By Molly M. Ginty
Friday, February 25, 2005
African American women are twice as likely as white women to develop diabetes, heart disease and other major health problems. As the government addresses these disparities, African American health advocates are forging initiatives of their own.
(WOMENSENEWS)--This February, as America celebrates Black History Month, health advocates are wrestling with a problem too often overlooked: the fact that African American women--more than any other group--are dying needlessly of preventable diseases such as HIV/AIDS, heart disease and diabetes.
This month, the Los Angeles-based Black AIDS Institute found that black women account for 72 percent of new HIV/AIDS cases among women, even though they represent just 13 percent of the female population. The Atlanta-based American Cancer Society reported that African Americans have the highest mortality rate for cancer of any racial or ethnic group.
These statistics, while stunning, come as no surprise to experts in black women's medical care.
"The health of African American women is in a state of crisis," says Lorraine Cole, president of the Washington, D.C.-based Black Women's Health Imperative. "But as Dick Cheney proved during the vice presidential debates, when he admitted he 'had not heard the numbers' on black women and AIDS, the crisis hasn't really hit the radar screen."
With a barrage of new initiatives on the government and grassroots levels, health advocates are working to "close the gap" and address the racism, sexism, medical problems and socioeconomic factors that are to blame for these health disparities.
Black women are 25 times more likely than white women to be infected with HIV/AIDS, according to the Atlanta-based Centers for Disease Control and Prevention, the Bethesda-based National Institutes of Health and other government agencies. They are twice as likely to be overweight, have heart attacks, develop diabetes (high blood sugar), lupus (an autoimmune disease) and hepatitis C (a liver disease). They also have a significantly higher risk of asthma, arthritis, cancer and the sexually transmitted disease chlamydia.
Experts say these disparities start when black women don't get adequate health screenings. Only 75 percent of African American women seek prenatal care, compared to 89 percent of white women. Only 7 percent of black women with depression get treatment, compared to 20 percent of other patients with depression.
Even when they do get medical care, African American women still often get short shrift. A 1994 study published in the Journal of the American Medical Association found that Medicare patients who are African American, poor and seriously ill receive worse care than other gravely ill Medicare patients in every type of hospital in America.
In a 1999 New England Journal of Medicine study, actors pretending to have heart problems described their symptoms to 720 physicians. Black female actors received the fewest referrals for specialized treatment--even though they related symptoms identical to those of white men, white women and black men.
The Black AIDS Institute reports that African American HIV and AIDS patients are half as likely as other patients to received aggressive "combination therapy" drugs.
"Research shows that if you control for all the variables that may contribute to health disparities, including education, income and access to health insurance, minorities and women still get the worst quality of care," says Cole. "Doctors often don't give black women equal treatment because they assume they won't follow instructions or won't be able to afford further care."
Complicating the problem, Cole adds, is the fact that black women are underrepresented among physicians and medical research subjects.
"Some clinical trials are set up to automatically exclude women of color," says Karen E. Jackson, president of the Sisters Network Inc., a Houston-based breast cancer group. "In breast cancer studies, for instance, most research is done on the estrogen-positive form of the disease and not on the estrogen-negative form common among African American women."
In addition to problems with the medical system, socioeconomic factors also add to poor health.
The poverty and unemployment rates for black women are double that of white women, according to 2000 data from the Washington, D.C.-based U.S. Census Bureau. Twenty percent of black women ages 18 to 64 are uninsured, compared to 16 percent of white women in the same age bracket, according to the Menlo Park, Calif.-based Kaiser Family Foundation.
The U.S. Census reports that nearly half of black families are headed by women raising children alone with no support from a partner. Cole says this--combined with the challenge of dealing with racism--can boost stress levels that increase black women's risk of high blood pressure and other health problems.
African American activists say diet and exercise, major factors in overall health, also contribute to health disparities. Black women are twice as likely as white women to get less than the 30 minutes of moderate exercise recommended daily.
"Our ethnic cuisine is high in fat, sodium, sugar and cholesterol," adds Cole. "And the fast-food restaurants in low-income areas where many black women live offer food that is affordable but super-sized."
Too often, the health disparities affecting African American women lead to tragic and untimely death. A black woman is less likely to get breast cancer than a white woman, but more likely to die from it. She has a threefold risk of dying during pregnancy and a significantly greater chance of dying from heart disease, diabetes and cervical cancer.
The average white woman in the U.S. will live to age 77, but the average black woman will be not live to see her 70th birthday, according to the Centers for Disease Control.
To help black women live longer, healthier lives, the National Institutes of Health is researching the health gap at its National Center on Minority Health and Health Disparities. The federal Department of Health and Human Services is also taking notice. Programs through its Office on Women's Health, its Office of Minority Health, and its "Initiative to Eliminate Racial and Ethnic Disparities in Health," which seek to "close the gap" in infant mortality, cancer, cardiovascular disease, diabetes, HIV and immunization by 2010.
"The government has increased funding for all these initiatives in recent years," says Frances Ashe-Goins, deputy director of the department's Office on Women's Health.
The Black Women's Health Imperative reports that in the last decade, 70 percent of government health initiatives affecting women of color have shown progress. But black women's health advocates say this still not enough.
"The government meets the needs of people who show up for services," says Toni Bond, executive director of African American Women Evolving, a Chicago-based reproductive health initiative. "But when you look at the rate at which curable diseases are sweeping through our community, you realize we need to raise the stakes much higher."
To address the health risks that threaten them, black women have launched organizations including Bond's Chicago organization, the Black Women's Health Imperative, the Sisters Network, and SisterLove, an Atlanta-based sexual health organization.
To supplement this work, other African American organizations are urging black women to eat healthier, exercise regularly and get health screenings. Spearheading these efforts are black churches; professional groups such as The Links, Incorporated; Alpha Kappa Alpha Sorority, Zeta Phi Beta Sorority, and Delta Sigma Theta Sorority and community organizations such as the International Black Women's Congress and the National Council of Negro Women.
"Society has failed the African American woman by devaluing the importance of her health," says Jackson of the Sisters Network. "But our community is fighting back by working to close the health gap."
Molly M. Ginty is a freelance writer based in New York City.
Black Women's Health Imperative:
National Institutes of Health--
National Center on Minority Health and Health Disparities:
Department of Health and Human Services--
"Initiative to Eliminate Racial and Ethnic Disparities in Health":
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