
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: SATURDAY, March 31, 1990                   TAG: 9004020192
SECTION: EDITORIAL                    PAGE: A11   EDITION: METRO 
SOURCE: 
DATELINE:                                 LENGTH: Medium

BLACK, WHITE

LOUIS W. SULLIVAN, the secretary of health and human services, is black. But he's impartial when it comes to cigarettes, whose use he discourages for all Americans. Within the past couple of months he has lit into the industry for marketing smokes aimed at blacks, on the one hand, and athletes on another.

But Sullivan, a physician, might have felt a special concern for others of his race when he lit into R.J. Reynolds for "promoting a culture of cancer" with its proposed Uptown brand. Already, statistics show, the lives of black Americans are shorter and they have more health problems than do white Americans.

The Uptown furor brought into focus the fact that more black adults (34 percent) smoke than white adults (29 percent). That's one way their lives are shortened. Others are high homicide rates, the spread of AIDS and a lack of medical care. "Health United States 1989," the 14th annual report on the nation's health, shows that the life expectancy of blacks has been declining (it is now 69.5 years) while that of whites has been rising (to 75.5 years).

Circumstances have a lot to do with anyone's life span. Violence is endemic to many of the inner-city areas where numbers of blacks reside: In 1987, a black man was seven times more likely than a white man to die of homicide, a black woman four times more likely to die in this way than a white woman. AIDS also is spreading faster among blacks, including children. As of last September, 55 percent of AIDS cases among those under 13 years old were blacks.

Only 61 percent of black mothers got prenatal care in 1987, compared with 79 percent of white mothers. That's one apparent reason for the 1987 rate of 17.9 deaths per 1,000 black infants; among white infants the rate was 8.6.

But circumstances or lifestyles don't explain all the differences. Dr. Sullivan notes that - regardless of age, education, marital status or prenatal care - black women are twice as likely to have a baby of low birth weight, a prime factor in infant mortality. And while from 1970 to 1987, deaths of Americans from heart disease dropped 33 percent and from stroke 50 percent, whites - for reasons not evident - were the greater beneficiaries of the decline.

The overall figures are not encouraging, either, for Hispanic Americans and for American Indians. "We need," says Dr. Sullivan, "to move toward equal health opportunity for our citizens, including the good-health information and the family and community support that will help every American make the right choices for healthy and productive lives."

That is elementary. It is apparent, too, that the nation needs to know more about why the health of some of its citizens is so much poorer than others'. We cannot make everyone equal, but we can try to narrow the gaps. Aside from the humane aspect, such an effort is in everyone's interest: In an interdependent society such as ours, the stronger members wind up carrying some of the load for the weaker ones. Everyone loses something.

by CNB