State of Black Women's Health: The Diagnosis Remains Dismal

Lee, Kendra

On a spring day in 1983, hundreds of Black women gathered in Atlanta on the campus of Spclman College for the first National Conference on Black Women's Health. Women, young and old, came from all across the country to voice their frustration at the lack of attention to I Black women's health.

Their story was in the statistics. On nearly every health index, Black women had the worst health status of any group of women in this country. Black women had more undetected diseases, higher rates of illness, more chronic disorders such as diabetes and high blood pressure, and shorter life expectancies than their White counterparts.

"I wanted to bring Black women together to share with them the poor statistics of our health," says Byllye Avery, organizer of the Atlanta conference. "I wanted us to develop our own perspective around health, provide analyses and figure out possible solutions."

The conference signaled the beginning of health empowerment for Black women and helped push minority and women's health issues to the forefront of the national agenda.

"Black women's health is in a state of evolution," says Dr. Nancy Norman, director of women's health at Fenway Community Health Center in Boston. "It's being recognized as a true and separate entity."

MORE OF THE SAME?

Unfortunately, more than two decades after the conference, Black women are still at the bottom of the health rung, says Lorraine Cole, president and CEO of the Washington, D.C.-based Black Women's Health Imperative (BWHI), an advocacy group established to promote improvement in African American women's health.

"When you ask Black women, generally we believe the state of our health has improved over the past 20 years," says Cole. "Nothing's changed; 2004 doesn't look that much different than 1994 or 1984 in terms of the overall health of Black women."

Heart disease is still the number one killer of Black women, with 28 percent dying from the illness. In 1980, death from heart disease was 50 percent higher among Black women than White women. Today, the disparity has increased to 67 percent.

Though Black women are diagnosed with breast cancer less often than women of other races, they are diagnosed at younger ages and with more aggressive forms of the disease. In fact, Black I women are 28 percent more likely to die of breast cancer than White women.

Obesity is also a major problem among Black women. According to the Centers for Disease Control and Prvention's 1999-2000 National Health and Nutrition Examination Survey, more than 50 percent of Black women are considered overweight. Obesity can lead to a number of health problems, including increased risk of stroke, heart disease, hypertension, some cancers, and diabetes, which affects one in four Black women over age 55.

"The battle is won and lost in the kitchen," says Avery. "We really need to work on eating a different kind of way."

Other diseases, such as lupus and HIV/AIDS, also affect Black women disproportionately. And while life expectancy has nearly doubled for all women over the last century, Black women still live roughly five fewer years than White women.

WHAT'S GOING ON?

Despite the dismal statistics, there has been progress, says Avery, founder of the Avery Institute for Social Change. The organization works with grass-roots activists, scholars and policy makers to examine health and social issues that affect women of color.

"Our numbers haven't changed dramatically. It's going to take a while before we can turn the numbers around," admits Avery. "But there are other signs. There is a greater awareness. There are many organizations - sororities and civic organizations - that have made health a part of their organizational agenda."

Poverty particularly can have a negative affect on health, leading to inadequate housing, lack of access to health care and medical bias.

Living conditions, such as substandard housing, have a major impact on health. For years in fact, studies have linked race, disease and hazardous environments. A 1983 study by the U.S. General Accounting Office found that out of four hazardous waste landfills in the Southeast, three were located in predominantly Black or poor neighborhoods. Another report by the Environmental Protection Agency released in 1992, found that Blacks were more likely to be exposed to hazards in their work and living environments than other groups.

Another concern is the limited access to medical care because of the lack of health insurance.

"The access to care is a major issue and that's for Black women across the socioeconomic spectrum," says Norman, who's also interim director at the Boston Public Health Commission,

According to the Census Bureau, more than 20 percent of African Americans are uninsured, compared with 15 percent of the overall population. As a result, a number of Black women frequently have to choose between medical necessities, such as prescriptions and annual doctor exams, and basics, such as food, thereby neglecting their health and well-being.

"Many African American women either woi'k in industries where they're part-time or industries that don't offer health insurance," says Maya Rockeymoore, vice president of Research and Programs at the Congressional Black Caucus Foundation. "Across the board, we're looking at a situation where African American women and households are in a tenuous position in regards to accessing health insurance."

Experts have also found that medical bias has been a cause of health care disparities. Research by the Agency for Healthcare Research and Quality found that Black women were less likely to have access to life-saving therapies for heart attacks than other women and less likely to be referred to methods that diagnose coronary artery disease.

"Those of us who have been dealing with health issues have known these things for a long time: that is that the quality of care of minority groups is unequal to that of the general population," says Cole. "There is bias. Built-in institutional bias."

WHAT WE DO?

Although it may seem that Black women are falling through the cracks in terms of better health, most agree there has been some progress.

"There's a general awareness of what the right thing is to do," says Cole. "We see a reduction in smoking. We know about changing our diet. We know the value of increasing our physical activity. It's just putting that knowledge into practice."

Norman says initiatives to get more people of color in the medical profession would also help to "empower Black women to be their own advocates and get the care they deserve."

Rockeymoore suggests contacting elected representatives.

"We have to engage in policy dialogue," says Rockeymoore. "We need to write our members of Congress. We have to bring this up at the community, state and federal levels. We need to do whatever it takes."

Avery, however, believes that Black women have to start with family first, by learning family history and breaking the bad habits that have been passed down from generation to generation.

"You need to know your medical history," says Avery. "Learn what you may genetically be predisposed to."

Avery's Institute for Social Change is working to reduce health disparities by educating minority communities on how to get better health information. The organization teaches women how to ask their medical practitioner about medical options and how to do their own research on the Internet.

She believes health care is a human right and calls for health care reform.

"There's no way a society can prevail without its women being healthy," says Avery. "Our health has to improve."

Kendra Lee, a Stafford, Va.,-based freelancer, writes frequently about women's health issues.

Copyright Crisis Publishing Company, Incorporated Mar/Apr 2004
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