Frederica Freyberg:

Now to a study out this week showing worst in the nation disparities for African-Americans in Wisconsin. This study in the Health Affairs journal looks at the life expectancy gap between whites and blacks. Nationwide that gap is decreasing. But Wisconsin was the only state in the study showing the life expectancy gap widening, especially for African-American women. Consider this, in 1990 white women in Wisconsin could expect to live five years longer than black women. That gap is now 6-1/2 years. For more on the results, we talked to the lead author of the study, Sam Harper, of McGill University, who joins us from Montreal. And, professor, thanks very much for doing so.

Sam Harper:

Thank you very much for having me.

Frederica Freyberg:

When you saw your results for Wisconsin, how surprising was it that this was the only state where the life expectancy gap between blacks and whites has grown?

Sam Harper:

Well, I would say it was mildly surprising in some ways. We were looking over a 20-year period at every state where we could measure this gap, and so we did expect to see some differences across the states. But I will say that it was a bit surprising, especially considering, as you said, that the nationwide gap has been decreasing over these years. So we expected most states to show decreases. So we were surprised in that sense to see Wisconsin was the one state where we were measuring an increase in this gap.

Frederica Freyberg:

What might explain the growing gap for black women in Wisconsin?

Sam Harper:

That's a great question. Our study doesn’t look in a lot of detail specifically at Wisconsin, but we can say a little bit something about what’s been happening there. I think primarily it’s not because Wisconsin fares really badly overall. Life expectancy, generally, in Wisconsin is actually pretty reasonable, pretty good. But in particular, there are large inequalities in the black community. And when we started look in more detail, it does look like one of the main reasons why we see this gap growing is slower declines in chronic diseases like cardiovascular disease and cancers among Wisconsin black women.

Frederica Freyberg:

So your study says that this racial gap in life expectancy a vital issue for policymakers. Why?

Sam Harper:

Well, I think, I mean, both for the US as a whole and Wisconsin and many state and local governments, many individuals and governments are committed to reducing these inequalities. So this clearly indicates that we’re not making enough progress on sort of our goals for reducing health inequalities. Health disparities like this also clearly contribute to health care costs. And I think in many cases people really believe that, fundamentally, these kinds of inequalities are linked to deeper social inequalities in society, and I think that’s unfair. And I think, lastly, I think it’s vital for policymakers because we know many of the reasons why these gaps exist are preventable and are amenable to policy intervention.

Frederica Freyberg:

So if health inequality is preventable, when the gap widens as it has in Wisconsin, does that suggest that we just don’t care here or we haven’t done the work necessary?

Sam Harper:

No, I don’t think it suggests that people of Wisconsin don’t care. I mean, I think really it suggests that the progress that Wisconsin is making generally– so life expectancy is improving in Wisconsin, but it seems clear that the things that are continuing to the rapid increases in– rapid– to the increases in Wisconsin life expectancy for white women are not effectively being implemented for the black community.

Frederica Freyberg:

I guess this is the question I haven’t asked yet and we haven’t shared. What is the life expectancy then in Wisconsin?

Sam Harper:

Overall, we separated our study into sort of men and women. So on average I think in Wisconsin it’s around 78 years. So it’s sort of in the sort of upper third of states overall, Wisconsin. But it’s clear that it’s very much that average hides a lot of difference, because things are not very good for black women in particular. Black women in Wisconsin have quite low life expectancy.

Frederica Freyberg:

Now, Wisconsin also has the dubious distinction of ranking worst as the worst state for childhood opportunities for black children, and we often end up on the bottom of these kinds of surveys. So if this is, and it is, a vital issue for policymakers, where should they start?

Sam Harper:

I think mentioning the childhood environment is a good place to think about starting. I mean, I think we know that many of the diseases, chronic diseases that are responsible for some portion of this gap do have roots in childhood experiences, and making sure that kids can start with a healthy life is important for guaranteeing health over the life course. And, as you say, Wisconsin, when we look at sort of some indicators of racial differences, does not fare particularly well. Milwaukee is a highly segregated city, has high rates of concentrated poverty. I think Wisconsin has the highest rate of incarceration of its black population amongst all the states. So, again, all of these things suggest an early life environment that is not particularly conducive to health and it seems to be affecting life expectancy over the long term.

Frederica Freyberg:

All right. Sam Harper, thanks very much for your work.

Sam Harper:

Thank you very much.