As President Obama celebrates passage of the health care reform bill, health disparities continue to plague blacks’ overall wellness, reports America’s Health Rankings, an annual, comprehensive, state-by-state assessment of our nation’s wellness.

In general, although African Americans face the same health issues threatening other Americans, blacks are disproportionately affected by them because of unequal and unmet health care needs.

Based on the Rankings’ data, Reed Tuckson, MD, executive vice president of United Health Group and a board member of the United Health Foundation, which publishes the data, focuses on two major areas of concern for black health: obesity and smoking. The deadly duo are major health risk factors for an array of illnesses.

“We are seeing a disconcerting persistence in the use of tobacco,” says Tuckson. “And we’ve always known that smoking has been the No. 1 preventable risk factor for death and disease in this country.”

In 2008, African Americans accounted for about 12 percent of the 46 million U.S. adults who smoked. Annually, nearly one in five deaths in the United States results from smoking-related illnesses, such as lung cancer and chronic obstructive lung disease. Other smoking-related illnesses include emphysema and bronchitis. But remember: Smoking harms nearly all parts of the body.

And if that’s not enough, statistics show that blacks are 51 percent more likely to be obese than whites. This is an important health barometer because the condition causes a slew of other illnesses.

As a result of these obesity- and smoking-related diseases, plus poor access to quality care, blacks experience a six- to 10-year decrease in life expectancy, 25 percent higher cancer death rates and a widening infant mortality gap, America’s Health Rankings found.

Although the reality of these stats is thoroughly depressing, there is hope, Tuckson says. It begins with making health-improving lifestyle changes. Obvious examples include quitting smoking and making healthier food choices for our children and ourselves. But Tuckson offers another, often overlooked suggestion: working with community organizations.

“We live our lives in the context of community—church, associations, men’s clubs, women’s clubs, card clubs,” he says. “We have to use our institutions as vehicles for life not death. That means what we eat in these environments has to change.”

By the year 2042, about half of all Americans will be people of color, America’s Health Rankings predicts. If America is defined by its people, then the health status of its diverse population groups will reflect the nation’s physical and mental wellness.

In other words, if black health doesn’t improve, America’s prognosis is not good.