Research also reveals that some risk factors have a more adverse impact on blacks than on whites even when their overall levels are lower than or similar to those of whites. This is evident for both tobacco and alcohol. For example, the risks of lung cancer do not mirror variations in smoking behavior with a given level of smoking associated with an elevated risk of lung cancer for African Americans and Native Hawaiians compared to whites, Japanese Americans and Latinos.23 In a similar vein, alcohol-related mortality is more than twice as high for black males than for their white counterparts and almost twice as high for females.24 A general population sample in New York State also found evidence of greater susceptibility to liver damage in blacks compared to whites.25 Compared to whites, blacks had higher levels of common biomarkers of liver damage at every level of alcohol consumption with the differences being largest at the highest level of alcohol use. This pattern persisted after adjustment for age, sex, education, BMI, and pack years of smoking. We are currently unaware of
