Take a moment to think about the men in your life that you hold dear. Once the person comes to mind, ask yourself these questions. Have they experienced any health issues in their lifetime? If so, what kind of care were they able to access based on their socioeconomic status? (Socioeconomic status is defined as the employment status, income level, education level, etc. of a person)1. If they were not able to receive adequate care, what were the barriers that made it difficult to access it?
As the month of May ends, June now comes with the expectancy of Men’s Health Month. This nationwide health initiative and the city of Washington have a shared commonality; the health status of men calls for attention. The Health Alliance Network, led by Ward 7 resident and activist Ambrose Lane Jr., advocates for a renewed focus on the health of Black men. Washington has been made the subject of social science journals and various news outlets as an example of exacerbated health outcomes. The District of Columbia has approximately 700,000 residents and 46.4% of those residents identify as Black or African American7; on the other hand, the city has the largest life expectancy gap between Black and White populations in the United States2. A study conducted by Benjamins et al. on mortality in the 30 most populous cities in the U.S., found that the racial disparities in Washington were the highest among all of the cities2,3. Another study by Hashemian et al. found that the overall mortality rate of the White population in D.C. has decreased since the year 2000, while the mortality rate of the Black population in D.C. has increased since 20122,4. This has caused the health disparities between the Black and White populations in the city to worsen over the past two decades2,4. The question at hand is, how did the District get to this point? To understand this multifaceted answer, we need to look at the risk factors that continue to affect the lives of men, specifically Black men with the District of Columbia.
The 51st, a new local news publication, quoted a native Washingtonian and a local health care worker stating, “Black men didn’t just start dying. We’ve been dying for decades as a direct result of opioid use disorder”5. During the decades of the 1960s and 1970s, D.C. was under the stronghold of a heroin epidemic; the realities of those, specifically Black men, who underwent the use and abuse of heroin are now currently suffering from fentanyl overdose5. In 2023, 96% of D.C.’s overdose fatalities were due to fentanyl and the pervasiveness of the opioid in current drugs5.
Higgins, Grablick and Pelt, writers for the 51st, highlighted a data analysis conducted by multiple news publications including the Baltimore Banner, The New York Times and Big Local News reported that in 2022, Black men born between the years 1951 and 1970 accounted for 38% of D.C.’s opioid fatalities5. However, these men only make up 4% of D.C.’s total population5. For the District, the transition between heroin and fentanyl started in the mid to late 2010s when fentanyl started to appear more heavily within the drugs in the city5. The increased disproportionate opioid-related mortalities for Black residents can be traced to the rapid change of the city’s landscape that has resulted in heightened segregation and gentrification by ward2,6.
These inequities stem from a historical context of structural racism and discriminatory policies within institutions such as employment, housing, education, criminal justice, health care, nutrition and others that have deeply impacted the health and well-being of Black residents in D.C4. In 2022, about 77% to 80% of the total homeless population in D.C. identified as Black or African American, and of those, a significant majority were men (roughly 60% to 65% of single adult men experiencing homelessness identify as Black) according to the D.C. Department of Human Services and The Community Partnership for the Prevention of Homelessness11. Beginning in the middle of 2021 through 2022, The D.C. Department of Employment Services reported that the unemployment rate for Black men in D.C. was approximately 11% to 15%, often two to three times higher than the rate for White men12. From 2020 to 2022, the D.C. Department of Corrections Facts and Figures found that Black individuals comprise roughly 90% of the D.C. jail population on a given day, while Black men alone typically account for 70% to 80% of all those incarcerated in the local D.C. Jail13. Precise incarceration rates can vary by source, but studies and advocacy organizations, such as the Prison Policy Initiative, have estimated that the incarceration rate for Black men in D.C. can be five to seven times higher than for White men, when looking at both jail (pretrial, short sentences) and federal prison (longer sentences)14.
Cardiovascular or heart disease, cancer, hypertension, obesity, smoking and diabetes, are a few of the prevalent health issues that are leading causes to the declining health of Black D.C. residents2,7. According to the D.C. Health Behavioral Risk Factor Surveillance System, or the D.C. BRFSS, between the years of 2019 and 2020, approximately 14% to 16% of Black men were diagnosed with either type 1 or type 2 diabetes8. Regarding cancer, specifically prostate cancer, The National Institutes of Health reported that the mortality rate for Black men is nearly 2.5 times higher than White men in the District9. In 2016, heart disease was the leading contributor to the health gap between Black and White residents7; risk factors such as obesity, smoking and lack of physical activity have been a huge concern for heart disease diagnoses among Black men in D.C7. In 2018, the D.C. Health Equity Report found that the life expectancy for Black men is between 68 to 72 years of age compared to the citywide average of 77 to 78 years of age10.
The life expectancy of Black men can be broken down further by ward; in the predominantly Black wards 7 and 8, Black men can have a life expectancy of 10 to 15 years less compared to the wealthier wards with a predominantly White population that can exceed 82 to 83 years of age10. The frequency of primary care visits can impact these issues; according to BRFSS 2019-2020, approximately 55% to 60% of Black men in D.C. reported at least one primary care visit in the past year, lower than 70% to 75% for White men15. Nutrition can also be sourced as a problem that exacerbates these health issues; a literature review about how structural racism can lead to health disparities, highlighted “that the majority Black geographic areas of Wards 7 and 8 together had only six full-service grocery stores in 2024 for their population of more than 148,000 people, whereas the majority-white wards 2 and 3 together had 28 full-service grocery stores for their population of less than 159,000 people”4.
As Men’s Health Month has arrived, there needs to be an urgent push for the D.C. Council and Mayor’s local government to address the lives of the Black men, especially those who are older in age, that have been suffering for decades. The Health Alliance Network advocates for opening an Office of Men’s Health at D.C. Health with a budget for research and robust outreach. Ambrose Lane Jr. has stated, “When it comes to the health of the children, the health of the mother is paramount. When it comes to the health of the family and community, the health of the father is paramount.” Those who have called Washington home for decades deserve to be given the proper services and resources to live healthy lives. This is a call to action for the local D.C. health department to increase their evidence-based programming and outreach for our Black men.
Ambrose Lane Jr. is founder and chairman of the Health Alliance Network. Micailah Guthrie is the program and research fellow for the Health Alliance Network
References
1. National Cancer Institute. (n.d.). NCI Dictionary of Cancer terms. Comprehensive Cancer Information – NCI. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/socioeconomic-status
2. Hashemian, M., Conners, K. M., Joo, J., Rafi, R., Henriquez Santos, G., Shearer, J. J., Andrews, M. R., Powell-Wiley, T. M., Shiels, M. S., & Roger, V. L. (2025). Demographic differences in mortality in the District of Columbia. JAMA Network Open, 8(3). https://doi.org/10.1001/jamanetworkopen.2025.2290
3. Benjamins, M. R., Silva, A., Saiyed, N. S., & De Maio, F. G. (2021). Comparison of all-cause mortality rates and inequities between black and white populations across the 30 most populous US cities. JAMA Network Open, 4(1). https://doi.org/10.1001/jamanetworkopen.2020.32086
4. Jones, L.N. (2024). Minding the Grocery Gap in the District of Columbia — A 2024 Update. D.C. Hunger Solutions. https://www.dchunger. org/wp-content/uploads/2024/11/Minding-GroceryGap-2024.pdf
5. Higgins, A., Grablick, C., & Pelt, S. (2024, December 20). Opioids are killing older black men in D.C. at some of the highest rates in the country. The 51st. https://51st.news/opioid-overdoses-killing-older-black-men-dc/
6. Kiang, M. V., Tsai, A. C., Alexander, M. J., Rehkopf, D. H., & Basu, S. (2021). Racial/ethnic disparities in opioid-related mortality in the USA, 1999–2019: The extreme case of Washington DC. Journal of Urban Health, 98(5), 589–595. https://doi.org/10.1007/s11524-021-00573-8
7. Roberts, M., Reither, E. N., & Lim, S. (2020). Contributors to the black-white life expectancy gap in Washington D.C. Scientific Reports, 10(1). https://doi.org/10.1038/s41598-020-70046-6
8. DC Health. (2021). Behavioral Risk Factor Surveillance System (BRFSS) Data 2019–2020.
9. National Institutes of Health (NIH). (2021). Racial Disparities in Prostate Cancer.
10. DC Health. (2019). Health Equity Report: District of Columbia 2018.
11. DC Department of Human Services & The Community Partnership for the Prevention of Homelessness. (2022). Point-in-Time Count Results.
12. DC Department of Employment Services. (2021–2022). Labor Force, Employment, and Unemployment Data.
13. DC Department of Corrections. (2020–2022). Facts and Figures. https://doc.dc.gov
14. Prison Policy Initiative. (2022). District of Columbia Incarceration Statistics. https://www.prisonpolicy.org
15. Prison Policy Initiative. (2022). District of Columbia Incarceration Statistics. https://www.prisonpolicy.org
