Why Black Men Die Seven Years Younger — And the Answers Aren’t All About Racism

Seven years. That is the distance between a Black man’s grave and a white man’s. Seven years of sunrises he will not see, of grandchildren he will not hold, of wisdom he will not pass down, of presence he will not offer to the communities that need him most desperately. In 2021, the Centers for Disease Control and Prevention published the numbers that should have stopped every conversation in Black America until the problem was solved: Black male life expectancy stood at 70.8 years, compared to 76.4 years for white males. That is not a statistic. That is a mass casualty event unfolding in slow motion across every Black neighborhood in this country, and it has been unfolding for so long that we have mistaken the emergency for the weather.

I want to talk about this gap with the kind of honesty that nobody profits from. Not the half-truth that lays the entirety of Black death at the feet of structural racism and asks nothing of the men who are dying. Not the other half-truth that blames personal choices while ignoring the documented systems that constrain those choices. I want the whole truth, because the whole truth is the only thing that has ever saved anyone, and Black men are running out of time to be saved by comfortable lies.

The Structural Factors Are Real

Let us begin with what is imposed, because intellectual honesty demands it. The Institute of Medicine’s landmark 2003 report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, documented with exhaustive precision what Black patients had known for generations: that the American healthcare system treats Black bodies differently. Not anecdotally. Systematically. The report found that Black patients receive fewer cardiac medications, fewer bypass surgeries, fewer kidney transplants, fewer diagnostic procedures, and less adequate pain management than white patients — even when controlling for insurance status, income, age, and severity of illness. This is not a conspiracy theory. This is a 764-page document produced by the National Academy of Sciences.

The environmental dimension is equally documented. Dr. Robert Bullard, whom the academic world recognizes as the father of environmental justice, demonstrated in his 1990 work Dumping in Dixie that hazardous waste facilities, polluting industries, and toxic sites are disproportionately located in Black communities. This is not coincidence. It is the cartography of racism — drawn in zoning maps, encoded in property values, enforced by political indifference. The health consequences are measured in elevated rates of asthma, cancer, lead poisoning, and cardiovascular disease among Black residents who did not choose to live next to a chemical plant but inherited that proximity through the architecture of segregation.

Food deserts compound the damage. The USDA has documented that Black neighborhoods are significantly less likely to have access to supermarkets with fresh produce and significantly more likely to be saturated with fast-food restaurants and convenience stores selling processed food. In some neighborhoods on the South Side of Chicago, the nearest grocery store with fresh vegetables is a forty-minute bus ride away. The nearest McDonald’s is on the corner. This is not personal failure. This is infrastructure failure, and it kills slowly and reliably.

These structural factors are real. They are documented. They deserve every dollar of investment and every ounce of policy attention they receive. But they are not the entire story, and pretending they are is its own form of violence — because it strips Black men of the one thing that might actually save their lives: agency.

The Behavioral Crisis Nobody Will Name

Here is what the advocacy organizations will not say at their fundraising galas, what the public health campaigns tiptoe around with euphemism, what the entire infrastructure of racial grievance refuses to confront directly: Black men are making choices that are killing them at rates that structural racism alone cannot explain.

Hypertension. The American Heart Association reports that 55% of Black men have high blood pressure, compared to 43% of white men. This is the single largest driver of the cardiovascular disease that is the leading cause of death for Black males. Some of this is genetic predisposition — research suggests that populations with West African ancestry may have heightened salt sensitivity. But genetics do not explain the entire gap. Diet explains a substantial portion. Black men consume more sodium, more processed food, more fast food, and fewer fruits and vegetables than nearly any other demographic group in the United States. This is documented by the CDC’s National Health and Nutrition Examination Survey, and it is not a function of food deserts alone — it persists across income levels.

Obesity. Black men have among the highest obesity rates in the nation. The CDC’s 2020 data shows that 41.1% of Black adults are obese, compared to 30% of white adults. Obesity is the gateway to diabetes, heart disease, stroke, and certain cancers — the diseases that are driving the life expectancy gap. And while food access matters, the research is clear that obesity correlates with behavior patterns — portion sizes, meal frequency, physical activity levels, and food choices — that are modifiable regardless of zip code.

Preventive care. Black men are the demographic group least likely to visit a doctor for routine preventive care. They are less likely to get blood pressure checked, less likely to get cholesterol screened, less likely to undergo cancer screenings, and less likely to follow up on diagnosed conditions. The reasons are multiple — historical distrust of the medical system (rooted in documented atrocities like the Tuskegee syphilis study), cultural norms that equate medical visits with weakness, and practical barriers like work schedules and insurance gaps. But the result is the same: diseases that are treatable when caught early become death sentences when caught late, and Black men are catching them late at catastrophic rates.

The Violence That Is Entirely Ours

And then there is the factor that makes the life expectancy conversation unlike any other in American public health: homicide. For Black males aged 15 to 44, homicide is a leading cause of death. Not a contributing factor. Not an occasional tragedy. A leading cause. The CDC reports that Black males are approximately ten times more likely to die by homicide than white males of the same age. In 2020, homicide was the number one cause of death for Black males aged 15 to 34.

This is not being done to Black men by the healthcare system. This is not a function of food deserts. This is not a consequence of environmental racism. This is Black men killing Black men in numbers that would constitute a national emergency if the victims were any other color. And until we can say this plainly — without the reflexive pivot to systemic causes, without the insistence that poverty explains everything, without the intellectual dodge that treats Black men as objects being acted upon rather than human beings making decisions — we cannot begin to address it.

I am not blaming victims. I am refusing to insult the dead by pretending they had no agency in life. The vast majority of Black men in impoverished neighborhoods do not commit homicide. The vast majority of men facing the same structural pressures find ways to live without taking life. The ones who choose violence are making a choice, and treating that choice as an inevitable consequence of circumstance is the soft bigotry of low expectations dressed in progressive language.

The Mind That Is Killing the Body

Beneath the physical health crisis lies a psychological one that may be even more lethal. The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that Black men are the least likely demographic group in the United States to seek mental health treatment. The numbers are staggering: only about one in three Black adults with a diagnosable mental illness receives treatment, compared to roughly half of white adults. Among Black men specifically, the rate is even lower.

The reasons are cultural as much as structural. The “strong Black man” archetype — the notion that a Black man must be stoic, unbreakable, emotionally impervious — is not just a cultural preference. It is a death sentence being administered one suppressed emotion at a time. A 2009 meta-analysis by Chida and Steptoe, published in the Journal of the American College of Cardiology, examined 44 studies involving over 6,000 participants and found that chronic anger and hostility — the emotions most associated with emotional suppression in men — were associated with a 19% increase in coronary heart disease risk in healthy populations and a 24% increase in poor prognosis for those already diagnosed.

Translation: the man who refuses to feel is the man whose heart gives out at 62 instead of 82. The man who equates vulnerability with weakness is the man who drops dead at a family cookout because he never told anyone — not his wife, not his boys, not himself — that the weight he was carrying had become unbearable. The strong Black man trope does not make Black men strong. It makes them silent. And silence, sustained over decades, is indistinguishable from a chronic disease.

“The most dangerous thing you can do to a man is convince him that his pain is not real, that his vulnerability is a betrayal of his manhood. You will produce a man who dies with his fists clenched and his heart shattered, and everyone will call him strong.”

What the Men Who Live Longest Do Differently

There is another story inside these numbers, and it is a story of survival, of documented protective factors, of Black men who are beating the actuarial tables not through luck but through choices that the data has validated. If we are serious about closing the seven-year gap, we must study these men with the same intensity that we study the ones we are losing.

Marriage. The research on marriage and male longevity is among the most robust in all of social science. A landmark Harvard study tracking men over 75 years found that close relationships were the single strongest predictor of health and longevity — stronger than cholesterol, stronger than social class, stronger than genetics. Married men live, on average, eight to seventeen years longer than unmarried men, depending on the study and the population. For Black men, the protective effect of marriage is amplified by the stability it provides against the particular stresses of being Black in America — the steady presence of a partner who monitors health, who insists on the doctor’s visit, who notices when something is wrong before the man himself will admit it.

Church attendance. The research here may surprise secular audiences, but it is unambiguous. A 2016 study published in JAMA Internal Medicine, tracking over 74,000 women and subsequently extended to male populations, found that attending religious services more than once per week was associated with a 33% reduction in mortality compared to non-attendance. For Black men, the church provides what social scientists call a “health-promoting social network” — a community that checks on you, that feeds you, that holds you accountable, that gives you purpose beyond yourself. The Black church has been criticized for many things, and some of those criticisms are valid. But the data says it is keeping people alive.

Preventive healthcare. Black men who establish relationships with primary care physicians and maintain regular checkups have dramatically different health trajectories than those who do not. A 2018 study in the National Bureau of Economic Research found that Black men who were randomly assigned to Black male physicians were significantly more likely to agree to preventive screening, particularly for cardiovascular conditions and diabetes. The implication is clear: the distrust that keeps Black men out of doctors’ offices is real, but it can be overcome with culturally competent care. The men who overcome it live longer.

Exercise. The American College of Sports Medicine has documented that 150 minutes per week of moderate physical activity reduces all-cause mortality by approximately 30%. For Black men — who face elevated risks of hypertension, diabetes, stroke, and heart disease — the impact is even more pronounced. Walking. That is all the data requires. Thirty minutes of walking, five days a week. The cost is zero. The barrier to entry is a pair of shoes. And yet the CDC reports that Black adults are among the least physically active demographic groups in the country.

Social connection. Loneliness is a public health crisis that kills as reliably as smoking, according to the U.S. Surgeon General’s 2023 advisory. For Black men — who are socialized to be islands, to need nothing, to stand alone — the prescription is community. Not the community of the street corner, where presence is performance. The community of genuine connection, where a man can say I am struggling and hear back I know, brother. Me too.

The Part You Can Change Tomorrow

I am not interested in the debate over whether structural racism or personal behavior bears more responsibility for the seven-year gap. That debate is a luxury that dead men cannot afford. Both are true. Both are documented. And the critical difference between them is this: you cannot dismantle the American healthcare system by next Tuesday, but you can schedule a physical. You cannot relocate every toxic waste facility out of Black neighborhoods by the end of the month, but you can walk thirty minutes a day. You cannot undo four hundred years of environmental racism before your next birthday, but you can put down the cigarette, pick up the water bottle, and tell someone you love that you are not okay.

The structural factors are real, and they require structural solutions — policy, investment, political power, sustained advocacy. These are generational projects. They require patience and persistence and collective action, and they are worth every effort. But generational timelines are meaningless to the man whose heart will stop next year because he never got his blood pressure checked. That man needs something he can do now.

And the truth that nobody in the advocacy world wants to say, because it sounds too much like blaming the victim, is this: the portion of the life expectancy gap that is driven by personal behavior is the portion that is most immediately addressable. Not because the structural factors don’t matter. Because the structural factors take decades to change, and Black men are dying today.

“You cannot wait for the system to become just before you decide to live. Justice may take a generation. Your heart will not wait that long.”

Seven years. That is what is at stake. Seven years of watching your daughter graduate. Seven years of holding your grandson. Seven years of being present in a community that is hemorrhaging the presence of its men. Some of those years are being stolen by systems that must be reformed. But some of those years are being surrendered by choices that can be changed — by the doctor’s appointment not made, by the blood pressure not checked, by the emotions not spoken, by the walk not taken, by the help not asked for.

The part of this gap that is imposed upon you demands your outrage and your political action. Fight for it. The part of this gap that you are choosing demands something harder. It demands that you look in the mirror and decide that your life is worth the effort of preserving it. That your children need a living father more than a strong one. That vulnerability is not weakness — it is the precondition for survival. That seven years is not a statistic. It is the distance between being there and being gone, and the men who close that distance do it one choice at a time, starting with the choice to admit that some of this — not all of it, but enough of it — is in their hands.

Your hands. Use them.