The Health Divide: D’Angelo’s death from pancreatic cancer is a painful reminder of its unequal toll
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October 20, 2025
Last week, the music world mourned the loss of neo-soul icon D’Angelo, who passed away from pancreatic cancer at the age of 51.
This disease is personal for me. I lost my father, James D. Causey, to pancreatic cancer on October 28, 2018.
Pancreatic cancer is a particularly insidious disease that disproportionately affects Black Americans, with rates of diagnosis being 50% to 90% higher than those of other racial groups. Black men bear the heaviest burden of this affliction, making it a pressing public health concern.
Pancreatic cancer is one of the most aggressive and deadly types of cancer, with a five-year survival rate of around 13%. Its lethality stems from its rapid spread and the difficulty of detecting early warning signs. The UK’s Royal College of Nursing magazine calls the disease “the silent killer.”
By the time pancreatic cancer reveals itself, half of the cases have already reached stage 4, an advanced phase where it has already invaded other organs, such as the liver or lungs.
When my father’s cancer was discovered in late April 2018, he was given six months to live.
My family had to make a difficult decision. We could either pursue aggressive treatments that involved chemotherapy and surgery to remove the pancreas, opt for a milder approach with a month of targeted radiation treatments, or do nothing at all.
My father, understandably overwhelmed, looked to my wife and me to make the decision.
We chose the path of radiation. At 81 years old, with only a few minor health issues, we wanted my father to enjoy the time he had left without being burdened by the harsh side effects of chemotherapy, a treatment that wasn’t guaranteed to extend or improve his life. In fact, it was likely he would be so ill from the treatments that he wouldn’t be able to enjoy the time he had left.
The decision gave our family a special chance: We celebrated his 82nd birthday with a party on October 5 and invited all his local friends and family. We traveled to Mississippi so he could spend time with his brothers and sister, creating a series of unforgettable memories that we would cherish forever. We decided not to tell anyone that he was sick until we got back home. We wanted his family to enjoy their time with him without having to mourn him while he was still with us.
African Americans have more risk factors
Many prominent Black figures have fallen to pancreatic cancer, including Aretha Franklin; Joe Jackson, the patriarch of the Jackson family; NFL Hall of Famer Gene Upshaw; and Grammy-winning soul and jazz singer Billy Paul.
To countless fans, D'Angelo was more than just a musician; he was a cultural icon who redefined masculinity. In the early 2000s, his famous video for "Untitled (How Does It Feel)" captivated audiences by showcasing his physique. He radiated health and vitality.
But over the years, we learned about his struggles with cocaine, marijuana, and alcohol. He also gained a lot of weight, which made him self-conscious about his public image.
Although the science behind pancreatic cancer remains unclear, risk factors include smoking, obesity, diabetes, regular alcohol consumption, drug use, gum disease, and genetic predisposition. Research has shown that African Americans have higher rates of obesity and diabetes than whites. Although smoking rates are similar, Black smokers often use menthol cigarettes, which are harder to quit and lead to more smoke exposure.
Other cases are harder to explain. My father did not smoke, drink, or use drugs, and there was no known family history of pancreatic cancer. He also did not have diabetes and maintained a healthy weight. He had regular checkups at the VA Hospital in Milwaukee.
Stark disparities in the diagnosis, treatment and outcomes of pancreatic cancer between Black individuals and people of other races urgently need more research attention.
Edith Mitchell, a medical oncologist at the Sidney Kimmel Cancer Center in Philadelphia, said that in addition to promoting healthy habits such as quitting smoking and exercising, studies should also focus on genetics, biology, and social and environmental factors.
“We still have a lot to learn about the biology of cancer, and we need more genomic profiling of tumors so that we can develop better preventive and treatment strategies,” Mitchell said in a story published with the Pancreatic Cancer Action Network.
Social factors such as economic stability, education, race, and insurance status also affect cancer outcomes, according to a June 2025 review.
Black patients are also less likely to undergo pancreatic surgery at high-volume hospitals, which are known for better survival rates, due to barriers in referral, insurance and geography.
Go beyond the numbers
Although the news of D’Angelo’s death captured national attention, health journalists have ongoing opportunities to humanize the data by telling moving narratives about individual patients, and delving deep into the systemic issues that extend beyond individual choices.
They can also weave in the vibrant threads of collective actions and community responses. This might resemble a support group, a listening session, or a church aiding one of its members. These can make for powerful stories.
Coverage might also examine how menthol cigarettes are explicitly marketed toward African American communities, and why buying cigarettes in some areas is easier than finding fresh, healthy food. Other stories might report on the dearth of hospitals and doctors in many communities, and the transportation barriers that make it harder for people to get medical care.
There’s a through line here: We need to go beyond just statistics by sharing stories and interviewing patients from communities most affected by disparities to demonstrate their real-world impact. We must hold local and state officials accountable for addressing these inequalities as if their own lives depended on it. The stakes are not abstract — they are the very lives of the people they are sworn to serve.