The Watch: July 6, 2023

Maternal deaths remain high for Black, American Indian and Alaska Native women

Maternal death rates in the United States more than doubled over two decades, with some women of color experiencing especially higher rates, a new study finds. 

Published July 3 in the Journal of the American Medical Association, the study found that U.S. maternal deaths increased from 13 per 100,000 live births in 1999 to about 32 per 100,000 in 2019. 

The rates were not even across all racial and ethnic groups, however. Black and American Indian and Alaska Native women had the highest maternal death rates, followed by white women. The lowest maternal death rates were among Hispanic and Asian women.

American Indian and Alaska Native women experienced the greatest increase in maternal death risks of all population groups, while the overall risk of maternal death was highest among Black women. 

The rates also varied significantly by U.S. region, even within racial and ethnic groups. For example, Black women who lived in the Northeast and South had significantly higher maternal death rates than those in the West and Midwest. Maternal death rates among American Indian and Alaska Native women were higher in the Midwest and West and lower in the Northeast and South.

While data collection on maternal deaths has improved during the past two decades, the worsening disparities show that prevention work has had “limited” impact, the researchers said.

Higher temperatures linked to increased vision problems

Older adults who live in warmer regions are more likely to have serious vision impairments than their peers who live in cooler areas, new research finds.

The findings have implications for people around the world as temperatures grow hotter with climate change, according to the study, which was published in June in Ophthalmic Epidemiology. 

Researchers compared vision problems among Americans ages 65 and older with temperature data, finding that the odds of severe vision impairment were 44% higher in U.S. counties with average temperatures of 60 degrees or above, as compared to counties with an average temperature lower than 50 degrees. The association held steady across both Black and white populations, with some variation for Hispanic people.

The researchers suggested that higher exposure to ultraviolet light owing to more time spent outdoors in areas with warmer temperatures may play a role in the regional differences, as could infections that occur in warmer climates and increased exposure to air pollution.

Vision impairment impacts about 12 million Americans ages 40 and older, but that number is expected to rise in coming decades as the nation’s older population grows. By 2050, the number of people around the globe ages 60 and older is expected to double, while the number ages 80 and older will triple, the World Health Organization predicts.

Some cancers on the rise for U.S. Hispanic population

While cancer incidence and deaths are usually lower for Hispanic Americans than white Americans, several types of cancer are on the rise in the population, new research finds. 

Reflecting an overall U.S. trend, cancer deaths for Hispanic Americans decreased population-wide from 1999 to 2020. However, liver cancer deaths increased among Hispanic men and liver, pancreatic and uterine cancer deaths increased among Hispanic women. The highest increases in liver cancer death rates by region occurred in the Western U.S., according to the study, which was published June 29 in JAMA Oncology.

By age group, the study also found an increase in cancer deaths for men ages 25 to 34, which researchers linked to high rates of colorectal and testicular cancer deaths among the age group.

Researchers suggested that problems with access to health care and insurance coverage may be driving some of the increased rates. Hispanic people with cancer also tend to be diagnosed at later stages of the disease, which can lower survival rates. Cancer is the lead cause of death for Hispanic people in the U.S.

Exposures, stressors aging Black Americans faster

Negative environmental and socioeconomic factors are leading Black Americans to age more rapidly than their white peers, a new study finds. 

Published July 5 in PLOS One, the research found that neighborhood environments, air pollution and socioeconomic status contribute to accelerated biological aging, also known as weathering, among Black Americans. 

Previous research has shown that Black Americans are often biologically older than their white peers, as reflected through measures in their DNA.

The new study, conducted by researchers at the University of Pennsylvania, found that exposure to particulate matter and nitrogen dioxide and to factors such as unemployment levels and feelings of neighborhood untrustworthiness can fuel weathering among Black Americans. 

Accelerated biological aging can cause people to experience poorer health earlier in their lives. Across U.S. and racial ethnic groups, Black Americans have earlier onset of illnesses such as colorectal cancer, diabetes and kidney disease and often have worse health outcomes. Addressing the exposures that contribute to faster biological aging could help close those disparities, the researchers said.

Rapid increase in injury-related deaths draws alarm

Injury-related deaths have increased rapidly over the past two decades in the U.S. and constitute a “national emergency,” researchers conclude in a new study.

Deaths from unintentional poisonings, firearms and all other injuries increased significantly from 1999 to 2020, according to the study, which was published July 3 in JAMA Internal Medicine.

From 2013 to 2020, gun-related deaths increased by an average of 4.7% each year among people ages 20 to 39. And from 2014 to 2020, deaths rose 6.9% a year from gun-related homicides specifically. Firearm-related death rates were consistently higher among Black Americans than other racial and ethnic groups, which the researchers suggested may be linked with both structural racism and neighborhood environments.

Death rates for unintentional poisonings, which include drug overdoses, had the fastest rate of increase among all injuries during the study period, with the quickest jump among American Indian and Alaska Native people. Black and Hispanic people also experienced sharp increases in poisoning deaths.

Across all injuries — which also include those from falls and motor vehicles — the death rate increased from about 66 per 100,000 people in 1999 to almost 104 per 100,000 in 2020 — a more than 57% increase.

The rapid increase in deaths requires “urgent public health interventions at the local and national levels,” said the researchers, who were associated with the National Cancer Institute, the National Institute on Minority Health and Health Disparities and other research institutions.

The Watch is written by Michele Late, who has more than two decades of experience as a public-health journalist.