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Poor African-American men have lowest likelihood of overall survival

The JAMA Network Journals

African American men living below poverty had the lowest overall survival in a study that examined the effects of sex, race and socioeconomic status on overall mortality, according to an article published online by JAMA Internal Medicine.

Alan B. Zonderman, Ph.D., of the National Institute on Aging, Baltimore, and coauthors used data from the Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) study for their research letter. The study recruited 3,720 participants, who self-identified as either white or African American, and poverty status was defined as above or below 125 percent of U.S. federal poverty guidelines. The majority of study participants were African American (59 percent), female (55 percent) and above poverty status (59 percent) with an average age of 48.

The analysis by the authors suggests African American men below poverty status had a nearly 2.7 times higher risk of death compared with African American men living above poverty status. White men living below poverty had about the same risk of death as those living above, according to the results.

Both African American women and white women living below poverty had a higher risk of death compared with those living above poverty but the risk was similar across race and almost two-fold.

"African American males are feared and marginalized in American society. This lifelong ostracism facilitates cascading negative outcomes in education, employment and in interaction with the criminal justice system. The resultant poverty is a virulent health risk factor for AA [African American] men. Our findings at 125 percent of the poverty line suggest that revision of poverty thresholds triggering eligibility for federal programs that influence quality of life, health and equal opportunity should take into account premature mortality driven by poverty as a first step to address the vulnerability of poor AA men," the authors conclude.


(JAMA Intern Med. Published online July 18, 2016. doi:10.1001/jamainternmed.2016.3649. Available pre-embargo to the media at

Editor's Note: The article contains funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Media Advisory: To contact corresponding study author Alan B. Zonderman, Ph.D., call Barbara Cire at 301-496-1752 or email

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