The State of Black Women’s Health

By Jeffries, Tamara

A groundbreaking ten-year study of 59,000 African-American women yields good news and important lessons for us BY TAMARA JEFFRIES

For the past ten years, researchers from Howard and Boston universities have been getting in all our business. They’ve probed into our diet and exercise habits, sexual activity and reproductive history, use of medications, interaction with health-care providers and other medical routines-all in an effort to learn why Black women have a higher mortality rate than the majority population.

This research effort, known as the Black Women’s Health Study (BWHS), has tracked some 59,000 Black women nationwide (a significant number of them ESSENCE readers), making it the largest longitudinal study conducted of African-American women’s health. According to Dr. Lucile Adams-Campbell, director of the Howard University Cancer Center in Washington, D.C., a study of this magnitude has never been done before. “No one expected us to be able to recruit thousands of Black women,” she says. “It was amazing to get the numbers of women we have reached. It shows that African- American women are interested in the future of their health.”

While the research is far from complete, the information the BWHS has already gleaned reveals significant facts.

Exercise and Fitness

FACT: Sisters who exercise regularly have less depression and obesity and may decrease their chances of developing certain cancers. “In our study, those who exercised showed a reduced risk of breast and colon cancer,” says Adams-Campbell. “The circulating estrogen levels that are produced in an overweight woman can increase the likelihood of her developing cancer. In fact, exercise improves people’s health outcomes overall.”

What it means for you: Getting at least a half hour of physical activity three days a week can possibly ward off some cancers-not to mention help you control your weight and reduce your risk of other diseases. From taking high-energy kickboxing and aerobics classes to using yoga videos at home and enjoying long walks around the block, staying active can save your life. That same 30 minutes of exercise will also give you a mood boost. Working out releases happy hormones (endorphins), gives you a reason to be social or introspective, and makes you feel good about yourself, says Rosenberg.

How We’re Living

FACT: Where you live can affect your health. The study shows that upwardly mobile sisters are less likely than low-income women to suffer from hypertension. But it’s not the amount of money you make, your lifestyle or even your personal health habits; it’s where you live. Sisters who live in socioeconomically disadvantaged neighborhoods have a higher incidence of hypertension compared with those residing in more affluent areas. “We have to look at Black women’s health from a different perspective,” says Adams-Campbell. “It entails a litany of things, and family history, environment and psychological factors are important, including access to fresh fruits and vegetables. You have to look at the whole experience.”

What it means for you: We all know how enticing junk food is when money is tight, but investing in quality food will give a serious boost to your overall well-being. In addition, finding an outlet to counteract stress or making a move to the safest neighborhood you can afford can mean a healthier, longer life.

Hormone-Replacement Therapy

FACT: Hormone-replacement therapy to combat menopause increases your risk of several major diseases. The BWHS participants who have used hormone-replacement therapy for at least five years may have an increased risk of breast cancer. The therapy has also been associated with increased risk of stroke and Alzheimer’s disease. Initially doctors had hoped HRT meds would prevent heart disease, but recent studies have shown it to be ineffective. “The symptoms of menopause, such as hot flashes, can be severe, but the trade-off for the risks of hormone-replacement therapy may not be worth it,” Adams- Campbell advises.

What it means for you: If HRT not only doesn’t appear to prevent heart disease but also increases your risk of other diseases, you should carefully weigh the pros and cons before beginning this course of action. Research more natural remedies for your menopausal symptoms. If you use HRT supplements, have your doctor prescribe the lowest effective dose and plan to make it a temporary fix.

Weight Loss

FACT: Your weight could be a matter of life and death. “The epidemic of obesity in America is growing-particularly among Black women,” says Dr. Lynn Rosenberg, principal BWHS investigator. If you’re obese (a body-mass index of 30 or higher), your chance of developing heart disease and type 2 diabetes increases significantly. We already are twice as likely as White women to have adult-on-set diabetes; in the BWHS test group, the most overweight women had more than 20 times the risk of developing diabetes than their leaner sisters.

In addition, smaller women were found less likely to develop uterine fibroids. More than 22,000 of the 59,000 BWHS participants reported that they had been diagnosed with the tumors. Research indicates that the more overweight you are, the more likely you are to have them.

What it means for you: If you’re at risk for diabetes-because you are overweight-keeping your weight under control may lower your chances of developing it. If you already have diabetes, weight control can help you keep the disease in check. Watch your diet and consult your health-care provider about the best way to keep your body in a strong, healthy condition.

Sure, fibroids are benign. But they can cause heavy bleeding, monster cramps, painful intercourse and fertility problems, and they’re a leading cause of hysterectomy. No one needs that- especially if you can avoid it by managing your weight.

Mammograms

FACT: More of us are having mammograms than ever before. Among other health disparities that it examined, the study aimed to uncover why African-American women died more frequently of breast cancer than their White counterparts. Twenty years ago, there was a glaring risk factor-namely, that many of us overlooked mammography screenings. “This used to be viewed as a middle-class White woman’s disease,” says Adams-Campbell. “We weren’t educated about how breast cancer affected us or what we could do about it. Now we’re finally getting the message, but we still need to work on increasing our rates of treatment.”

What it means for you: Early screening results in earlier detection. And early detection may mean that you can treat the cancer before it advances and thereby increase your chances of survival. Sisters should get a mammogram annually beginning at age 40, according to the Susan G. Komen Breast Cancer Foundation. And be sure not to forget to do your breast self-exam each month, two weeks after your period ends, or at the same time every month if you are postmenopausal. Currently the team is studying the many issues- including high-fat diets and other lifestyle factors such as smoking and access to and use of health care-that contribute to the disproportionate rates of obesity, diabetes, hypertension and heart disease among the Black-female population. The group intends to continue the research for at least another five years in the hopes of learning more about our unique health issues, such as the genetic causes of lupus, the mystery of sarcoidosis (an inflammatory disease that disproportionately affects the African-American community), and the secrets of breastcancer survivors. The researchers are also investigating what it takes to prevent diabetes and how stress affects our overall health, among other matters.

“You can change your reaction to stress and gain more control over your life.”

“Watch your diet and consult your doctor about how to keep strong and healthy.”

Tamara Jeffries, a former executive editor at ESSENCE, writes frequently about health issues affecting African-Americans. Additional reporting by Zulaika Jumaralli.

Copyright Essence Communications, Inc. Mar 2006