Abstract
ObjectiveTo examine whether investments made in public health research align with the health burdens experienced by white and black Americans.MethodsIn this cross-sectional study of all deaths in the United States in 2015, we compared the distribution of potential years of life lost (PYLL) across 39 causes of death by race and identified key differences. We examined the relationship between cause-of-death-specific PYLL and key indicators of public health investment (federal funding and number of publications) by race using linear spline models. We also compared the number of courses available at the top schools of public health relevant to the top causes of death contributor to PYLL for black and white Americans.ResultsHomicide was the number one contributor to PYLL among black Americans, while ischemic heart disease was the number one contributor to PYLL among white Americans. Firearm-related violence accounted for 88% of black PYLL attributed to homicide and 71% of white PYLL attributed to homicide. Despite the high burden of PYLL, homicide research was the focus of few federal grants or publications. In comparison, ischemic heart disease garnered 341 grants and 594 publications. The number of public health courses available relevant to homicide (n = 9) was similar to those relevant to ischemic heart disease (n = 10).ConclusionsBlack Americans are disproportionately affected by homicide, compared to white Americans. For both black and white Americans, the majority of PYLL due to homicide are firearm-related. Yet, homicide research is dramatically underrepresented in public health research investments in terms of grant funding and publications, despite available public health training opportunities. If left unchecked, the observed disproportionate distribution of investments in public health resources threatens to perpetuate a system that disadvantages black Americans.
Highlights
The goal of public health is to protect and promote the health of all people.[1]
Firearmrelated violence accounted for 88% of black potential years of life lost (PYLL) attributed to homicide and 71% of white PYLL attributed to homicide
Black Americans are disproportionately affected by homicide, compared to white Americans
Summary
The goal of public health is to protect and promote the health of all people.[1]. The existence of persistent racial health disparities between black and white Americans is at stark odds with this goal. Public health research creates the evidence base for effective health policy[6] and for medical breakthroughs that can lead to rapid improvements in disease and injury treatment and prevention.[7,8,9] not all health conditions are studied and conditions that represent larger public health burdens tend to receive more attention. External forces such as funding opportunities and training experiences could direct the focus of public health research towards or away from specific health conditions that may be disproportionately distributed across racial groups. Several in the public health community have questioned if our research and research applications protect the health of all Americans .[10, 11]
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