Migration, Cultural Transformation and the Rise of Black Liver Cirrhosis Mortality

Abstract

Throughout the 19th and most ofthe 20th century, liver cirrohsis mortality rates among U.S. blacks were usually similar to or slightly below rates in the white population. After 1955 this pattem rapidly changed and black Americans experienced an epidemic of cirrhosis which greatly exceeded the moderate increases in the white population. Increases in cirrhosis mortality were highly specific to geographical region. Rates among blacks increased as much as four limes in urbanised coastal and northern regions and remained low in the southem rural areas of the U.S. Among whites this pattem was reversed and tnortality rates increased more in the south than in northem industrial areas.This paper analyses these epidemiological trends vnth a focus on cohort differences and migration patterns in the U.S. black population. The contemporary distribution of Hack cirrhosis rates appears to refiect in part, shifts in the political climate of the 19th century temperance movement and the mass migration of blacks from the rural south to the urban north in the early decades ofthe century. The early 19th century temperance movement was highly favourable to black political liberty thus creating marty black allies for temperance; by the tum of the century the political base of the temperance movement became associated with strategies for black political disfranchisement and racial segregation, thus alienating many blacks. These changes in the movement and the simultaneous mass migration of blacks to 'wef urban areas seemed to stimulate a rapid alcoholisation of some parts ofthe black population beginning in the 1920s and 1930s.

Exploring Heavy Drinking Patterns Among Black and White Young Adults

“…This fi nding extends previous work with students to a more general population. We note, however, that the negative consequences measured here do not include aspects such as involvement with the legal system (e.g., arrests), serious morbidity (e.g., cirrhosis of the liver), and mortality, which are problems that disproportionately affect Blacks (Beckett et al, 2006;Chartier and Caetano, 2010;Galea and Vlahov, 2002;Gary, 1986;Herd, 1985).…”

Multicultural contexts and alcohol and drug use as symbolic behaviour

“…In the urban Northern environments, drinking and heavy drinking acquired positive associations, for instance with the Harlem Renaissance of African-American musicians, writers, and artists of the 1920s. Herd (1985a) shows that cirrhosis mortality rates, reflecting rates of heavy drinking, marched inexorably upwards in successive cohorts of 20th-century African-Americans, particularly in the North, passing and exceeding white rates in the 1950s.…”

“…Herd (1985a) has tracked what happened to cirrhosis death rates among African-Americans in the great internal migration northward in the United States in the first half of the 20th century. While the anti-alcohol movement in the U.S. had originally…”

Historical Overview of Alcohol in the African American Community

“…The patterns of alcohol use among African Americans began to shift. Since the late 1950s, there has been a rapid annual increase in the frequency of cirrhosis of the liver as a cause of death in Blacks (Herd, 1985). Cirrhosis of the liver is not always caused by excessive use of alcohol, yet it does provide a crude measure of alcoholism.…”