Family and Health

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Family and Health

Rose M. Brewer

Family Structure and Stability

Marriage

Gay/Lesbian/Bisexuality/Transgender Issues

Fertility and Births

Children

Health

Life Expectancy

Assessment

Social Activists

Vital Statistics

It is increasingly clear that despite formal definitions of family, family formation in the U.S. is in the process of change. While the formal definition of the family as defined by the U. S. census is a group of two or more persons (one of whom is the householder) who are related by birth, marriage, or adoption, and who reside together, a wide range of family formations are being organized. Increasingly family in the everyday is defined as those who are significant and supportive of one another. Thus flexibility is the signature feature of U.S. family life today. This contrasts with the ideal or normative notion of the American family. In the ideal, the American value system rooted in white normative assumptions, has traditionally embraced the concept of lifetime monogamous marriage and prized the “nuclear” family pattern of husband and wife living with their own children in the same household. This structure has been supported in family policy and the cultural imagination. Yet, with divorce rates still hovering at about 50 percent, the prevalence of this idealized pattern has diminished. Remarriages have created increasing numbers of “blended” families comprised of various configurations of stepparents and stepchildren. Formal adoptions of stepchildren and increasing adoptions of children from other countries are also more common. The growth in the numbers of single-parent families headed by women continues apace in all sectors of the population. Cohabitation has virtually become a rite of passage for many twenty-somethings. And, doubtless, the push to formalize through marriage gay and lesbian unions is a prominent feature of the current period. Indeed according to Zinn and Eitzen in Diversity in Families (2005, 7th ed.) “nonmarriage has nearly doubled in the past three decades, from 28 percent of the adult population in 1970 to 40.5 percent in 2000” (citing the U.S. Bureau of the Census, 2002d, p. 439).

Key noteworthy shifts in family formation and change in the U.S. include:

  1. The push for same sex partner guarantees and marriage
  2. The increases in interracial marriages and unions
  3. The continuing formation of blended families constituted as “yours, mine and ours” (Zinn and Eitzen, 2005)
  4. Single female-led family formations

FAMILY STRUCTURE AND STABILITY: THE AFRICAN AMERICAN EXAMPLE

While these features of family change continue to draw media attention, African American families, historically,

have been more diverse in family structure than the idealized norm of the nuclear family. Black families have been crafted in the context of the remembered cultures of Africa, cultural creativity within the United States, enslavement, racism, and persistent institutionalized inequality. Family life was central to African cultures and social organization, and enslaved Africans brought this value with them to America. However, the conditions of enslavement often prohibited the existence of a stable African American family. Harshness and cruelty, rape and the severing of family bonds were all too common during enslavement, and slave marriages were not recognized by law. Even so, strong bonds could be formed among enslaved men and women. Herbert Gutman’s classic work, The Black Family in Slavery and Freedom (1976) indicates that some unions lasted 10, 15, and as many as 25 years depending on the region and the time period. Nonetheless, kin relations rather than marriage were the linchpin of African American families under enslavement. This kin principle remains strong to the present.

Thus, one family pattern that has historically been common among African Americans is that of the “extended” family. This family grouping includes other relatives such as grandparents, aunts, uncles, cousins, nieces, nephews, or other relatives, formally or informally adopted, who share the household temporarily or for a longer time period with a nuclear family. Extended families have long been a strong support system within the African American community. Today, members of extended families may not all live in the same household because of the migratory patterns of family members or cluster together under the same roof or geographic space but they nonetheless function as a supportive intergenerational kinship unit.

Andrew Billingsley, in his now classic work Black Families in White America (1968), identified an additional category of families called “augmented” families, which included unrelated persons. In “Understanding African American Family Diversity,” an essay from The State of Black America (1990), Billingsley describes these supportive, dependable, families as networks of relationships. Another classification, “fictive kin,” as defined by Carol Stack in All Our Kin (1974), includes “play” mothers, brothers, sisters, and so on, who usually do not live together. In some communities, these friendship networks resemble and substitute for extended family networks that may no longer exist. In the recent scholarship of Leanor Boulin Johnson and Robert Staples, Black Families at the Crossroads (2005), it is demonstrated that the collective ethos persists in 21st century Africa America. Across class lines, extending into the middle classes, the expectation and practice of reaching out to extended kin is a feature of African American family life.

As Billingsley contends, diversity is and always has been characteristic of African American family life. African American households presently fall into the following categories: (1) married couples with children; (2) married couples without children; (3) extended families (usually those including grandparents); (4) blended families; (5) single-parent families (usually but not always headed by women); (6) cohabitating adults (with or without children); and (7) single-person households (predominantly female).

Foster families are also a growing phenomenon in the African American community and have been the source of considerable debate. It is usually argued that not enough African American families are sought out to foster African American children. As poverty has increased for many African American families, the issue of bureaucratized foster care will remain a contentious one, and so will the issue of the large number of single female-headed households who are quite vulnerable to scrutiny by the child welfare system. Indeed, this family form is more characteristic of the African American

population than of any other American racial or ethnic grouping today. Dorothy Roberts (2002) in Shattered Bonds: The Color of Child Welfare reports extensively on the racial bias permeating the entire child welfare system in the United States. Especially chilling are her data on foster care. Her analysis of foster care emphasizes the crisis of Black children caught in this system. Hundreds of thousands of Black children are languishing in foster care across the U. S. In cities such as New York and Chicago the numbers are truly staggering. In Chicago, for example, 95% of the children in foster care are Black. Roberts is quite clear that racism is a key factor in this situation. She points out the crisis is rooted in often arbitrary, racially based decisions regarding what constitutes neglect. This becomes the pretext for removing children. The crisis is also fueled by the staggering incarceration rate among African American men and women.

NUMBER AND SIZE OF FAMILIES

According to U.S. Census reports, there were 8.7 million African American family households in the United States in 2000, up from 6.2 million in 1980. This increase was most evident in the number of married-couple families and female-headed families with no husband present. In 2000, married-couple families comprised only 47.8 percent of all African American families, contrasted with 1980 when they comprised 56 percent. Forty-four percent of African American families in 2000 were headed by a female householder with no husband present, an increase from the 1980 proportion of 40 percent.

The increase in African American female-headed families can be attributed to a multiplicity of factors: racism, the shortage of eligible African American males, the economic vulnerability of African Americans, the shorter life expectancy of African American males, increasing separation and divorce rates among African Americans, the rising rate of out-of-wedlock parenthood, and significantly, the rising incarceration rates of African men and increasingly women. Many communities have been virtually emptied of 18-34 year old Black men. Black and Brown men make up more than half the U.S. prison population of over 2 million with over 6 million having some contact with the criminal justice system. Gender and sexual norms have changed. The

historic stigma associated with out of marriage births has diminished significantly. The assumption that any relationship is preferable to being without a partner is challenged as women live independently and separately from unfulfilling or abusive relationships. This emerging American pattern of female autonomy coincides with the existing African American cultural norm of more egalitarian relationships between women and men than typically found in European American families. Significantly, male-headed households with no spouse present represented a mere 8.2 percent of African American families in 2000.

The African American family’s structure and status have changed dramatically over the last 40 years, and its configuration, while following the majority population’s general post-World War II trends, reflects historical inequities between the races that make the African American family’s security especially tenuous as the nation is the first decade of the twenty-first century. The same forces that have molded the United States into what it is today have been at work on all facets of African American family life and culture. In that sense, the fortunes of African Americans ebb and flow with the tide of the general economic and social conditions of the nation, especially racial, class, and gender inequities. The African American family also faces dilemmas that emanate from its unique position and identity within American society and the persistence of institutional racism in American society.

Unfortunately, social policies have historically and contemporariy disadvantaged African American families. For example, the racial wealth divide in the U.S. is deeply located in governmental policies which boosted the prospects of white families and created barriers and blocked the mobility of African Americans (Lui, et. al., 2006). Moreover, by 2003 the median family net worth for African American families was $20,600. This is compared to the $140,000 median family net worth for white families (Lui, et. al., 2006). These figures can be located in state policies which provided access to housing and mortgages which kept Black families out of home ownership. The discrepancy is partially attributed to the fact that African Americans tend not to have accumulated assets to pass onto the next generation through inheritance, one of the most significant ways in which people amass wealth.

Some analysts are theorizing complex systems to explain these inequities. This scholarship on Black families introduces the framework of the intersectinality of race, class and gender for analyzing families. Shirley Hill’s recent publication, Black Intimacies: A Gender Perspective on Families and Relationships (2005) is a case in point. While centering gender, she understands that race, the fulcrum of black family inequality in the U.S., has been deeply embedded in gender and class. Thus the kind of culturally centered analyses which have dominated Black family discussions must be thought about in the context of a capitalist, class based society which is heavily racialized and gendered.

As Hill points out, the intersection of race, class and gender inequality converge to create deeply rooted inequities as indicated in these data. Class does matter in this equation.

Indeed, the political struggles of the Civil Rights movement culminated in increased opportunities for a segment of the African American population, but a significant number of African American families remain locked in poverty. Deindustrialization and globalization of the economy represent a notable structural shift with devastating consequences for many urban and rural African American families. As old city industries close down to settle in white suburbs or out of the country, many African Americans face increasing joblessness.

In fact, the U.S. census data reveal that since the late 1960s the African American unemployment rate has been twice as high as the white unemployment rate, regardless of the economic condition of the country. The 1970s and 1980s, however, were periods of severe economic instability and recession in the United States. African American males were particularly hard-hit by joblessness and underemployment during these decades due to the decline of the manufacturing industries in which many African American males were employed in the automobile and steel industries, for example. This combination of double-digit inflation and high levels unemployment during the 1970s and 1980s disproportionately eroded the purchasing power of African American families. Yet even in the 1990s, during a period of economic expansion and prosperity, many African Americans were still marginalized from the economy.

The data for the early 21st century are also quite disturbing. The poverty gap has increased in the U.S. as reported in dated analyzed by the McClatchy group of newspapers in February 2007. “Nearly 16 million people are now living on an individual income of less than $5000 per year”. And officially, at least 37 million people in the U.S. are classified as poor. Most strikingly, the report points out that those living in severe poverty is the fast growing segment of those who are poor. A disproportionate number of those in severe poverty are African Americans.

African American families in the lower economic strata are earmarked by the growth in the numbers of households headed by poor, never-married African American females. In 1994, the Center for the Study of Social Policy found that this growth in female-led families correlated almost perfectly with the growth of African American male joblessness. Other issues for these families include: high levels of teenage pregnancies; the shortage of marriageable, employed African American males; disparities between black and white earning power; inadequate housing and social services; and chronic unemployment and underemployment. Some of the social and psychological costs of these phenomena are the crime, violence, drug abuse, and despair that are frequently endemic in many low-income communities, along with the disproportionate numbers of imprisoned African American males from those communities.

With drug trafficking pervasive in a number of inner-city areas, drug-related homicides among African Americans are still quite high. Young people turn to the illegal economy as the broader economy remains closed to them. Moreover, a disproportionate amount of drugs and guns are brought in from the outside and dumped into these communities. These activities continue to have very negative impacts on African American families and communities.

Some analysts place the primary blame for the deterioration of inner-city African American families on public policies that are inimical to these families, or on the absence of public policies that provide corrective measures that could empower them to help themselves. This argument was made over fifteen years ago by Robert B. Hill, who in a 1990 essay entitled, “Economic Forces, Structural Discrimination, and Black Family Instability,” contended that, “the key economic policies that undermined black family stability have been anti-inflation fiscal and monetary policies, trade policies, plant closings, social welfare, block grants, and federal per capita formulas for allocating funds to states and local areas that have not been corrected for the census undercount.”

Particularly crippling in Hill’s view was the absence of policy to provide affordable housing for moderate and low-income families, an absence that has a greater impact on African American families because of their unique employment and income problems. One consequence of this shortage is a return to traditional African American extended or augmented family arrangements as dispossessed family members seek temporary housing with relatives and as friends share their abodes with the less fortunate. Another consequence is that increasing numbers of African American families are homeless. Hill estimated the number of homeless individuals and families in 1989 at two to three million. Many of these families, but not all, were single-parent families headed by women.

Other progressive analysts have placed the deterioration of inner-city families squarely on the structural inequality of increasing privatization and the deteriorating employment, income, and wage levels for these families. These analysts also argue that the dismantling of the social welfare state and mandatory work to welfare expectations now in effect will not lift single-parent, female-headed families out of poverty. This dismantling of the U.S. social welfare state through welfare reform is embedded in a fundamental shift in the social contract: increased pursuit of global private profit with little commitment to domestic social programs.

As noted, the recent work of Lui, et. al (2006) points the finger at governmental policies which have deeply disadvantaged African Americans and other groups of color in wealth accumulation, access to housing markets, GI benefits, educational equity, land and basic citizenship rights.

Even other analysts, many of them neoconservative or conservative in their sociopolitical orientation, continue to attribute the marked erosion in the social and economic stability of African American families to internal factors within the families themselves, to the welfare system, and to the “Great Society” programs. For example, Irving Kristol noted that, while illegitimate births have increased startlingly since World War II, among African Americans the rate had risen to 66 percent in 1992, by 1998, this rate stood at 69 percent. Kristol decried the decline in “family values” among these “single moms” who, after having one illegitimate child, opt for and remain on public welfare support as they continue to produce additional children. Daniel Patrick Moynihan alleged that “Great Society” programs destroyed the inner-city black family structure, largely through welfare policies, and argued that social scientists still do not know what public policies will reverse the downward spiral of life conditions of inner-city African American families. Central to Moynihan’s analysis and that of his neoconservative successors who have sought to

understand changes in African American community and family relations were the relationships between African American family stability and male employment, unemployment, and labor force nonparticipation rates. In 1965, Moynihan and his staff reported strong indicators of change in behaviors of the African American urban poor including a rise in Aid to Families with Dependent Children (AFDC), even as the African American unemployment rate declined, and an increase in the percentage of non-white married women separated from their husbands. As a result of these factors, Moynihan argued, the African American community had become immersed in “a tangle of pathology” that included family breakdown. Many prominent African Americans disputed Moynihan’s conclusions and accused him of “blaming the victims” of social conditions rather than looking at the causes of their problems (i.e., racism, segregation, economic inequities).

K. Sue Jewell continued this line of argument by maintaining that “policies, procedures, and assumptions underlying social and economic programs in the 1960s and 1970s, the ‘Great Society’ years, contributed to the disintegration of black two-parent and extended families and to an increase in black families headed by women.” Jewel asserted that “social and economic programs and civil rights legislation could not effectively remove social barriers, which prevent black families from participating fully in mainstream American society.” In her view, the liberal social policy of the Great Society era resulted in modest, but not substantial, gains for middle-class African American families. Since Jewell’s analysis, welfare reform legislation passed in l996 which, in effect, ended AFDC. There is a five-year limit on how long families can receive AFDC aid with this legislation (sometimes less, depending on the state) and women are expected to work. This welfare to work feature is known as “workfare.” It is too early to determine the long-term impact of these policy changes on African American families, but there is little evidence that the strategy will move a significant number of poor, female-led families out of poverty.

THE BLACK MIDDLE AND UPPER CLASSES AND FAMILIES IN THE AFRICAN AMERICAN COMMUNITY

While disproportionate segments of African American families are poor, significant growth in the number of middle-class and affluent African American families at the upper end of the family spectrum has occurred, particularly of younger, college-educated, dual-income, married-couple families. This growth has largely occurred since the opening of the opportunity structure in the mid-1960s with the passage of the Civil Rights Act of 1964 and the Voting Rights Act of 1965. Less research has been focused on these upper-strata families than on low-income African American families; as a result, less is known about African American families that are prospering in the current economic climate, though they are one of the largest and fastest-growing segments of the nation’s consumer population.

In February of 1996, Stephen Garnett of Dollars & Sense noted that “blacks represent less than 13 percent of the American population but exercise a purchasing power that equals the gross national product of the ninth largest country in the world.” In 1994, African Americans spent $304 billion, much of it on leisure-oriented goods and services, reflecting a more sophisticated consumer. In the recent past, African Americans tended to spend more on cars, furniture, and home appliances and to devoutly express brand loyalty. In the 1990s, African Americans began to seek superior quality and value rather than blindly purchasing products based on established shopping habits. Support of African American-owned businesses remains an issue, however.

By the mid-1990s, a growing economic differentiation among African American families was increasingly evident; approximately one-third were prospering. Indeed, some African American families& primarily married-couple families headed by highly educated spouses with two or more fully employed earners are becoming more affluent. These families, who tend to live in suburban areas, are primarily nuclear families, though some are blended units. They may also be part of supportive friendship networks.

Affluent African American families have benefited from the formal abolition of segregation and other legal barriers to social, educational, occupational, and residential access and equity. Many of them are headed by persons who are second-, third-, and even fourth-generation college graduates, the beneficiaries of a heritage of education, motivation, and hard work. Nonetheless, such affluent African Americans continue to face “glass ceilings” and attitude-related barriers in many jobs as they seek to move upward in corporate or government hierarchies. Housing discrimination remains a fact for all classes of African Americans. Housing and urban development testers who tract access to rental and home ownership markets for various racial-ethnic groups, report continuing housing discrimination along racial lines.

Another third of African American families, the working (middle) class, is comprised of families that are struggling to maintain themselves and provide support systems for their young in the face of reductions in force (RIFs), layoffs, or terminations as the corporations upon which they depend for their livelihood have downsized, moved to different regions of the country, gone out of business, or exported jobs to other countries. The extended or augmented family structure is visible in many of these homes. “Fictive kin” often are part of these family relationships.

The final third includes the nation’s poorer African American families. This grouping includes (1) former working-class families who have fallen on hard times; (2) the “working poor,” who are employed daily but at minimum wages that do not permit secure or dependable livelihoods; and (3) families of the poorest of the poor, most of which are headed by females alone. While a small percentage of those who have been on welfare, many of this latter group have been supported by the welfare system for one or more generations.

MARRIAGE

In 1999, married-couple families constituted only 47.1 percent of all African American families. 45.1 percent of African American families were headed by a female householder with no husband present. Overwhelmingly, the nation’s poor black families fell into this latter category. In 1999, only 38.6 percent of African American women 18 years of age and over were married, compared to 60.3 percent in 1960. The corresponding percentages for African American men were 44.8 percent in 1999 and 63.3 percent in 1960. Clearly issues around sex ratios, redefinition of gender expectations in intimate relations, and alternative life styles such as increasing levels of cohabitation figure into the change.

In 1997, married couple families comprised only 46 percent of all African American families.

THE UNAVAILABILITY OF AFRICAN AMERICAN MEN THESIS

One of the prevailing theories regarding the declining rate of marriage among African American centers on the population of African American males aged 15 years old and over in 2000 stood at 12,248,240 compared to 14,181,294 African American females in the same age grouping. The resulting ratio of approximately 86 males to every 100 females makes the matching of every African American female with a same-race male for the traditionally valued lifetime monogamous marriage a numerical impossibility. This perspective was popularized in the work of William J. Wilson, most developed in his book, The Truly Disadvantaged (1990). There simply are not enough African American men in the available marriageable pool. When one also removes from consideration those males who are gay who choose not to marry, the proportion of eligible African American men for African American women is further reduced. Moreover, when one counts the number of African American males who are ruled out because of educational inequality and therefore educationally mismatched for marriage to their relatively more highly educated African American female counterparts, the pool of eligible men shrinks even smaller. High African American male unemployment rates further compound the problem. These factors help to explain the increasing numbers of never-married African American females.

Incarcerated single African American men are unavailable as marriage partners, and African American men in prison who are married are unavailable to be at home with their families and/or provide for them. According to the U.S. Census Bureau’s Statistical Abstract, in 1999 there were approximately 251,800 African American male inmates in jails alone, not including those in federal and state prisons or juvenile institutions.

In 1997, 9.7 million or 42.4 percent of African American adults (18 years old and over) were married.

Reportedly, many of today’s young African American men delay marriage or never marry because of their unemployment or underemployment status, the rationale being that lack of a job or small earnings will not enable them to support families. However, well-educated black men who are employed at good salaries are also less likely to be married than their white counterparts. Marriage outside the race further reduces the number of African American men available for marriage to African American women. Although not nearly enough explored in African American family studies, shifting norms around gender expectations are impacting African American marriage expectations. The work of Beverly Guy Sheftall and Johnetta Cole, look at the impact of sexism on gender roles. They point out that validating self through marriage has been challenged. The marriage rate for upper income, highly-educated African American women has traditionally been low and continues to be so. Issues of sexism, male violence, and domestic abuse also figure into the equation in African American women’s decisions of whether to marry or not.

INTERRACIAL MARRIAGE

In the three decades between 1960 and 1990, interracial marriages more than quadrupled in the United States, but the number remains small. By 1999 less than one percent of all marriages united African Americans with people of another racial heritage. As late as 1967, anti-miscegenation laws prohibiting the marriage of whites to members of another race were still on the books in 17 states; that year, the U.S. Supreme Court finally declared such laws unconstitutional. Surveys indicate that young Americans approaching adulthood at the dawn of the twenty-first century are much more open to the idea of interracial unions than earlier generations.

Still, according to the 1994 National Health and Social Life Survey, 97 percent of African American women are likely to choose a partner of the same race. Conflict in the United States over black-white relationships stems from the nation’s brutal history of slavery, when white men held all the power in society. More than a century after the abolition of slavery, America’s shameful legacy of racism remains. While many black women oppose the idea of interracial marriage, opting instead for racial strength and unity through the stabilization of the African American family, there is evidence that this stance is slowly changing. Indeed, the number of African American women who are now dating and increasingly marrying interracially is up. Nonetheless, the vast majority of interracial marriages in Africa America are between Black men and white women. In 1999, there were 215,000 marriages of black men to white women, compared to 92,000 marriages of white men to black women.

GAY/LESBIAN/BISEXUALITY/TRANSGENDER ISSUES

African American gays, lesbians, and bisexuals have made some strides in the 1990s in terms of increasing visibility and activism. However, while there appears to be greater awareness of gay and lesbian concerns, there are continuing hate crimes and homophobia. Certainly most would agree that true equality and acceptance have hardly been achieved, but a course has been set for those looking to break the same chains of oppression with which all African Americans gay or straight are familiar.

Today, as historically, the arts, literature and film, have been sources of information on the gay and lesbian experience in Africa America. Historically, from Bruce Nugent, “The Bohemian of the Harlem Renaissance” and the first African American writer to deal openly with homosexuality, to James Baldwin and Audre Lorde, African American literature has had its share of gay/lesbian/bisexual representation. In the 1980s and 1990s, the mantle has been passed to Samuel R. Delany, E. Lynn Harris, and Alice Walker’s The Color Purple. In music and fashion, supermodel/house music maven/actor RuPaul had an impact on the American psyche as has bassist and songwriter Me’Shell NdegeOcello. In Hollywood, Wesley Snipes was unafraid to play a drag queen in the film To Woo Fong, Thanks For Everything! Julie Newmar, while Denzel Washington played an extremely homophobic lawyer who has a change of heart after working with a gay client dying of AIDS in Philadelphia. The poignant documentary Paris Is Burning, a depiction of several cross-dressers and drag queens in New York City, was well-received by audiences and critics alike. Another penetrating documentary, gay African American filmmaker Marlon Riggs’s Black Is . . . Black Ain’t, attempted to peel away the levels of meaning attached to black skin and the impact of those meanings on gay and straight members of the African American community. African American actresses, meanwhile, had prominent roles in the lesbian-focused commercial releases Go Fish, The Incredibly True Adventures of Two Girls in Love, and Bar Girls.

Outside of the mainstream, the black gay/lesbian/bisexual community is replete with heroes and heroines unknown to the rest of society. Rights activists include: Gregory Adams; Bayard Rustin, Alliance founder and executive director; Derek Charles Livingston, North Carolina Pride Political Action Committee executive director; Gilberto Gerald, African American Gay and Lesbian Studies Center founder and director; Cary Allen Johnson, International Lesbian and Gay Human Rights Commission board member; Ron Simmons, Us Helping Us, People Into Living, Inc. executive director; Paul Davis, Minority AIDS Project of Los Angeles director of education; Nadine Smith, Human Rights Task Force of Florida executive director; Cornelius Baker, National Association of People With AIDS president; Charles W. B. Tarver, IV, the first African American male lobbyist for the Human Rights Campaign Fund (HRCF); and Keith Boykin, National Black Gay and Lesbian Leadership Forum executive director.

Examples of African American individuals contributing to the visible image of gays in society include: Peter Gomes, Harvard University chaplain; Willa Taylor, the education program coordinator for the Lincoln Center Theater; Sabrina Sojourner, legislative aide to California Congresswoman Maxine Waters; Wynn P. Thomas, production and set designer for director Spike Lee’s film production company; H. Alexander Robinson, legal representative for both the American Civil Liberties Union AIDS Project and the Lesbian and Gay Civil Rights Project; Darlene Garner, the first African American elder in the Metropolitan Community Church, a universal fellowship created in 1968 by and for gay Christians; Sherry Harris, Seattle City Council member; Evelyn C. White, San Francisco Chronicle reporter and editor of Black Women’s Health Book: Speaking for Ourselves; Bill E. Jones, president of New York City’s Health and Hospitals Corporation, the largest public health network in the United States; Pat Norman, San Francisco Institute for Community Health Outreach executive director and Stonewall 25 Organizing Committee member; Suzanne Shende, director of the Center for Constitutional Rights’ Anti-Bias Violence Project; Sandra Robinson, president and CEO of Samaritan College, the international school of ministry for the Universal Fellowship of Metropolitan Community Churches; and Keith St. John, the first African American, openly gay elected official in the United States (Second Ward Alderman, Albany, New York). They are joined in every field and industry and in every region of the country by a host of peers who face challenges because of their sexual orientation, but who do not allow intolerance to hold them back.

The Black feminist scholarship of lesbian and gay scholars and activists such as the late Audre Lorde, Barbara Smith and Roderick Ferguson are also central to the way African American families and lived experience is being articulated. Black gay and lesbian scholars are the source of recentering and challenge to the way we conceptualize and think about African American life. Sociologist Roderick Ferguson, for example, has pioneered a queer of color critique to traditional sociological work on race, class, and gender. Scholars such as Ferguson are giving visibility and creativity to the complicated space in which Black families reside.

FERTILITY AND BIRTHS

FERTILITY RATES

According to the National Center for Health Statistics, the year 1999 saw 70.1 live births per 1,000 black women aged 15 to 44 years of age, and 65.1 such live births to comparable white women. The 605,970 live births by African American females that year accounted for approximately 15.3 percent of all births nationwide. Black women have had higher fertility rates than white women for the past two centuries; however, birth rates are similar for black and white women with the same level of educational attainment.

THE THOMPSON SEXTUPLETS

On May 8, 1997, in Washington, DC, Linden and Jacqueline Thompson gave birth to the first set of African American sextuplets in the United States. The naturally-conceived pregnancy, which lasted 29 weeks and six days, was the longest gestational period for sextuplets born in the United States. In spite of the remarkable nature of this event, the surviving five babies ;four girls and one boy received little attention from the media until the birth of septuplets to a white Iowa couple a month later. In the wake of the attention and financial support that family received, certain African American groups protested that the Thompsons had not received similar treatment. The National Political Congress of Black Women, Inc. “adopted” the Thompsons, and many companies such as Toys ’R’ Us came forward to pledge needed items for the financially-strapped family. For many in the African American community, the neglect of the Thompson family further demonstrated the inherent racism of American society, arguing that if the Thompsons had been white and middle-class, the media would have rushed to publish their story.

TEENAGE PREGNANCY

For a number of years Marian Wright Edelman of the Children’s Defense Fund has stressed that teenage pregnancy is a special problem among poor and minority groups who usually have limited opportunities to offer their offspring. Joyce Ladner has explained that the causes of teenage pregnancy range from attempts to find emotional fulfillment and the desire to achieve “womanhood” to ignorance of contraceptives. Political conservatives and neoconservatives maintain that poor teenagers view welfare programs such as Aid to Families with Dependent Children (AFDC) as a viable source of economic support and consequently perceive pregnancy as a means of tapping into the welfare system at an early age. This belief helped shape welfare reform legislation in the 1990s that required adolescent mothers to stay within the households of their families of origin if they are to continue to receive benefits.

Teenage pregnancy is both a national problem and an African American problem. Data from the National Center for Health Statistics reveal that in 1999 the birth rate for all teenagers aged 15 to 19 years old was 49.6 live births per 1,000. Black girls in that age group were over two times more likely than white girls to give birth (83.7 compared with 34.0 per 1,000). For girls between 15 to 17 years old, the birth rate was three times higher among blacks than whites. Furthermore, black girls in the 18 to 19 year old age group had a birthrate of 126.8 live births per 1,000 as compared to 58.9 live births for white girls. This state of affairs and its social, economic, and political ramifications cause great consternation in the African American community as well as in the larger society. Teenage childbearing exacerbates such social problems as high infant mortality, poor physical and mental health, educational insufficiencies, long-term welfare dependency, and poverty. Many teenage mothers do not complete high school, the basic educational expectation in this country; as a result, they are often seriously under-educated and lack marketable skills. Nonetheless the percentage of Black Teens becoming pregnant is down. Because the absolute base rate is high, the numbers remain substantial. It is also worth noting that some research suggests that the prospects of these very young mothers are not entirely bleak. For example, studies indicate that grandmothers play a significant role in the care and raising of these children.

Various efforts have been aimed at stemming the tide of teenage pregnancy. At the bureaucratic level, some states have decreed punitive measures such as sterilization and/or reduced welfare payments for girls and women on public assistance who have more than one out-of-wedlock birth. African American sororities, fraternities, churches, and civil groups have initiated programs to work directly with African American teenagers. The Children’s Defense Fund continues to enlighten the public through a multimedia campaign that urges African American males as well as females to be more responsible for their sexual behavior.

BIRTHS OF MIXED RACIAL PARENTAGE

According to the Population Reference Bureau’s December of 1992 report, the proportion of mixed-race births for which the race of both parents was known increased from one percent to 3.4 percent between 1968 and 1989; births of children with a black and a white parent increased from 8,700 in 1968 to 45,000 in 1989. This increase was described as “a striking sign of social change” with respect to attitudes about interracial relationships.

Attitudes towards persons with multiracial identities remained volatile in the 1990s, but those with mixed heritages who refuse to be reduced to “black” or “white” became more vocal. A key issue concerned the manner in which the federal government categorizes people. In 1997, new guidelines for designating race on all federal forms were established with five major groups identified: “American Indian/Alaskan Native”; “Asian”; “Native Hawaiian or Other Pacific Islander”; “Black or African American”; and “White.” Also added were two categories for ethnicity: “Hispanic or Latino” and “Not Hispanic or Latino.” In 1995, the Office of Management and Budget had considered making changes to the existing policy in response to a deluge of complaints from people of all walks of life including European Americans who want to be recognized as more than just white. To address such issues, the government proposed a “multi-racial” category. Opponents felt that such a seemingly superficial change could lead to significant cultural difficulties including a hidden system of colorism that may play out between light- and dark-skinned African Americans. Interestingly, Newsweek reported that, at the time, 49 percent of blacks favored the new category versus 36 percent of whites.

CHILDREN

LIVING ARRANGEMENTS OF CHILDREN

In 1998, only 36 percent of African American children lived with both parents, compared to 67 percent in 1960 and 58.5 percent in 1970. This dramatic decline roughly parallels the changes in living arrangements of African American adults resulting from increased divorce and separation rates as well as increases in births to never-married females. By contrast, 74 percent of white children were living with both their parents in 1998, down from 90.9 percent in 1960 and 89.5 percent in 1970. According to a 2001 U.S. Census Bureau report, five percent of black children lived with their grandparents in 1996, compared to one percent of whites and two percent of Hispanics. Black grandparents, particularly grandmothers, are more likely to care for their grandchildren than are whites or Hispanics. Also in 1996, two percent of African American children lived with other relatives, and one percent lived with non-relatives.

In 1995, 31 percent of black children under six years old were regularly left in a relative’s care, compared to 18 percent of white children of the same age range.

In 1999, 65 percent of African American female-headed families had one or more children under 18 years of age present in the household; 38 percent had two or more. These families were more likely to be poor than were married-couple families.

CHILD SUPPORT

In years past, when parents have been unable to support their children, extended family members were expected to assist in the process. In today’s dismal economic climate, many more mothers than in the past are working in the paid labor force and contributing a larger share of their earned income to their families. Grandparents continue to do and provide what they can, including providing child care while the parent or parents work. Poor families are supported by the welfare system, but with fixed terms of support; this source of income will be phased out for recipients after five years. Many families have been forced to accept unemployment compensation

as their support base when one or more member loses a job.

When African American parents divorce, child support becomes a critical issue. In 1989 there were 2,770,000 divorced or separated African American women. Child support payments were court-awarded to only 955,000 (35 percent) of these women. Of those who were supposed to receive child support, only 70 percent actually received payment. The mean child support amount received was $2,263, or 16 percent of total household income. As these figures reveal, in the event of divorce or separation, African American women were primarily responsible for the support of their children. In terms of dollars received, African American women with incomes below the poverty level fared worse than the average in 1989. Of 325,000 such women who were supposed to receive child support, 70 percent actually received payment. Their mean child support sum, a mere $1,674, nevertheless amounted to 32 percent of their total household income.

HEALTH

For African Americans, the incidence of heart disease, high blood pressure, diabetes, obesity, cancer, asthma, and several other conditions is higher than the national average. Another area in which African Americans lag is organ donorship. In 2001, over 32,000 minorities were in need of an organ transplant according to statistics from the United Network for Organ Sharing. In 1995 CQ Researcher projected that by 2010, one out of every 20 people will need an organ, tissue, or corneal transplant at some point in their lives. While medical advances have improved survival rates, the best chances for a successful transplant; particularly with bone marrow transplants and skin grafts are when an organ comes from someone of the same race. Unfortunately, not nearly enough African Americans choose to donate. The lack of available organ donors ultimately means long waits for a compatible organ, death for those who do not receive one, higher costs due to low supply and high demand, and lack of coverage by insurance carriers because of the expense.

THE TUSKEGEE SYPHILIS STUDY

At least part of the reason behind the higher rates of disease in African Americans stems from a reluctance to get regular check-ups because of a general distrust of doctors by the African American community. In 1997, a national poll survey conducted for Emory University’s Institute of Minority Health Research revealed that 36 percent of African Americans believed it was “very likely” they would unwittingly be used as guinea pigs for medical research. This belief is grounded in an actual instance of the government’s exploitation of African American men for the purposes of medical research in the mid-twentieth century. Now known as “The Tuskegee Syphilis Study,” the experiment, conducted by government doctors from the Public Health Service, studied the effects of untreated syphilis on 400 African American men in Macon County, Alabama. The doctors never informed the men as to the nature of the study and even withheld medical treatment when it became available in 1942. As a result, over 100 men had died by the time the details of the study were revealed in 1972, and others suffered from serious syphilis-related conditions that could have been relieved by penicillin had it been given to them. Civil rights lawyer Fred Gray brought a class-action lawsuit against the institutions and doctors involved in the experiment in 1973, and the government agreed to a 10 million dollar out-of-court settlement. In 1997, President Bill Clinton formally apologized to the survivors of the experiment.

Herman Shaw, a victim of the Tuskegee Syphilis Study, attends a 1997 press conference in which President Clinton and Vice President Gore apologized for the shameful experiment.

MEDICAID

Many American families receive health care through the federally-funded Medicaid program. Disproportionately high percentages of these families are African American. The total number of Medicaid recipients in the United States increased from 24.3 million in 1990 to 27.9 million in 1998. That year, 7.9 million African Americans were covered by Medicaid.

CHILD HEALTH

Many African American children suffer from the lack of quality health care. In 1990, only about half of inner-city children had been immunized against measles, mumps, and rubella. Measles outbreaks have erupted in many American cities in the 1990s; most were among poor, inner-city children. Nearly 100 deaths from measles were reported in 1990.

A new and growing population of children are born of mothers who used drugs (including alcohol) during their pregnancies. Many of these children experience after-birth withdrawal problems from drugs that affected them in utero; they are later more prone to physical and mental disabilities, behavioral problems, and learning impairments when they arrive in the nation’s schools. Infants whose mothers drink alcoholic beverages during pregnancy are at risk of Fetal Alcohol Syndrome. Each year, Acquired Immune Deficiency Syndrome (AIDS) afflicts a growing number of children, who usually contract the disease from their mothers before or at birth. Urban children who live in old and/or poor housing also remain at risk of being exposed to high levels of lead. It has been estimated that 12 million American children, primarily those who are poor, are at risk of lead poisoning and potentially will have their intellectual growth stunted because of exposure to lead. Similar to African American adults and, perhaps due to their affiliation with them, African American children are also at greater risk of accidents, physical abuse, and other violence that may result in disability or death.

HIV/AIDS

In the early years of the 21st century, African Americans at the highest levels of risk for becoming HIV positive. Moreover, African Americans suffer disproportionately from AIDS, the final stage of a disease caused by the Human Immunodeficiency Virus (HIV). The HIV virus severely weakens the body’s immune system, leaving HIV-infected people vulnerable to other infections. According to the U.S. Centers for Disease Control and Prevention (CDC), while African Americans represent approximately 12 percent of the U.S. population, 47 percent of all new AIDS cases reported in 2000 were African American. This figure was up from 32 percent in 1990. The CDC also estimates that African Americans make up close to 38 percent of the total number of reported AIDS cases, and that at the end of 1999, 129,000 African Americans were living with AIDS. According to data generated by the CDC during the period from 2001-2005 and included in a recent effort by the Black AIDS Institute located in Los Angeles, CA, of the new HIV/AIDS diagnoses among 25-44 years old, Africans Americans accounted for 48 percent of the new HIV/AIDS diagnoses. This rates rival and even exceed those in some African countries. The rates remain quite high for African American women.

The CDC has kept updated statistics concerning reported cases of AIDS, deaths caused by the disease with breakdowns for various age groups, and various data on the occurrence of AIDS across ethnicities. Data from those organizations showed that in 1996 the age-adjusted AIDS death rate for blacks was higher than that for whites (42.6 percent to 37.5 percent). Data also revealed that, between 1991 and 1996, the number of Africans American AIDS-related deaths increased nearly 8 percent compared to a 13.2 percent decrease in its incidence among gay or bisexual men.

AIDS is spread by viral passage during unprotected sexual intercourse, intravenous drug use, or blood transfusions; it can also be transmitted from mother to child in utero or during birth. It is estimated that a clear majority of the AIDS cases among African Americans result from intravenous drug use. While AIDS is fatal, it is preventable if sexually active adults and teenagers engage in “safe sex” practices such as using condoms and avoid behaviors that put them at risk of AIDS infection such as promiscuity, having multiple sex partners, using drugs, and exchanging drug paraphernalia. The African American community and the larger society are saturating the public with information about AIDS in the hope that education will cause people to behave differently and thereby slow the progress of the disease.

LUPUS

Lupus is a chronic, autoimmune disorder in which the body’s immune system loses the ability to differentiate between itself and foreign substances and forms antibodies that attack healthy tissues and organs. Inflammation of the skin, joints, and kidneys are the most common result, although other areas of the body are subject to swelling as well. The medical community has not yet discovered why the disease overwhelmingly tends to affect women more than men. In fact, nine of every ten sufferers are women. Lupus seemingly targets women of childbearing age, i.e. between the ages of 15 and 40 and is three times more common in black women than white women.

An incurable, excruciating, and often debilitating condition, lupus can present itself in many different forms, making the initial diagnosis difficult. A range of mild to severe symptoms gradually develop including hair and/or weight loss, fatigue, photosensitivity, loss of appetite, fever, nausea, abdominal pain, and pain in any inflamed areas. With improvements in early diagnosis and better treatments, lupus is no longer considered fatal. Most patients are able to continue with their lives and lifestyles. The American Lupus Society (1-800-331-1802) and the Lupus Foundation of America (1-800-558-0121 can both offer more information.

DIABETES

Persons with diabetes are unable to convert food sugar, or glucose, into energy that is used by the body’s cells or stored for later use. The hormone insulin, produced by the pancreas, plays a crucial role in the conversion. Diabetics either do not produce enough insulin, or any at all, or may produce ineffective insulin. Regardless, the unused glucose collects in the blood and urine and can damage organs such as the kidneys and eyes. The onset of insulin-dependent, or type I diabetes, which usually affects children and young adults, can be very rapid. Symptoms can include frequent urination, excessive thirst, extreme hunger, weight loss, irritability, weakness and fatigue, nausea, and vomiting. Ninety percent of diabetes is noninsulin-dependent. Known as Type II diabetes, the illness most often occurs in adults over the age of 40 and particularly in obese individuals. Symptoms are similar to those associated with the Type I form, however, Type II is also characterized by the chronic presence of wounds that will not heal, stubborn infections, blurred vision, tingling or numbness in the extremities, and burning or itching sensations.

Similar to lupus, diabetes is noncontagious, incurable, potentially debilitating, and disproportionately strikes African Americans. Figures from the American Diabetes Association estimate that blacks are 2 times more likely than whites to contract the condition. In 2002, diabetes afflicted 2.8 million African Americans. African Americans also experience higher rates of serious complications from the disease including blindness, kidney failure, and the need for amputations of the legs or feet. Unfortunately, one-third of those African Americans affected are unaware of their illness, a dangerous statistic because immediate, appropriate medical attention is crucial.

Once informed of their condition, diabetics can maintain relative good health by eating low fat, high carbohydrate meals with a moderate amount of protein; engaging in physical activity that stimulates the body’s cells into utilizing glucose; and by tracking their glucose levels. Low blood sugar, or hypoglycemia, is just as much a danger as is the presence of a high glucose level. Over-weight individuals are very much encouraged to lose excess weight in order to increase the body’s ability to use insulin. Physicians can prescribe medication including insulin shots to help a patient maintain a normal glucose level.

In an effort to reach the African American community, the American Diabetes Association launched the African American Program in 1994. They educate the public through media campaigns and community-based forums such as local churches. For more information contact the American Diabetes Association (1680 Duke St., Alexandria, VA 22314; 1-800-DIABETES.

CIGARETTE, ALCOHOL, AND DRUG USE

The use and abuse of cigarettes, alcohol, marijuana, and cocaine (including addiction thereto) is a serious social problem in contemporary American society. The National Center for Health Statistics reports that, in a given month in 1991, four percent of black youth 12 to 17 years old smoked cigarettes, compared with 13 percent of whites and nine percent of Hispanics of the same age. Cigarette smoking has been identified as a major risk factor in lung cancer, cardiovascular disease, and chronic obstructive lung disease. Twenty percent of blacks, 20 percent of whites, and 23 percent of Hispanics in this same age group had used alcohol; 5 percent of blacks and Hispanics and 4 percent of whites had used marijuana; and 0.5 percent of blacks, 0.3 percent of whites, and 1.3 percent of Hispanic youths had used cocaine. In the 18 to 25 year old group in the given month, 22 percent of blacks had smoked cigarettes compared to 36 percent of whites and 25 percent of Hispanics; and 56 percent of blacks had used alcohol compared to 67 percent of whites and 53 percent of Hispanics. Fifteen percent of blacks compared to 14 percent of whites and nine percent of Hispanics, had used marijuana; and 3.1 percent of blacks had used cocaine compared to 1.7 percent of whites and 2.7 percent of Hispanics. It is clear that youths are using these substances as early as age 12 and that usage increases through the young adult period. These percentages represent large numbers of young people. In regard to all age groups, a higher percentage of whites 60 percent reported alcohol use compared to 42 percent of blacks.

One of the key campaigns to stem the usage of cigarettes and alcohol has been to target advertisers who appeal in their marketing to young, Black kids. Billboards which glamorize smoking and alcohol use have also been targeted and protested against.

SICKLE CELL ANEMIA

Sickle Cell Anemia (SCA) is a chronic inherited affliction caused by a defect in the hemoglobin component of the blood. It occurs as a result of the mating of two people, each of whom carries the gene for the defective trait, which is passed on to their children. The presence of this abnormal hemoglobin trait can cause distortion (sickling) of the red blood cells and a decrease in their number. The source of SCA seems to be malarious countries; people with sickle cell disease are almost always immune to malaria, so it appears that the sickle cell is a defense mechanism against malaria.

Sickled red blood cells have been found in 1 of every 12 African Americans; but the active disease occurs about once in every 600 American blacks and once in every 1,200 American whites. It is estimated that about 50,000 persons in the United States suffer from the disease. Persons of other races and nationalities are affected by the trait and the anemia including people from Southern India, Greece, Italy, Syria, Caribbean Islands, South and Central America, Turkey, and other countries.

The disease is diagnosed through microscopic and electrophoretic analysis of the blood. The first symptoms of SCA usually appear in children with the disease at about six months of age. Because SCA is a chronic disease, medical management is directed toward both the quiescent and active periods (called “crises”) of the malady. Good medical and home care may make it possible for persons with SCA to lead reasonably normal lives. When crises occur, they experience fever, pain, loss of appetite, paleness of the skin, generalized weakness, and sometimes a striking decrease in the number of red blood corpuscles. Complications and infections from these crises can be controlled with antibiotic drugs. A drug, hydroxyurea, has been developed to stimulate fetal hemoglobin to produce more red blood cells and thereby ameliorate SCA crises. However, hydroxyurea is very toxic, and thus far has only been tested on adults with SCA. In other efforts, a female SCA sufferer, also stricken with leukemia, recently received a radical bone marrow transplant from her brother. Since the transplant, she has been free of symptoms from both diseases. This case, the first of its kind, is being closely monitored to determine the mechanisms by which the patient’s remission occurred and to see if the results of this procedure can be duplicated with other persons with SCA.

African American people who intend to have children are advised to undergo blood tests to determine whether they are carriers of the sickle cell gene. Two such carriers should agree not to produce children, since half the children will have the trait and one in four the anemia. There is only one chance in four that their child will be free of the disease. Some jurisdictions (Washington, DC, for example) have enacted laws mandating that newborns be screened for sickle cell anemia, along with other diseases. As a result of such legislation, newborns found to be afflicted with SCA can be cared for from birth.

BREAST CANCER

The National Cancer Institute has estimated that one in eight women in the United States will develop breast cancer during her life, the risk increasing with age. Breast cancer is the leading cause of cancer death among African American women. Although black women develop breast cancer at slightly lower rates than white women, blacks are twice as likely to die from the disease and at a younger age. Though more research needs to be done, some reasons for the discrepancy include the facts that black women are often in poorer general health than whites; are often less likely to seek out preventive medical care and when they do are less likely to receive adequate medical care; are more likely to have worse prognoses for tumors that do not respond to treatment; and are often pessimistic about their own outlooks. (Studies have shown that maintaining a positive attitude can have an impact on just about any illness.)

African American women must focus on early detection. Approximately 90 percent of breast cancers are discovered via self-examination. Besides self-examinations which should be conducted monthly, one week after one’s menstrual period the importance of mammo-grams should not be overlooked. In a recent study, the U.S. Department of Health and Human Services determined that nearly three out of four African American women over the age of 40 had never had a mammogram, though all women regularly should after reaching that age. Many women do not follow early detection guidelines because they can not afford health care, because they have had no prior incidence in their family history, or because they do not display any symptoms, failing to acknowledge that treatment prior to symptoms is more effective. Once discovered, breast lumps may be diagnosed as premenstrual lumpiness or fluid retention caused by hormonal changes; cysts; benign tumors; or cancers.

Treatment programs are determined on a case-by-case basis. In the mid-1990s, the experimental drug tamoxifen was introduced to breast cancer patients. The Cancer Information Service Center (1-800-4-CANCER can provide more information at as can the Breast Cancer Resource Committee (1765 N St., NW, Ste. 100; Washington, DC 20036-2802; 1-202-463-8040 or www.afamerica.com/bcrc/>), founded by Zora Brown, an African American.

PROSTATE CANCER

As the most common cancer in men, prostate cancer afflicts black men more often than whites; in fact, blacks are more than twice as likely to get the disease and are three times as likely to die of the disease. Particularly at risk are those living in rural areas, because they are less likely to regularly visit a physician. As with other forms of cancer, early detection plays a role in treatment and in deterring the likelihood of dying from the disease. Diet is a factor as well; high-fat, low-fiber diets increase the risk of developing cancer. Genetics and personal history are a third factor. In 1996, a new type of radiation treatment option which was 20 percent more effective than conventional radiation was used on patients with early cancer. Called neutron therapy, Seattle’s University of Washington and Detroit’s Karmanos Cancer Institute were the first two facilities to make the innovative technique available.

LIFE EXPECTANCY

Life expectancy at birth increased substantially during the first 90 years of this century, from 33 years for African Americans of both sexes in 1900 to 71.5 years in 1998. Corresponding figures for both sexes of all races are 47.3 years in 1900 and 76.7 years in 1998. Provisional data of the U.S. National Center for Health Statistics Statistics project a life expectancy of 67.8 years for African American males born in 1998 and 75.0 years for African American females born that year. Corresponding life expectancy projections for white males and females born in 1998 are 74.6 and 79.9 years, respectively, averaged at 77.3 years. That black babies born should have a lower life expectancy at birth than their white counterparts is an ignominious social problem. At the other end of the age continuum, African American males aged 65 years old in 1998 are projected to live 14.4 more years, and African American females 17.5 additional years. This compares with 16.1 more years for white males, and 19.2 additional years for white females. Thus the same pattern holds: white people in the United States continue to have longer life expectancy than African Americans.

These black/white differences can be attributed to a number of factors. African Americans have higher death rates due to the following major causes: accidents, homicides, suicides, heart disease, strokes, liver disease, cancer, diabetes, and AIDS. It is also true that whites, more than blacks, have health insurance coverage of some kind and sufficient personal income to partake of higher-quality health care, both preventive and curative. Whites’ higher education and income levels also assure them the greater likelihood of eating nutritionally balanced, healthy meals. Dietary patterns and food choices of low-income African Americans include too many fats and sweets, factors that contribute to obesity and high blood pressure, which carry their own sets of health risks.

HOMICIDE AND DEATH BY ACCIDENT

Homicide among young African American men is a primary cause for the drop in their life expectancy. In 1999, homicide accounted for 45.3 percent of the deaths among 15 to 19 year old African American males, 46.2 percent in the 20 to 24 year old age range, and 26.8 percent for 25 to 34 year old age range. Some social theorists claim that the increasing numbers of African Americans who are poor and hopeless, added to those who are involved in drugs or other substance abuse, account for the homicide rates among African Americans. In 1999, motor vehicle deaths and other accidents accounted for 12,728 deaths among African Americans.

SUICIDE

Suicide rates are significantly lower among blacks than whites, but black suicide rates are on the rise, a most undesirable form of parity. In 1985, the suicide rate for white males exceeded that for black males by 70 percent; by 1989, the difference had narrowed to 40 percent. Data from the National Center for Health Statistics show that more than 30,000 lives are lost through suicide annually. Among all Americans, the age-adjusted death rate by suicide in 1989 was 11.3 deaths per 100,000. For African American males, the rate was 12.5 per 100,000, and for African American females, it was 2.4 per 100,000. Among African American adolescents and young adults aged 15 to 24 years old, the suicide rate for males was 16.7 per 100,000, and 2.8 per 100,000 for African American females, increases of 49 percent (from 1984 to 1989) and 40 percent (from 1986 to 1989), respectively.

INFANT MORTALITY

Infant mortality rates for African Americans remain more than double that of whites. In 1998, 13.8 deaths per 1,000 live births were reported for black infants, compared to 6.0 deaths per 1,000 live births for whites. The black/white infant death ratios have changed appreciably since 1950, however, when the black infant mortality rate was 43.9 deaths per 1,000 live births and the white rate was 26.8 deaths per 1,000. Progress has been made since 1950, as the infant mortality statistics have improved for both races.

African American women are more likely than whites to give birth to low-weight babies, many of whom fall victim to serious health problems or die during their first year. These babies are particularly susceptible to Sudden Infant Death Syndrome (SIDS), respiratory distress syndrome, infections, and injuries. This phenomenon occurs because disproportionate numbers of African American babies are born to low-income, less-educated teenage mothers who have inadequate prenatal care and poor nutrition, and who smoke, use drugs, or otherwise fail to take care of themselves properly during their pregnancies.

ASSESSMENT

SOCIAL CHANGE POSSIBILITIES AND AFRICAN AMERICAN FAMILIES

Within the African American community itself, certain attitudinal and behavioral changes are essential. Most significant is economic fairness across racial lines since many problems confronting the African American community stem from poverty. There is also the need for gender justice in the labor market. Salary equity and occupational opportunities which pay a living wage for African American women would make a tremendous difference in poor African American families. Marriage as something other than an fading option could make a difference for many families. Family planning information, including sex education and intervention programs, must be disseminated among teenagers, so that the out-of-wedlock birth rate can be reduced. Substance abuse must be curtailed; people who have hope for the future and who feel that they have some power and control over their lives are less likely to “escape” through drugs or alcohol. At the same time, drug dealers should be severely prosecuted. Children and youth need more adult interaction and supervision in their lives, whether it comes from family members or “significant others” such as mentors provided by such organizations as Concerned Black Men, Inc. or other community service-minded groups.

So many of the problems faced by African American and other low-to-moderate-income families are systemic and interlocking. Action on only one problem will not solve the network of family woes that our society has allowed to accumulate. Once again, the National Urban League has called for a “Marshall Plan for the Cities” to address the totality of current problems. Broader issues around global change and the deindustrialization of citizens must also be examined. In the new global order where cheap labor is sought all over the world, a systemic response to African American economic inequality is required. Quite important too are eliminating discriminatory policy practices in housing, access to education, and fair employment. Economy, polity and racial justice initiatives are all significant elements in creating social justice for African American families.

THE MILLION MAN MARCH

On October 16, 1995, The Million Man March, a rally masterminded by Nation of Islam Minister Louis Farrakhan, was held 21 blocks from the steps of the U.S. Capitol Building in Washington, DC. Intended as “a national day of atonement,” the thousands of attendees pledged their commitments to family and community. The gathering had spiritual, economic, and political implications for non-marchers as well, including women and children; they were asked to stay home from work/school and spend the day praying and fasting.

The march was organized by the Nation of Islam and promoted by the National African American Leadership Summit. Women, excluded from the actual demonstration, were welcome in the nearly 120 local organizing committees scattered about the country. A grass-roots affair, expenses were covered mostly by donations. Linda Green, appointed as national director of fund-raising, also found financial support for the march. However, a number of African American women such as feminist activist Angela Davis spoke out public ally about the exclusionary nature of the march.

Other forms of support came from a wide range of camps;political, religious, and business-oriented & including civil rights heroine Rosa Parks; former NAACP head Rev. Ben Chavis; Rainbow Coalition leader Rev. Jesse Jackson; Georgia Congresswoman Cynthia McKinney; Southern Christian Leadership Conference (SCLC) executive director E. Randel Osburn; and Melvin Foote and Ambassador Andrew Young, constituency for Africa’s executive director and chairperson, respectively. African American colleges scheduled bus trips to the march and the NAACP Youth Councils also encouraged participation from the younger generation. Nonetheless, many African Americans who upheld the tenets of the march distanced themselves from the socio-political action because of Farrakhan’s inflammatory views which are often perceived as misogynistic, anti-gay, and anti-Catholic.

Still, the march was deemed a success on many levels given the sheer number of men it reached and the changed representation of African American men it offered, helping to shake the myth of all African American men as convicts, hustlers, and pimps, and replacing it with one of responsible, self-confident, culturally aware men. A number of men registered to vote and a national database of African American male voters was established. The march also spawned a number of spin-off demonstrations including the cross-theological gathering “The New Revival in America: The Emerging Black Male as Man, Husband, Father, and Leader,” which took place November 16 & 18, 1995.

THE MILLION WOMAN MARCH

The Million Man March was followed by the Million Woman March in Philadelphia, Pennsylvania, on October 25, 1997. Organizers cited their desire to strengthen the cohesiveness of African American women of all walks of life as the primary reason for the march, and key speakers included Winnie Mandela, former wife of South African activist Nelson Mandela, and Congresswoman Maxine Waters. Thousands of women came to Pennsylvania from across the United States to participate in the show of solidarity and to address such issues as the growing number of African American women in prisons, the start of independent African American schools and the hiring of African American women, and the importance of getting more African American women into business and politics.

THE MILLION FAMILIES MARCH

On October 16, 2000 a Million Families March, also organized by the Minister Louis Farrakhan and the Nation of Islam occurred. The numbers were smaller than the original march in 1995. And the organizers made an effort to emphasize taking political action. They note in the home page http://www.millionfamilymarch.com of the march the following pieces of a much larger agenda crafted by the organizers:

  1. “. . . There must be a national agenda by the people, of the people, and for the people.”
  2. “. . . the national body must be enlightened so that we will make proper choices as to who will lead us and help to create a future for us and our children.”

SOCIAL ACTIVISTS

(To locate biographical profiles more readily, please consult the index at the back of the book. For example, physicians/doctors are located in the Science & Technology chapter.)

STACEY DAVIS (1960– ) Foundation Executive

As president and chief executive officer (CEO) of the Fannie Mae Foundation, Stacey H. Davis guides the Foundation’s efforts to make home ownership a reality for millions of Americans. Davis received a bachelor’s degree in economics from Georgetown University, and later earned a M.B.A. with an emphasis on finance from the University of Michigan Graduate School of Business Administration. After graduate school, Davis worked in a number of investment banking positions. She worked for three years in Merrill Lynch’s public finance division; later, she served as a vice president at Pryor McClendon Counts, an Atlanta investment bank.

Davis’s tenure with the Fannie Mae Foundation began in 1992. She remained in the southeast and spent three years as the Foundation’s director of regional public affairs for the region. From that position, Davis was promoted to vice president for housing and community development for the southeastern region. From 1995 to 1999, while serving in that capacity, Davis put into place innovative home buying programs aimed at helping lowand moderate-income families buy their own homes. In September 1999, Davis was named president and CEO of Fannie Mae, one of the nation’s biggest private foundations. Just as she did in her previous posts within the Foundation, Davis has introduced groundbreaking initiatives, such as the introduction of technology driven methods of improving the role that Fannie Mae plays in home ownership and city, community, and neighborhood revitalization.

In addition to her leadership role at the Foundation, Davis has served on the board of a number of organizations, including: Georgetown University, the Distict of Columbia Chamber of Commerce, the Thurgood Marshall Scholarship Fund, and Social Compact. She was the recipient of an honorary degree from Washington, D.C.’s Trinity College in 2001.

PAULA GIDDINGS (1947– ) Editor, Educator, Journalist, Social Historian

Paula Giddings has followed a definite focus in her life’s work, that of giving a voice to generations of African American women. Through her writings, many issues previously not discussed such as race, gender, and discrimination, came to the forefront of discussion. Beginning at a young age, Giddings knew she wanted to write. She attended Howard University in Washington, DC, became editor of the literary magazine Afro-American Review, and began moving away from creative writing toward journalism and social history. Giddings received an undergraduate degree in English in 1969.

After graduating, Giddings worked as a Random House copy editor during a very exciting time; some of the authors there included the political activists Stokely Carmichael and Angela Davis. A fellow editor was the now-famous author Toni Morrison. In 1984, after five years of extensive research and with the help of a Ford Foundation Grant, Giddings’s first book was published, When and Where I Enter: The Impact of Black Women on Race and Sex in America. Some of the themes covered in the book include the relationship between sexism and racism, the effect of “double discrimination” on the basis of gender and race on African American women, and the relevance of historical issues to contemporary life.

In 1988, Giddings came out with a second book called In Search of Sisterhood: Delta Sigma Theta and the Challenge of the Black Sorority Movement. Giddings has been lauded for her accomplishments by many groups, such as the New York Urban League and the National Coalition of 100 Black Women; Bennett College in North Carolina awarded her an honorary doctorate in humane letters in 1990. In 1992, she was a visiting professor at Princeton University. She earned several fellowships during the next few years and served as a visiting scholar with Phi Beta Kappa in 1995 and 1996. In 2000 Giddings edited a book entitled Burning All Illusions: Writings from the Nation on Race, a collection of magazine pieces by great African American writers and thinkers such as W.E.B. Du Bois, Langston Hughes and Ralph Ellison.

CLARA AND LORRAINE HALE Humanitarian, Educator, Hale House Co-founder

Clara Hale affectionately as “Mother Hale”—was born Clara McBride on April 1, 1905, in Elizabeth City, North Carolina. She grew up in Philadelphia, Pennsylvania, where her father was killed during her infancy. Clara’s mother struggled to support her three children but died when Clara was only 16. Soon after graduating from high school, she married and moved to New York City. Her husband died of cancer when she was only 27, leaving behind three children, including six-year-old Lorraine E. Hale (1926?–). Mother Hale took both day and evening work as a cleaning person to support the family but was dismayed about leaving her daughter and two sons in childcare facilities. Eventually the elder Hale began taking in children in her own home, and by 1940 she was a foster parent whose modest Harlem apartment often included her own three offspring as well as seven or eight foster children. In all, Mother Hale fostered in excess of 40 children in about 25 years.

Growing up in such an atmosphere, Lorraine became determined to make a difference in her community, earning a B.A. from Long Island University in 1960 and then becoming a public school teacher in New York City. She also pursued her master’s degree in special education, and worked variously as a guidance counselor, school psychologist, and special education teacher until 1969.

One spring night that year, Lorraine was driving home from a visit with her mother, who had recently retired as a foster parent. She saw a young woman in obvious distress on a street corner and felt sympathy for both the woman and the baby she had with her. She gave the woman her mother’s address and, within a few months, the elder Hale’s apartment was again home to children; this time 22 babies born addicted to drugs. For the next year-and-a-half, the Hale children worked overtime to support what would come to be known as Hale House, a pioneering facility in the treatment of babies born to drug-addicted mothers. Their organization received a city grant in 1971 and a federal grant four years later, which helped it move into its own five-story Harlem facilities. Hale House received permission from New York to manage an official “boarding home” on October 5, 1976.

Mother Hale won the Harry S Truman Award for Public Service in 1989 and was personally invited by President Ronald Reagan to attend his State of the Union address in 1985, where she received a standing ovation after being called “a true American hero.” She passed away on December 18, 1992, in New York City. Hale House was already renowned for its innovative treatment and research into mother-infant addictions and boasted a tremendous success rate in helping the women overcome their abuse patterns to reunite with their children. Lorraine expanded the foundation’s services after her mother’s death to assist mothers and children afflicted with AIDS. Hale chronicled this work in her 1992 book Hale House: Alive With Love. She also worked toward establishing a hospice retreat for such needs in a rural setting. In 1994 Hale traveled to Zaire under the auspices of the relief organization AmeriCares to provide aid for children in refugee camps. In 2001, however, amid financial investigation by the New York Attorney General’s office, Hale resigned her leadership positions to be succeeded by long-time board-member Edna Wells Handy. She and her husband were indicted in early 2002 on charges relating to improper use of funds.

CHARLESZETTA “MOTHER” WADDLES (1912–2001) Community Activist, Spiritual Leader

Mother Waddles, as she is commonly known, was born Charleszetta Lena Campbell in St. Louis in 1912, the oldest of seven children of a successful barber. When her father, an upstanding member of his local church, was ostracized after his business failed, his daughter vowed to repudiate the hypocrisy she witnessed in organized religion by promoting truly Christian principles. As a young girl, Waddles worked as a domestic and married at the age of 14. Widowed before she was 20 years of age, she married again and eventually had ten children. She left her second husband, due to his lack of ambition, after they had relocated to Detroit. In 1946, Waddles learned that her neighbor, a single mother of two, was about to be evicted. Waddles collected food from neighboring businesses to enable the woman to feed her children while making immediate payments to keep her home. Soon afterward, Waddles entered a Bible study course and eventually became an ordained Pentecostal minister. Her religious work soon turned into charitable work, however, and in 1950 she opened her Helping Hand restaurant in a rough area of Detroit, where the indigent could get a sit-down, home-cooked meal for 35 cents. Her third husband, Payton Waddles, provided much support for his wife’s work during these years.

In 1956, Waddles expanded the aims of restaurant when she founded the Perpetual Mission for Saving Souls of All Nations, which later became simply the Mother Waddles Perpetual Mission. The center is home to numerous community outreach programs including a medical clinic, a job placement service, and a tutoring program. Staffed entirely by volunteers; sometimes numbering up to 200—and financed solely through the donations Waddles extracts from a supportive local business community, the Mission is famous in Detroit for its

decades of service. Still actively involved even though well into her eighties, Waddles sees her work as evidence of Christian principles in action. She has won numerous awards including several presidential commendations and the National Urban League’s 1988 Humanitarian Award. Waddles died on July 12, 2001, at her Detroit, Michigan, home. She was 88.

FAYE WATTLETON. SEENATIONAL ORGANIZATIONS CHAPTER.

TERRIE M. WILLIAMS. SEEENTREPRENEURSHIP CHAPTER.

PHILL WILSON (1956– ) Activist, Educator

Phill Wilson was born into a close-knit Chicago family on April 22, 1956. During his formative years, he became an active participant in local African American issues-raising organizations such as Operation PUSH. He graduated from Illinois Wesleyan University with a dual degree in Spanish and theater but forsook law school for marriage and a career with AT&T. Both choices left Wilson with a troubling feeling that there was something lacking, and he ventured into Chicago’s gay community in the late 1970s. He met his partner, Chris Brownlie, in 1979, and two years later they relocated to the Los Angeles area where they began an African American-centered giftware company.

The specter of AIDS changed Wilson’s life in several ways. He and Brownlie first became politically active in 1986 when they campaigned to win voter rejection of Proposition 64, a ballot referendum that called for the quarantine of all AIDS patients in California. It was also during this time that Brownlie was diagnosed with AIDS himself and, before he died in 1989, he and Wilson founded the AIDS Health Care Foundation and the National Black Gay and Lesbian Conference and Leadership Forum. Wilson has also been involved as Stop AIDS Los Angeles’s director of community outreach and has served as the national director of training for the National Task Force on AIDS Prevention. Of especial import to the activist is the building of recognition and support between the African American community and the gay community, and he was a significant force behind the 1990 “Summit on Homosexuality in the Black Community” symposium at Atlanta’s Martin Luther King Jr. Center. Since 1992 Wilson has been the director of public policy for AIDS Project Los Angeles, and, as a spokesperson for gay issues, met with Bill Clinton shortly after his election in 1992.

Wilson is also living with HIV. In 1999 he founded the African American AIDS Policy and Training Institute (AAAPTI). Its main goal, he said, was to develop African American community leaders free of ignorance regarding HIV/AIDS. The institute’s Nia Plan—from the Swahili word meaning “purpose”—was rolled out in 18 cities and before critical organizations, including the Congressional Black Caucus and the NAACP. AAAPTI also created the African American HIV University, designed to educate people living with HIV as well as the medical community how to deal with the virus and how to prevent transmission of it. Also in 1999, Wilson coordinated the twelfth World AIDS Conference, held in Geneva, Switzerland. He helped prepare for the 13th conference by setting up educational opportunities in Durban, South Africa.

VITAL STATISTICS

Expectation of Life at Birth, 1970 to 1998, and Projections, 1999 to 2010
[In years. Excludes deaths of nonresidents of the United States]
NA Not available.
1 The 1998 life table values are based upon an 85 percent sample of deaths.
2Based on middle mortality assumptions; for details, see source. Source: U.S. Census Bureau, Population Division Working Paper No. 38.
SOURCE: Except as noted, U.S. National Center for Health Statistics, Vital Statistics of the United States, annual, and National Vital Statistics
Reports (NVSR) (formerly Monthly Vital Statistics Reports).
 TotalWhiteBlack and otherBlack
YearTotalMaleFemaleTotalMaleFemaleTotalMaleFemaleTotalMaleFemale
197070.867.174.771.768.075.665.361.369.464.160.068.3
197572.668.876.673.469.577.368.063.772.466.862.471.3
198073.770.077.474.470.778.169.565.373.668.163.872.5
198274.570.878.175.171.578.770.966.874.969.465.173.6
198374.671.078.175.271.678.770.967.074.769.465.273.5
198474.771.178.275.371.878.771.167.274.969.565.373.6
198574.771.178.275.371.878.771.067.074.869.365.073.4
198674.771.278.275.471.978.870.966.874.969.164.873.4
198774.971.478.375.672.178.971.066.975.069.164.773.4
198874.971.478.375.672.278.970.866.774.868.964.473.2
198975.171.778.575.972.579.270.966.774.968.864.373.3
199075.471.878.876.172.779.471.267.075.269.164.573.6
199175.572.078.976.372.979.671.567.375.569.364.673.8
199275.872.379.176.573.279.871.867.775.769.665.073.9
199375.572.278.876.373.179.571.567.375.569.264.673.7
199475.772.379.076.473.279.671.767.575.869.664.974.1
199575.872.578.976.573.479.671.967.975.769.665.273.9
199676.173.079.076.873.879.672.668.976.170.366.174.2
199776.573.679.477.174.379.9(NA)(NA)(NA)71.167.274.7
1998, prel176.773.979.477.374.679.9(NA)(NA)(NA)71.567.875.0
Projections:2            
199977.074.179.777.574.780.2(NA)(NA)(NA)72.268.775.4
200077.174.279.977.774.880.4(NA)(NA)(NA)72.468.975.6
200577.874.980.778.375.481.1(NA)(NA)(NA)73.569.976.8
201078.575.681.479.076.181.8(NA)(NA)(NA)74.570.977.8
Percentage of Adults Engaging in Leisure-Time Physical Activity: 1998
[In percent. Covers persons 18 years old and over. Based on response to question about physical activity in prior month. Based on a sample survey of approximately 150,000 persons in 50 states, the District of Columbia and Puerto Rico; for details, contact source]
1 Any type or intensity of activity that occurs 5 times or more per week and 30 minutes or more per occasion.
1Rhythmic contraction of large muscle groups performed at 50 percent or more of estimated age- and sex-specific maximum cardio-respiratory capacity, 3 times per week or more for at least 20 minutes per occasion.
SOURCE: U.S. National Center for Chronic Disease Prevention and Health Promotion, unpublished data.
CharacteristicNo participation in physical activityParticipates in regular, sustained activity1Participates in regular, vigorous activity2CharacteristicNo participation in physical activityParticipates in regular, sustained activity1Participates in regular, vigorous activity2
Total28.720.813.630 to 44 years old28.219.914.8
45 to 64 years old31.519.813.2    
Male26.221.913.365 to 74 years old35.920.313.0
Female31.019.713.875 years old and   
over47.114.912.3    
White, non-Hispanic26.721.614.0    
Black, non-Hispanic33.817.812.3School years completed:   
Hispanic38.417.411.4Less than 12 years49.714.38.2
Other28.821.814.312 years33.918.210.7
Some college (13-15       
Males:years)23.922.313.9   
18 to 29 years old17.626.512.2College (16 or more   
30 to 44 years old24.919.011.8years)16.325.719.7
45 to 64 years old30.620.514.1    
65 to 74 years old31.124.814.2Household income:   
75 years old andLess than $10,00042.417.810.7   
over39.122.222.0$10,000 to $19,99939.816.910.5
$20,000 to $34,99931.319.412.1    
Females:$35,000 to $49,99924.421.414.0   
18 to 29 years old25.120.914.2$50,000 and over16.925.517.6
Deaths by Selected Causes and Selected Characteristics: 1997
[In thousands (2,314.2 represents 2,314,200). Excludes deaths of nonresidents of the United States. Deaths classified according to ninth revision of International] Classification of Diseases.
-Represents zero.
1Includes other causes, not shown separately.
2Includes allied conditions.
3Includes other races, not shown separately.
4Includes those deaths with age not stated.
SOURCE: U.S. National Center for Health Statistics, Vital Statistics of the United States, annual.
Age, sex, and raceTotal1Heart diseaseCancerAccidents and adverse effectsCerebrovascular diseasesChronic obstructive pulmonary diseases2PneumoniaSuicideChronic liver disease, cirrhosisDiabetes mellitusHomicide and legal intervention
ALL RACES3
Both sexes, total42,314.2727.0539.695.6159.8109.085.730.525.262.619.8
Under 1 years old28.00.60.10.80.30.10.4---0.3
1 to 4 years old5.50.20.42.00.1-0.2---0.4
5 to 14 years old8.10.31.03.40.10.10.10.3--0.5
15 to 19 years old31.51.11.613.40.20.20.24.2-0.16.1
25 to 34 years old45.53.34.612.60.70.40.55.70.50.65.1
35 to 44 years old89.413.217.114.52.80.91.46.73.51.93.7
45 to 54 years old144.935.345.410.45.72.82.24.95.64.31.9
55 to 64 years old232.066.086.37.19.710.13.72.95.38.40.9
65 to 74 years old464.3139.4156.78.624.930.610.52.75.816.30.5
75 to 84 years old670.5227.5156.312.154.142.127.22.33.519.60.3
85 years old and over594.1240.069.910.761.321.839.30.80.911.40.1
WHITE
Both sexes, total41,996.4639.2468.579.9138.3100.876.227.521.749.99.9
Under 1 years old18.50.40.10.50.2-0.3---0.2
1 to 4 years old3.80.10.31.4--0.1---0.2
5 to 9 years old2.50.10.41.0--0.1---0.1
10 to 14 years old3.30.10.41.4---0.3--0.1
15 to 19 years old10.50.30.55.60.10.10.11.5--1.1
20 to 24 years old12.00.40.75.60.10.10.11.9-0.11.3
25 to 29 years old13.40.71.24.90.10.10.12.30.10.11.2
30 to 34 years old18.81.62.45.30.30.10.22.60.30.31.2
35 to 39 years old27.63.34.76.00.60.20.43.11.00.51.1
40 to 44 years old37.66.28.65.71.10.40.63.01.90.80.9
45 to 49 years old48.510.814.34.71.50.70.72.62.31.20.7
50 to 54 years old62.916.222.53.62.21.60.92.02.31.80.4
55 to 59 years old78.421.630.23.02.83.01.11.62.12.50.3
60 to 64 years old109.531.442.02.84.26.01.81.22.33.50.2
65 to 69 years old165.648.360.73.37.311.23.11.22.65.30.2
70 to 74 years old234.271.276.14.113.117.15.81.32.67.50.2
75 to 79 years old290.694.877.15.220.720.59.91.32.08.40.2
80 to 84 years old313.0110.363.45.827.519.214.60.91.38.00.1
85 years old and over545.3221.262.910.056.520.536.40.80.89.70.1
BLACK           
Both sexes, total4276.577.261.312.718.16.97.92.12.811.19.3
Under 1 years old8.50.2-0.20.1-0.1---0.1
1 to 4 years old1.40.10.10.5------0.1
5 to 9 years old0.9-0.10.4------0.1
10 to 14 years old0.9-0.10.3------0.1
15 to 19 years old3.20.10.10.8---0.2--1.4
20 to 24 years old4.60.20.20.9---0.3--2.1
25 to 29 years old5.10.40.31.0-0.10.10.3-0.11.5
30 to 34 years old6.60.60.50.90.10.10.10.30.10.11.1
35 to 39 years old9.51.21.21.20.30.10.20.20.20.20.9
40 to 44 years old12.22.12.01.20.60.20.20.20.30.30.7
45 to 49 years old14.73.33.21.00.80.20.30.10.50.50.4
50 to 54 years old14.94.14.20.70.90.30.20.10.40.70.2
55 to 59 years old17.35.15.40.61.00.40.30.10.40.90.1
60 to 64 years old21.46.56.90.51.30.60.40.10.31.20.1
65 to 69 years old25.37.88.10.51.60.90.50.10.31.40.1
70 to 74 years old30.69.89.20.52.21.10.80.10.21.60.1
75 to 79 years old30.210.07.90.52.41.11.0-0.11.5-
80 to 84 years old27.19.55.70.42.40.91.1-0.11.2-
85 years old and over42.116.26.10.64.11.02.3--1.5-
Live Births by Race and Type of Hispanic Origin—Selected Characteristics: 1990 and 1998
[4,158 represents 4,158,000. Represents registered births. Excludes births to nonresidents of the United States. Data are based on Hispanic origin of mother and race of mother. Hispanic origin data are available from only 48 States and the District of Columbia in 1990]
NA Not available.
1Births less than 2,500 grams (5 lb.-8 oz.).
2Includes other races not shown separately.
3Hispanic persons may be of any race. Includes other types, not shown separately.
SOURCE: U.S. National Center for Health Statistics; Vital Statistics of the United States, annual; National Vital Statistics Report (NVSR) (formerly
Monthly Vital Statistics Report); and unpublished data.
 Number of births (1,000)Births to teenage mothers, percent of totalBirths to unmarried mothers, percent of totalPrenatal care beginning first trimesterLate or no prenatal carePercent of births with low birth weight1
Race and Hispanic origin199019981990199819901998199019981990199819901998
Total4,1583,94212.812.526.632.874.282.86.03.97.07.6
White3,2903,11910.911.116.926.377.784.84.93.35.76.5
Black68461023.121.566.769.160.773.310.97.013.313.0
American Indian, Eskimo, Aleut394019.520.953.659.357.968.812.98.56.16.8
Asian and Pacific Islander1421735.75.4(NA)15.6(NA)83.1(NA)3.6(NA)7.4
Filipino26316.16.215.919.777.184.24.53.17.38.2
Chinese23281.20.95.06.481.388.53.42.24.75.3
Japanese992.92.49.69.787.090.22.92.16.27.5
Hawaiian6618.418.845.051.165.878.88.74.77.27.2
Hispanic origin59573516.816.936.741.660.274.312.06.36.16.4
Mexican38651617.717.533.339.657.872.813.26.85.56.0
Puerto Rico595721.721.955.959.563.576.910.65.19.09.7
Cuban11137.76.918.224.884.891.82.81.25.76.5
Central and South American83989.010.341.242.061.578.010.94.95.86.5
Other and unknown Hispanic5650(NA)20.2(NA)45.3(NA)74.8(NA)6.0(NA)7.6
Family Groups With Children Under 18 Years Old by Race and Hispanic Origin: 1980 to 1999
[In thousands. As of March (32,150 represents 32,150,000). Family groups comprise family households, related subfamilies, and unrelated subfamilies. Excludes members of Armed Forces except those living off post or with their families on post. Based on Current Population Survey.]
- Represents or rounds to zero.
1Includes other races, not shown separately.
2Hispanic persons may be of any race.
SOURCE: U.S. Census Bureau, Current Population Reports, P20-515, and earlier reports; and unpublished data.
    1999
      Subfamilies
Race and Hispanic origin of householder or reference person198019901995TotalFamily householdsTotalRelatedUnrelated
All races, total132,15034,67037,16837,43034,6132,8162,328488
Two-parent family groups25,23124,92125,64025,53825,06647245616
One-parent family groups6,9209,74911,52811,8929,5472,3441,872472
Maintained by mother6,2308,3989,8349,8417,8411,9991,591408
Maintained by father6901,3511,6942,0511,70634528164
White, total27,29428,29429,84630,13228,2401,8921,475417
Two-parent family groups22,62821,90522,32022,13921,75937936415
One-parent family groups4,6646,3897,5257,9936,4811,5121,111401
Maintained by mother4,1225,3106,2396,3685,1101,258918340
Maintained by father5421,0791,2861,6251,37125419361
Black, total4,0745,0875,4915,4804,71576871355
Two-parent family groups1,9612,0061,9622,0171,9714646-
One-parent family groups2,1143,0813,5293,4632,74472166655
Maintained by mother1,9842,8603,1973,1392,47766361152
Maintained by father12922133232426758553
Hispanic, total22,1943,4294,5275,1934,61457949782
Two-parent family groups1,6262,2892,8793,3543,2181361297
One-parent family groups5681,1401,6471,8391,39644336875
Maintained by mother5261,0031,4041,5601,17438631967
Maintained by father4213824327922257498
Marital Status of the Population by Sex, Race, and Hispanic Origin: 1980 to 1999
[In millions, except percent (159.5 represents 159,500,000). As of March. Persons 18 years old and over. Excludes members of Armed Forces except those living off post or with their families on post. Based on Current Population Survey.]
1Includes persons of other races, not shown separately.
2Hispanic persons may be of any race.
SOURCE: U.S. Census Bureau, Current Population Reports, P20-491, and earlier reports; and unpublished data.
 TotalMaleFemale
Hispanic origin198019901995199919801990199519991980199019951999
Total159.5181.8191.6199.775.786.992.095.983.895.099.6103.9
Never married32.340.443.947.618.022.424.625.814.317.919.321.9
Married104.6112.6116.7118.951.855.857.759.052.856.758.959.9
Widowed12.713.813.413.52.02.32.32.510.811.511.110.9
Divorced9.915.117.619.73.96.37.48.56.08.810.311.1
Percent of total100.0100.0100.0100.0100.0100.0100.0100.0100.0100.0100.0100.0
Never married20.322.222.923.923.825.826.826.917.118.919.421.0
Married65.561.960.959.568.464.362.761.563.059.759.257.7
Widowed8.07.67.06.72.62.72.52.712.812.111.110.5
Divorced6.28.39.29.95.27.28.08.97.19.310.310.7
White, total139.5155.5161.3166.866.774.878.180.972.880.683.285.9
Never married26.431.633.235.715.018.019.220.011.413.614.015.6
Married93.899.5102.0103.546.749.550.651.647.149.951.351.9
Widowed10.911.711.311.31.61.91.92.19.39.89.49.2
Divorced8.312.614.816.33.45.46.37.15.07.38.49.1
Percent of total100.0100.0100.0100.0100.0100.0100.0100.0100.0100.0100.0100.0
Never married18.920.320.621.422.524.124.624.715.716.916.918.2
Married67.264.063.262.070.066.264.963.864.761.961.760.4
Widowed7.87.57.06.82.52.62.52.612.812.211.310.8
Divorced6.08.19.19.85.07.28.18.96.89.010.110.6
Black, total16.620.322.123.67.49.19.910.59.211.212.213.0
Never married5.17.18.59.22.53.54.14.32.53.64.45.0
Married8.59.39.69.84.14.54.64.74.54.84.95.0
Widowed1.61.71.71.80.30.30.30.41.31.41.41.4
Divorced1.42.12.42.80.50.80.81.10.91.31.51.7
Percent of total100.0100.0100.0100.0100.0100.0100.0100.0100.0100.0100.0100.0
Never married30.535.138.439.234.338.441.740.727.432.535.837.9
Married51.445.843.241.454.649.246.744.848.743.040.438.6
Widowed9.88.57.67.64.23.73.13.714.312.411.310.7
Divorced8.410.610.711.97.08.88.510.89.512.012.512.8
Hispanic, total7.913.617.620.33.86.78.810.14.16.88.810.3
Never married1.93.75.05.91.02.23.03.30.91.52.12.6
Married5.28.410.412.12.54.15.16.02.64.35.36.1
Widowed0.40.50.70.80.10.10.20.10.30.40.60.7
Divorced0.51.01.41.50.20.40.60.60.30.60.80.9
Percent of total100.0100.0100.0100.0100.0100.0100.0100.0100.0100.0100.0100.0
Never married24.127.228.629.027.332.133.832.721.122.523.525.3
Married65.661.759.359.467.160.957.959.664.362.460.759.3
Widowed4.44.04.24.01.61.51.81.57.16.56.66.5
Divorced5.87.07.97.64.05.56.66.37.68.59.28.8
Living Arrangements of Persons 15 Years Old and Over by Selected Characteristic: 1999
[In thousands (211,676 represents 211,676,000). As of March. Based on Current Population Survey which includes members of Armed Forces living off post or with families on post but excludes other Armed Forces.]
1Includes other races and persons not of Hispanic origin, not shown separately.
2Persons of Hispanic origin may be of any race.
SOURCE: U.S. Census Bureau, unpublished data.
Living arrangementTotal15 to 19 years old20 to 24 years old25 to 34 years old35 to 44 years old45 to 54 years old55 to 64 years old65 to 74 years old75 years old and over
Total211,67619,86418,05838,47444,74435,23222,90917,84314,551
Alone26,6061381,1753,7144,0744,2083,5494,1255,622
With spouse111,7153453,35820,35029,21024,49516,04711,4286,479
With other persons73,35519,38113,52514,41011,4606,5293,3132,2902,450
White176,21315,73614,39730,89736,94629,75419,72515,64213,118
Alone22,1761229082,9103,2453,3722,8853,5775,158
With spouse98,3743043,02817,51825,30321,40214,38310,4056,032
With other persons55,66315,31010,46110,4698,3984,9802,4571,6601,928
Black25,4463,0672,6475,2575,6133,8542,2851,6031,120
Alone3,63310183569692722593455409
With spouse8,134211981,7172,3791,865993667295
With other persons13,6793,0362,2662,9712,5421,267699481416
Hispanic origin21,9952,8372,7345,5314,6302,8641,7051,092604
Alone1,3292798261211197177212145
With spouse10,6061137443,1212,8981,8441,041590254
With other persons10,0602,6971,8922,1491,521823487290205
Health Insurance Coverage Status by Selected Characteristics: 1990 to 1998
[Persons as of following year for coverage in the year shown (248.9 represents 248,900,000). Government health insurance includes medicare, medicaid, and military plans. Based on Current Population Survey.]
1Includes other government insurance, not shown separately. Persons with coverage counted only once in total, even though they may have been covered by more that one type of policy.
2Related to employment of self or other family members.
3Beginning 1994, data based on 1990 census adjusted population controls.
4Includes other races not shown separately.
5Persons of Hispanic origin may be of any race.
SOURCE: U.S. Census Bureau, Current Population Reports, P60-208; and unpublished data.
 Number (mil.)Percent
  Covered by private or government health insurance Covered by private or government health insurance 
   PrivateGovernment     
CharacteristicTotal personsTotal1TotalGroup health2MedicareMedicaidNot covered by health insuranceTotal1PrivateMedicaidNot covered by health insurance
1990248.9214.2182.1150.232.324.334.786.173.29.713.9
19943262.1222.4184.3159.633.931.639.784.870.312.115.2
1995264.3223.7185.9161.534.731.940.684.670.312.115.4
1996266.8225.1187.4163.235.231.541.784.470.211.815.6
1997269.1225.6188.5165.135.629.043.483.970.110.816.1
1998, total271.7227.5190.9168.635.927.944.383.770.210.316.3
Age:           
Under 18 years72.060.948.645.60.314.311.184.667.519.815.4
Under 6 years23.720.015.114.40.15.73.784.563.823.915.5
6 to 11 years24.621.016.815.90.14.93.685.468.220.014.6
12 to 17 years23.820.016.815.40.13.73.884.070.515.516.0
18 to 24 years26.018.215.913.10.12.57.870.161.19.830.0
25 to 34 years38.529.326.725.10.42.59.176.369.56.423.7
35 to 44 years44.737.034.132.00.72.67.782.876.35.817.2
45 to 54 years35.230.428.226.41.11.64.886.479.94.613.6
55 to 64 years22.919.517.215.22.01.43.485.075.06.215.0
65 years and over32.432.020.211.231.13.00.498.962.39.11.1
Sex: Male132.8109.794.084.315.511.723.082.770.88.817.3
Female139.0117.796.984.320.416.221.384.769.711.615.3
Race: White223.3189.7163.7143.731.218.233.685.073.38.215.0
Black35.127.318.717.13.77.97.877.853.222.522.2
Hispanic origin31.720.514.413.32.05.611.264.745.417.635.3
Household income:           
Less than $25,00068.451.227.518.818.218.617.274.840.227.325.2
$25,000-$49,99979.064.256.049.210.46.214.881.370.97.918.8
$50,000-$74,99957.350.648.044.73.71.86.788.383.73.111.7
$75,000 or more67.061.559.455.83.61.25.591.788.71.98.3
Persons below poverty34.523.38.86.04.514.011.267.725.640.632.3

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