There's a Racial Gap Even in Bereavement
WHY YOU SHOULD CARE
Because losing family members can cut your own life short.
By Carly Stern
Smoking. Drinking. Sleep Deprivation. Processed foods.
These are all things your 8th grade health teacher probably told you are bad for your lifetime health. But one thing that doesn’t top the list, and feels impossible to prepare for? Bereavement.
Of course, losing a family member is devastating in a multitude of ways. Perhaps for that reason, societal conversations around death and loss rarely focus on bereavement as a health determinant — for the living. But research shows that the likelihood of experiencing multiple family deaths in early adult life — and the health outcomes that stem from that loss — differ starkly across racial groups.
Black people are three times more likely than white people to experience the death of multiple family members before turning 30.
This data comes from research published in 2017 by Debra Umberson, a sociology professor and director of the Population Research Center at the University of Texas, Austin. Racial gaps in life expectancy and mortality rates have been well-documented. But this study, which used data from the U.S. Bureau of Labor Statistics’ National Longitudinal Survey of Youth and the University of Michigan’s Health and Retirement Study, was the first population-based look at “repeated bereavement experiences” among Black Americans, according to Umberson.
By the time Black Americans turn 60, they are 90 percent more likely than their white peers to experience at least four deaths of family members (defined here as mothers, fathers, siblings and children). It’s also dramatic at the other end of the life cycle: Black children are three times more likely than white children to lose a mother, according to Umberson, who is currently working on research that examines similar questions in Latinx populations. These events early in people’s life trajectories compound racial disadvantage in a way that researchers aren’t adequately capturing, she argues. Health effects of death and dying are “not part of our national dialogue on racial equity right now,” says Joyal Mulheron, founder and executive director of Evermore, a nonprofit that advocates for bereavement care. Mulheron lost her own daughter in 2010.
Experts say that research on the effects of loss is predominantly focused on white populations, and doesn’t account for racial disparities in exposure to death. It’s already known that factors like poverty, higher rates of chronic health conditions and the race gap in environmental elements like air quality, for example, lead to lower life expectancies for Black Americans. But Umberson goes a step further, saying that experiencing repeated kin death is a mortality risk, in and of itself: losing family members lowers one’s own life expectancy, and it doesn’t touch all racial groups equally.
Bereavement is a public health problem.
Global research bears this out: A study of children from Scandinavian countries who lost a sibling revealed that the survivors’ risk of dying was increased by 71 percent for the year after the death. Losing a parent or sibling as a young child can influence everything from educational outcomes to relationship patterns to socioeconomic outcomes and lifelong health behaviors, says Umberson. For example, Umberson’s other research shows that losing a child by age 40 heightens one’s risk of developing dementia. Black Americans already face higher risk of dementia compared to whites — a likelihood exacerbated by Black parents’ higher chances of losing a child by midlife.
“Bereavement is a public health problem,” Umberson says. And it’s one that remains invisible in part because agencies focus on the effects of death on those who die — not on those around them. Authorities are “looking at the front end, but they’re not looking at what happens in the aftermath,” says Mulheron. “The CDC tracks the mortality event. They don’t track who survives it, and what the outcomes are.” And the way she sees it, the U.S. is also behind other countries when it comes to building formal support systems for those who’ve experienced family losses — what Mulheron calls “bereavement care.”
It’s a message taking on increasing urgency amid the coronavirus pandemic. The sobering reality is that a lot of Americans in the coming days, weeks and months are about to experience losing a loved one — and doing it largely alone, as even long-standing grieving rituals like coming together for funerals are disrupted by social distancing rules. Research has shown that Black Americans already face inequitable treatment in the health care system — Black women die of pregnancy-related complications at roughly three times the rate of white women and Black patients are routinely under-treated for pain, for instance. And while some have claimed this virus is a “great equalizer” that doesn’t discriminate, early data shows that Black Americans are being infected and dying at higher rates than whites.
Even beyond the stunning permanence of a death toll, the experience of bereavement will reach outward in inequitable ways, too. Grief will disproportionately threaten the health and life expectancy of the broader Black community. Of course, feeling one’s own life ebbing away can be a frightening process, especially in pandemic-induced isolation. But it’s perhaps even more unsettling that it can, in quite tangible ways, simultaneously derail the health of loved ones who must live on with that loss.