PHOTO: A new JAMA report details reasons that more funding is needed for public health and social service programs, such as Boston's Men's Health Crew, which focuses on preventing domestic violence. The report says the U.S. health system is failing young men of color. Photo courtesy Boston Public Health Commission.

BOSTON - There is no shortage of medical spending or technology in New England, but a new report says young, black men are more likely to survive in prison than they are on the street.



While health-care spending is at an all-time high in the United States, said Dr. Stephen Martin of Boston Medical Center, a coauthor of the report, young men of color see little benefit from it. In fact, he said, they have a better chance of surviving in prison.



"Your odds of dying are half in prison what they'd be on the street because you have the things that you need to stay alive and stay healthy," he said. "You have nutrition, you've got a roof over your head, you've got medical care that's accessible and guaranteed by the Constitution."



The Viewpoint commentary in the Journal of the American Medical Association noted that African-American men can expect to live about five fewer years than white men. To help change that, Martin said, the nation needs to increase funding for social and public-health programs.



Martin described what he calls "a significant asymmetry" to unbelievable technical advances in medicine - and the absence of social services and effective primary care in communities of color that he said could do much to help men.



"It's striking how only three cents of our American health-care dollar goes to public health - just three cents," he said. "This is the same public health that gave us 90 percent of our life-expectancy gains in the 20th century. And yet, compared with medical care, public health and social support funding have been eviscerated."



The researchers noted that heart disease and cancer contribute to lower life expectancy - but homicide is the leading cause of death for black males ages 15 to 34. It also ranks among the top three causes of death for black male children ages 1 to 14.



The report is online at jama.jamanetwork.com.