subject on the podcast Hidden Brain.
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