If blacks and whites had equal death rates, 90,000 fewer American blacks would die each year, the University of Dayton's Vernellia Randall writes in her new book, Dying While Black.

"We are quite literally dying from being black," said Randall, a former registered nurse who is an expert in health care and race law. "(Society) wants to address them in an egalitarian way, as to say, 'See, it's not about race. It's about being poor.' Without focusing on race, the problem never will be fixed."

A black urban U.S. man's life expectancy is closer to that of people living in West Africa than to the average white American, the Harvard School of Public Health reported last month, and black men overall have 6.4 fewer years of life expectancy than white men. Blacks also have higher rates than whites of infant mortality, low-weight births and many diseases.

Black neighborhood hospitals have decreased by 90 percent over two decades, Randall said. "Unhealthy people living in unhealthy situations — not having suitable access to a hospital or other health care or facing discrimination and racism — perpetuates poor health from generation to generation."

Solving the disparity will require changing institutions, she said. Her recommendations include increasing the number of health care facilities in minority neighborhoods, removing dump sites and offering incentives to change unhealthy behaviors.

More about the book, due out this month from Seven Principles Press, is at www.dyingwhileblack.org