WASHINGNTON (NNPA) – Racism and gender-bias is killing Black women – literally, according to scholars and health care advocates.
During an online discussion that capped a week-long series dedicated to raising the awareness about the many challenges Black women and girls face living in the United States, activists, scholars and stakeholders addressed the critical need to improve the health outcomes of Black women.
“The myriad forms of marginalization that we experience on a daily basis take a toll on our health,” said Kimberlé Crenshaw, the co-founder of the African American Policy Forum (AAPF), a think tank that advances racial justice, gender equality and human rights. “Racism and patriarchy are not just things we talk about, these are forces that are literally killing us.”
Crenshaw, who is also the director of the Center for Intersectionality and Social Policy Studies at the Columbia Law School in New York City, said that an array of social factors from the stress associated with systemic racism to living in environmentally toxic neighborhoods and the consequences of culturally incompetent health care contribute to elevated death rates for Black women when it comes to diseases like AIDS and some forms of cancer.
Although White women had a higher incidence rate of breast cancer in 2011, Black women were more likely to die from it. The rate of new HIV infections among Black women in 2010 was 20 times that of White women.
“Though anyone may experience stress, the stress that Black women experience is different. It’s constant, it’s cumulative, it’s often lifelong, and it’s often invisible,” said Janine Jackson, the program director of Fairness and Accuracy in Reporting (FAIR), a national media watchdog group.
Admitting that Black women “are not okay” is not a source of shame, said Jackson, “It’s a cause for intervention.”
Amani Nuru-Jeter, associate professor of epidemiology, community health and human development of the School of Public Health at the University of California-Berkeley, said that the notion that Black women are so resilient and that they can handle everything thrown their way is incredibly harmful, because that myth comes at great cost.
“And that cost is the slow deterioration of our bodies,” said Nuru-Jeter. “One of the unique aspects of Black women’s stress experiences has to do with the caretaker role they take on.”
In focus groups, Black women were more likely to report higher levels of social network distress, a form psychological distress, that was a result of the stress experiences of family and close friends, than their male counterparts.
That lifestyle requires constant psychological and biological adaption to stress and learned responses to chronic stress constantly erode the ability for Black women to cope mentally and for their bodies to function normally.
Nuru-Jeter said that even bracing for the stress associated with micro-aggressions or “everyday racism” is enough to activate the physiological “flight or fight” response in the body that can lead to chronic inflammation over time.
“This slow deterioration may not be captured in a typical clinical encounter, because doctors are not measuring our stress hormones or the level of inflammation in our bodies,” said Nuru-Jeter. “So often this sub-optimal functioning goes unnoticed until it becomes a chronic disease, such as the diseases we see Black women suffering from the most, like diabetes, cardiovascular disease and hypertension.”
According to the Centers for Disease Control and Prevention (CDC), nearly 60 percent of Black women over 20 years old are obese compared to roughly 34 percent of White women and nearly 45 percent of Black women suffer hypertension compared to 33.5 percent of White women.
A 2011 CDC report on health disparities said that 37.9 percent of Black women died of coronary heart disease before the age of 75 compared to 19.4 percent of White women. Black women were also more than twice as likely to die from strokes before the age of 75 (39 percent) than White women (17.3 percent).
Ladonna Redmond, the co-founder of Campaign for Food Justice Now, a membership-based group that uses race, class, and gender to address injustices in the food and agricultural industries, said that when you live in a community where many of the food options are loaded with sugar, fat or salt, those public health outcomes are likely to reflect the consumption of those products.
According to a 2012 report by the Agriculture Department, 14.6 percent of African American children lived with “disrupted eating patterns,” didn’t have an enough food or were forced to skip meals altogether. Almost half of all households led by a single mother lived in poverty, according to Bread for the World Institute, the research arm for the Christian group that battles hunger in the United States and abroad.
Redmond stressed the need for community ownership in developing cooperative models for grocery stores and urban farm sites and warned against creeping corporate control of food resources in communities of color.
“If we’re not careful when we’re trying to create just solutions, we will replicate the systems of injustice that have already harmed us and continue to harm us,” she said. “We have to be increasingly aware of how those systems come together.”
Not only do Black women have to develop solutions that address the systems of injustice, they are also forced to navigate a landscape where health care providers often deliver services under the influence of unconscious bias.
Nuru-Jeter cited a study by researchers at Georgetown University who interviewed more than 700 physicians and reported that in a mock setting, the doctors referred Black women to heart specialists for cardiac catheterization only 40 percent of the time when compared to referrals for White males with the same symptoms.
In a 2012 report published in the American Journal of Public Health, researchers said that even though racial bias may not be overt, it can still have negative effects. In that study, most of the patients surveyed were middle-aged women and 80 percent were Black. Nearly two-thirds of the physicians were women, almost half of them were White.
A press release about the report from “Medical News Today” stated that, “Primary care physicians who hold unconscious racial biases tend to dominate conversations with African-American patients during routine visits, paying less attention to patients’ social and emotional needs and making these patients feel less involved in decision making related to their health, Johns Hopkins researchers report. The patients also reported reduced trust in their doctors, less respectful treatment and a lower likelihood of recommending the biased doctor to a friend.”
The press release said that the findings reinforced the idea that there may be a link between racial biases and stereotypes playing out in the doctor-patient relationship and the racial disparities in the United States.
“Trust is the cornerstone of provider-patient relationships and equity in health,” said Lorece Edwards, director of community practice and outreach health and outreach and associate professor in Department of Behavioral Health Sciences at School of Community Health and Policy Morgan State University in Baltimore. “Moving forward, physicians’ attitudes and investments in patient relationships and communication play a major and central role for poorer health outcomes of African Americans.”
Quality of care within the health care system is a big issue and just having health insurance is not enough, said Nuru-Jeter, adding that, “[Black women] want access to the same quality of care across the board.”
Redmond said that Blacks suffer “post-traumatic slavery syndrome,” intergenerational trauma and the consequences of centuries of slavery and institutionalized racism, that continues to negatively impact the health and wellness of Black women today.
“So it’s not a ‘him and her’ conversation it is a ‘we and us’ conversation,” said Redmond. “And just because we’re talking about African American women right now, doesn’t mean we’re talking about [them] at the exclusion of any other group of people.”
Redmond continued: “It’s really about the compilation of all of those systems and generations and generations of harm that are manifesting themselves, right now. We have to understand that historical trauma is really something that we have to take ownership of and we also have to use that narrative as a backdrop to understand why life is not the way that it should be for African Americans.”