Breaking Barriers to Longevity for Black Americans

America is graying rapidly and profoundly, with the number of us living to 100—many hitting that milestone in surprisingly good shape—expected to grow sixfold by 2060, pushing the ranks of U.S. centenarians to nearly 600,000. Indeed, centenarians are one of the fastest-growing segments of the U.S. population, and 25 years from now, there will be 3.7 million 100-somethings globally—roughly equivalent to everyone now living in Connecticut or Los Angeles.

The researchers at Stanford University’s Center on Longevity, meanwhile, believe half of today’s five-year-olds can expect to join them. And the United Nations says we stand at the dawn of “a longevity revolution” driven by a wave of aging baby boomers and astonishing new medical advances in treating and even curing the things that kill us.

But few centenarians look like Senhouse, who acknowledged in an interview for my new book, THE BIG 100: The New World of Super-Aging: “I’ve had a journey I never thought I’d ever have.”

Why the barriers to access for longevity are higher for Black people

Extreme longevity is an overwhelmingly white space: People of color account for fewer than two in 10 of all Americans who make it to a triple-digit age. Life, at its essence, is about time—and white people get more of it than people of color do.

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The average life expectancy for Black people in the United States in 2022 (the most recent year for which figures are available) was 72.8 years. By contrast, white Americans could expect to live to 77.5 years, on average, that year. Nearly five years of existence separated the races.

Figures from the U.S. Centers for Disease Control and Prevention (CDC) lay bare just how harrowing the racial gap in health and longevity is: Black Americans ages 18 to 49 are twice as likely to die of heart disease than white Americans, and those ages 35 to 64 are 50 percent more likely to have high blood pressure.

Black Americans ages 18 to 49 are twice as likely to die of heart disease than white Americans, and those ages 35 to 64 are 50 percent more likely to have high blood pressure.

Experts in demography and racial injustice believe this disparity is a consequence of what’s known as “weathering theory,” the idea that the health of Black Americans begins to deteriorate in early adulthood as a physical consequence of socioeconomic disadvantages that add up and take a toll.

It’s already evident at the beginning of life, when Black mothers are roughly three times as likely to die during or after pregnancy, and their newborns face nearly double the risk of dying as that of white infants. And scientists believe weathering is a factor¹ that keeps a disproportionate number of Black people from reaching or exceeding the age of 100.

Arline Geronimus, ScD, the University of Michigan public health and population researcher who coined the term “weathering,” has done pioneering work on the effects of poverty and structural racism on health and longevity. Black women in particular, Dr. Geronimus’s research has found, age faster and develop chronic diseases² such as high blood pressure earlier simply because of the stress of living in a society that discriminates against them. “Accelerated biological aging,” she calls it.

It’s one of the primary reasons COVID-19 had such a disproportionate and devastating effect on communities of color, which tend to have higher incidences of hypertension, diabetes, and other chronic conditions that also increase the risk of being hospitalized or even dying from a respiratory disease like COVID. (COVID, of course, caused U.S. life expectancy for everyone to tumble, but the longer-term trend lines still point to significant life span gains for people of all races and ethnicities.)

Adding to the sense of urgency for addressing this racial disparity in aging, the Census Bureau projects that in 2045, just a little over two decades from now, the United States will become a “minority white” nation. White people will constitute 49.7 percent of the population; Hispanic people, 24.6 percent; Black people, 13.1 percent; and Asian people, 7.9 percent. People identifying as multiracial will make up the remaining 3.8 percent. If the longevity gap remains, we’ll have even more people of color with diminished life spans watching their white neighbors live appreciably longer.

The climate crisis, of course, threatens us all. A 2023 study warns that more people in a warming world will die of heart attacks, strokes, and heart failure³, but it says Black adults would see more than four times the increase in cardiovascular deaths associated with extreme heat as their white counterparts. And wealthy white people hold another advantage over people of color with fewer resources: It’s easier for them to move away from areas imperiled by the effects of climate change.

Maddeningly, the life expectancy gap was narrowing and would have closed in 2036, but progress stalled around 2012 for reasons that still aren’t entirely clear. Researchers, meanwhile, find that Black Americans tend to receive less—and lower-quality—care for serious conditions across the board, as well as less preventive care due to systemic racism⁴.

What it will take to eliminate the racial disparity in longevity

Outliers like Senhouse aside, if you’re a Black American hoping to live to 100, are you doomed to a shorter life? Not necessarily.

Over the past few decades, researchers have demonstrated a fascinating phenomenon that’s become known as the “Black-white mortality crossover.” It says that Black Americans who reach 85 in good shape have demonstrated their survival prowess, and at that point, their ability to go on to 100 or older is demonstrably better than that of their white counterparts of the same age.

Black people aged 85 and older “have kind of gotten over this hump, and to get there, they had to be in amazing shape to fight all the problems of structural racism,” says longevity expert Thomas T. Perls, MD, MPH, founder and director of the New England Centenarian Study. “If they’ve gotten to that point, they really have demonstrated this increased ability to age slowly and get to a very old age.”

How can we give everyone—including Black Americans—an equal shot at achieving extreme longevity? There are no easy answers, but it’s going to take a functioning democracy that responds to the needs of all of its citizens by ensuring everyone is paid a living wage; gets equal access to quality health care; and has affordable and healthy alternatives to fast food, a basic need that eludes millions living in urban food deserts.

For far too many people, fresh food, time to exercise, and access to preventive health care are inaccessible luxuries.

Setting aside a favorable family history, studies show you’re a prime candidate for making it to 100 if you have a good socioeconomic status at midlife; you’re a nonsmoker; you eat a whole-food, plant-forward diet; and you exercise or move your body regularly. But here’s the catch: For far too many people, fresh food, time to exercise, and access to preventive health care are inaccessible luxuries.

“Good food, time to exercise, and access to reasonable health care…are in short supply in many parts of the U.S.,” says sociologist Beth C. Truesdale, PhD, a research fellow studying inequities in aging and work at the W.E. Upjohn Institute for Employment Research.

Much of Dr. Truesdale’s research has examined the effects of toxic stress on aging bodies—and if anyone in American society is hammered relentlessly by stress, it’s people of color. “Those of us who live pretty cushy lives often think stress is like, ‘Oh, I’ve got a work deadline,’” she says. “But the kind of stress that comes from, ‘There’s no way I can pay the rent. I’m going to get evicted;’ the kind of stress that comes from, ‘I cannot stretch the budget to the end of the month, and somebody is going to have to eat less, or less well, than I wish they could’—those sorts of stress really get to the body.”

Toxic stress also manifests in more insidious ways. Wendy McCrae-Owoeye, a Rhode Islander who identifies as biracial, says she’s constantly worrying about her 22-year-old son being stopped by police in Providence. McCrae-Owoeye’s grandmother lived to 104, but at 56, she answers quickly when asked about a 100-year life for herself: “I hope not. I mean, if my destiny is to live to be 100, then I hope it’s a productive 100 years. But if it’s a situation where there’s pain and turmoil, I don’t want to be here.”

Within the realm of longevity and diet, University of California-Berkeley sociologist Caitlin Daniel, PhD, has done intriguing work examining why low-income parents tend to buy less healthy food for their children⁵ than higher-income parents do (beyond issues of cost, access, food deserts, and the time and energy it takes to prepare healthy foods without a stable work schedule). Through interviews with parents at grocery stores, Dr. Daniel discovered that higher-income parents can afford to buy broccoli 20 times—even if their child refuses to eat it 19 times—to teach them to eventually appreciate food that’s good for them. Lower-income parents, by contrast, can’t afford to waste food, so they buy something less nutritious they know their kid will eat.

It’s the same set of realities that prompts a single parent working two jobs to resort to a fast-food drive-thru, if only because it’s cheap and they know their kids will eat it. Millions of Americans make these decisions every day—not necessarily because they want to, but because it’s an affordable path of least resistance. In the long term, however, it undermines their health.

Sociologists and think tanks tick off some practical fixes. For starters, raise the income of people in the bottom half through a higher federal minimum wage. Provide a more robust safety net for people who have disabilities and those who are out of work. Give workers a greater voice, partly by reviving labor unions which, until recently, had unspooled badly over the last few decades. (Unions now look to be having a resurgence, judging from new gains by Starbucks baristas, Hollywood scriptwriters, and Big Three auto workers.)

And find ways to help more people, including more Black Americans, enjoy the longevity benefits of a college degree—which stretch far beyond the bank. Education helps us speak up for ourselves. People who have college educations are more likely to be taken seriously at a doctor’s office and to take care of their own health⁶. They’re also less likely to smoke⁷, or to face dangerous work conditions or work outside in the heat in agriculture, construction, and landscaping jobs, which lead to poorer health than white-collar professions pursued in air-conditioned offices and homes.

As long as something as random as being born in the wrong ZIP code can shorten our lives, lifting communities of color out of poverty will always be the key. “Neighborhoods with large Black populations tend to have lower life expectancies,” writes Jessica Owens-Young, PhD, an associate professor of health studies at American University, in a commentary for The Conversation. And it’s not because of the individual people within them; those predominantly Black neighborhoods are also more likely than majority white neighborhoods to have limited access to longevity-boosting resources, like healthy food and green space. “Place, race, and class shape how well, and how long, people live,” writes Dr. Owens-Young.

Failing to act isn’t an option. If we don’t take steps to close the longevity gap, our very life spans threaten to inflame the unjust divide that already separates the haves and the have-nots.

Having beaten the harsh odds herself, 112-year-old Senhouse—who credits her own longevity to staying active and positive, and maintaining a live-and-let-live approach—remains hopeful the centenarians of the future will look more like her. “We’re not going anywhere,” she says. “So they might as well live with us.”