3 Health Conditions That Disproportionately Affect Black Women and How to Reduce Your Risk
Experts reveal the steps you can take to protect your health
While we know that anyone can develop heart disease or cancer, some people are at a higher risk based on their genetics. Things like race, gender, age and household income all play a role in who gets sick and how serious their illness may become based on access to health care. And experts share that Black women are particularly at risk for common chronic health conditions.
How race plays a role in health care
Even among groups that face disadvantages, health risks aren’t the same for everyone and race is often a key factor. In fact, a study published in Journal of Racial and Ethnic Health Disparities found that people of color generally, but specifically Black Americans, experience a higher risk and younger diagnosis of disability and chronic illness.
One cause of continued racial disparities in healthcare for the Black community in particular is a fractured relationship between the community and healthcare system due to historical instances of injustice, says Mary Branch, MD, MS, a board-certified cardiologist.
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Dr. Branch mentioned the 1932 Tuskegee Syphilis Study, where the U.S. Public Health Service explored how syphilis would impact Black men when left untreated. In the study, they did not inform the participants with syphilis that they had the condition and instead told them their treatment was due to “bad blood.”
Dr. Branch also mentioned “Mississippi appendectomies,” a practice where Black women in the South experienced hysterectomies that were not medically necessary so that medical residents could gain practice.
“Without the ability to strengthen relationships with the healthcare community due to feeling overall unwelcome and experimented on, this can lead to misdiagnosis or delay in diagnosis, which leads to poor results,” says Dr. Branch.
Health conditions that disproportionately affect Black women
This Black History Month, we wanted to shine a light on some of the most common health conditions that impact Black women. Experts explained what these conditions are, why they impact Black women in particular and what we can do to combat them.
Cardiovascular disease
Cardiovascular disease (CVD) describes different medical conditions of the heart and blood vessels. The four most common types of cardiovascular diseases are:
- Coronary heart disease, which reduces blood flow to the heart
- Strokes and mini-strokes, which still disturb blood flow to the brain but for a shorter time
- Peripheral arterial disease, meaning a lack of blood flow from the arteries to the legs and arms
- Aortic disease, like an aortic aneurysm, where a damaged aorta swells and is at greater risk of rupture
A study published in the American Heart Association journal Circulation found that, despite a general decline in cardiovascular deaths among Black and white adults in the U.S. from 1999 to 2019, Black adults continue to die from cardiovascular-related conditions at a higher rate than white adults.
According to the American Heart Association, almost 50,000 African American women lose their lives to cardiovascular disease annually, cites Dr. Branch. She also mentioned the stress of racism as a contributing factor to Black women’s cardiovascular disease risk, as well as genetics and neglect from the medical community and local government. One form of this neglect can be seen in the presence of “food deserts”, places where community members struggle to access healthy foods, says Dr. Branch. In fact, Feeding America says that Black communities are more likely to be in food desert areas.
Without access to healthy food, Black women may find themselves at risk for other issues that impact the heart. “Hypertension is a leading cause of heart failure. Among Black women ages 20 and older, nearly 58 percent have high blood pressure,” says Dr. Branch, who also highlighted high rates of obesity and diabetes as contributing factors to Black women’s high rates of cardiovascular disease.
They, “can increase the risk of sleep apnea which is associated with atrial fibrillation,” she adds. Diets consisting of fried and salty foods also play a role in these health conditions.
Dr. Branch pointed out that Black women may struggle to wear their hair naturally without receiving comments from others, and that a preference for non-Black hair can be seen even in medical workplaces where surgical caps are not designed to properly fit Black hair.
Because of the pressures for hair assimilation, some Black women might opt to not wear their natural hair and choose styles that are restrictive and impact their ability to be physically active or break a sweat so that they can maintain that hairstyle.
How to reduce your risk
Dr. Branch recommends taking the time to form a relationship with a primary care doctor by at least age 40 (though ideally earlier) and ensuring that your annual physical exam includes lab work that measures blood pressure, complete blood count, A1c, weight, lipid profile and complete metabolic panel.
Premature menopause
Black women also have a disproportionate experience with perimenopause and menopause symptoms, says Jayne Morgan, M.D, an advisor to Midi Health, the virtual care platform for women navigating midlife and menopause.
“Research shows that Black women tend to reach menopause 8.5 months earlier than white women. They’re about three times more likely to experience premature menopause compared with white women,” says Dr. Morgan. This is “partially because they are twice as likely as white women to have undergone hysterectomy or oophorectomy.”
Black women not only have a higher likelihood of experiencing menopause before it’s supposed to occur, they also have a tougher menopause experience and are at a higher risk of dealing with depression and inflammation, says Dr. Morgan. These differences in perimenopause and menopause tie back to access to healthcare generally and high-quality healthcare.
“Factors like unconscious bias on behalf of medical professionals and the impact of redlining on access to healthcare also affects Black women’s experience of menopause, from diagnosis to treatment,” says Dr. Morgan.
Dr. Morgan also cited a study published in The Journal of The Menopause Society as an example of unconscious bias in medicine. The study found that among a population of 200,000 women veterans, “Black women were 26 percent less likely to be prescribed hormone therapy than white women,” even though there was no difference among their symptoms.
How to reduce your risk
Dr. Morgan recommends women over 30 look for an ob-gyn or physician who is well-versed in the latest menopause treatment and research. Dr. Morgan says, “treatments like hormone replacement therapy—so long stigmatized—now provide relief for countless women experiencing symptoms like hot flashes, sleep issues, libido issues and more.”
Cancer
“Black women have a 1 in 9 chance of developing breast cancer, while for white women, the odds are 1 in 8, according to the American Cancer Society,” says Olutunmike Kuyoro, MD, a reproductive endocrinologist and fertility specialist at the Prelude Network’s Advanced Fertility Center of Chicago.
“However, Black women are more likely to die from the disease. White women have a 1 in 37 probability of dying from breast cancer, while Black women have a 1 in 31 chance,” says Dr. Kuyoro.
Dr. Kuyoro says the reason for the statistical difference comes from a multitude of factors, “but often stems from or relates to socioeconomic issues, which impede access to care and thus early diagnosis for women in such circumstances.”
How to reduce your risk
Dr. Kuyoro says living a healthy lifestyle is important for decreasing your risk of breast cancer, which may include limiting alcohol use, getting regular exercise, and avoiding tobacco products. “I would also recommend women have at least a general awareness of their breast anatomy and schedule regular screening mammograms from age 40 onward,” says Dr. Kuyoro.
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