Health Reports, April 2025

Looking beyond mortality: health events before death shape mortality differences between Black and White adults in Canada after accounting for known social determinants of health

To better understand why Black adults in Canada experience higher mortality risks for certain diseases, it is useful to examine the health events that occur before death, while accounting for other known social determinants of health and other disease conditions. Differences in diagnosis rates, disease severity and hospitalizations can provide insight into the factors driving the relatively higher mortality risks of Black adults.

The study, entitled "Understanding mortality differentials of Black adults in Canada," analyzed data from the 2001, 2006 and 2011 Canadian Census Health and Environment Cohorts. It followed individuals until 2016 or 2019 to track cancer diagnoses, hospitalizations and mortality risks for HIV/AIDS, diabetes, prostate cancer and uterine cancer.

High mortality risks for HIV/AIDS, diabetes and prostate cancer match the high diagnosis rates and severity of these disease conditions in Black adults

Among Black men, the likelihood of being diagnosed with prostate cancer or dying from it was high, compared with White men. For example, after accounting for known social determinants of health, Black men were 68% more likely to be diagnosed with prostate cancer, and 19% more likely to die from it, as compared with White men. Similarly, for both Black men and women, the likelihood of hospitalization due to HIV/AIDS and diabetes was as high as the risk of mortality from these disease conditions. These findings indicate that disease severity is an important factor of mortality disparities between Black and White adults in Canada.

Lower diagnosis rate despite higher mortality risk: the case of uterine cancer in Black women

Despite having a higher risk of dying from uterine cancer, Black women were 15% less likely to be diagnosed with the disease compared with White women. The difference between diagnosis rate and mortality risk highlights the need to investigate barriers to early detection among Black women in Canada such as timely screening and early diagnoses.

Late diagnosis and lower survival rates in Black women with uterine cancer

When diagnosed with uterine cancer, Black women had a survival rate that was two-times lower than that of White women. An additional analysis revealed that delayed diagnosis played a larger role in uterine cancer mortality among Black women (14.9%) compared with White women (8.9%). This suggests that improving early detection and timely treatment among Black women could help reduce survival gaps.

Overall, understanding the health events leading to mortality—such as diagnosis rates, disease severity and hospitalizations—is essential to addressing health differences between Black and White people. These results can inform targeted interventions and early detection strategies to improve survival outcomes and reduce health inequities for Black adults in Canada.