Movie star Boseman's death begs the question: why are Black Americans more likely than others to die of cancer?

The website of the US government’s cancer research agency lists a range of risk factors for colorectal cancer, from smoking and obesity to family history. But one in particular stands out: “being Black”.

Colon and rectal cancers, which the National Cancer Institute (NCI) says are the third most common form of the disease in the country, are front-page news after the death of the American actor Chadwick Boseman.

Boseman died at the age of 43, four years after he was told he had colon cancer. The Black Panther star had not made this diagnosis public and had continued to work on hit films in between treatment. His death rocked both the movie industry and fans worldwide.

The shock is understandable – Boseman was relatively young when he passed. After all, as the NCI says, older age is the main risk factor for most cancers. And it’s true that colorectal cancer isn’t as common in those under 50. But incidences are rising among younger age groups, increasing since the mid-1980s in adults aged 20-39, and since the mid-1990s in those aged 40-54, according to the American Cancer Society.

Doctors are unsure about the causes of this rise, but some think changes in diet, obesity and alcohol consumption could be among them.

Higher risk

It’s when it comes to race that the statistics are truly surprising, though. Black Americans are about 20% more likely to get colorectal cancer than most other groups. They’re more often diagnosed with it at an earlier age and with more advanced disease. And they’re 40% more likely to die from it.

In fact, Black Americans are disproportionately affected by cancer full stop. So why is this?

It’s largely a reflection of differences in risk factors and healthcare access, both of which are related to socioeconomic status, according to the American Cancer Society.

One of those risk factors is obesity, which also disproportionately affects Black people in the US. Many Black communities live in "food deserts" – areas in which people have limited access to a variety of healthy and affordable food – and they can face targeted marketing of unhealthy foods and a lack of convenient places to exercise.

Black Americans often experience greater obstacles to preventing, detecting and treating cancer too. These obstacles can include things like lower-paying jobs, poor-quality housing, insufficient health insurance and, again, a lack of access to healthy foods.

For one cancer epidemiologist at the American Cancer Society, Rebecca Siegel, it’s the big difference in mortality this situation creates that’s most striking. "It’s also the elephant in the room of systemic racism that has been going on for decades and affects everyone in the Black community, regardless of their wealth status," she told USA Today.

Entrenched issues

Systemic racism – where racism is embedded throughout the systems and structures of a society – impacts many factors interlinked with health, and more besides. It can affect everything from pay and employment chances to the political engagement of ethnic minorities.

Overcoming these deeply entrenched problems will require them to be recognized and addressed by organizations and governments, according to leading campaigners speaking at the World Economic Forum’s online debate Ending Systemic Racism.

But as debate participant Lysa John Berna, Secretary-General of Civicus – an organization that works to strengthen civil society – noted, recent protests over issues from civil rights to climate change demonstrate a real appetite for change among younger generations.

"Every single person, no matter where they are, has the ability and the agency to call for change and do something about it," she said. "For me that really is the sign that we cannot fail because our failure is only determined by the barriers we impose on ourselves."