By S. E. Williams, Staff Writer
“The inherent dignity of human persons requires that people be treated with dignity and respect, which includes the fulfillment of the basic human need for health care… Health is a fundamental good necessary for human flourishing . . .” – Margaret R. McLean , PhD, Associate Director of Bioethics, Santa Clara University
The benefit of good health is a most valuable asset in the game of life. It determines the quality of our day to day existence; and, in the final analysis barring a catastrophic accident—is the final arbiter of the breadth of our mortal existence.
Dr. Martin Luther King Jr. is attributed with saying, “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”
African American women make up 13 percent of the female population in America. The lack of health insurance coverage coupled with a myriad of other socioeconomic factors has contributed to the grim health issues faced by these individuals.
For African American women, inequality in America’s healthcare system as leveraged across generations created a health crisis for them and their daughters that only recently began a long and arduous turn toward resolution.
Admittedly, improvements worthy of recognition and celebration in this area have already helped minimize some problems. With continued focus and attention these improvements may over time neutralize and possibly, eliminate the racial and ethnic disparities in health care so long endured by these women.
For example, with the implementation of the Affordable Care Act (ACA) approximately three million African American women secured affordable health insurance coverage. In addition, another five million with private health insurance received expanded coverage that included preventive services.Unfortunately, despite the health care enrollment progress of the ACA, one in four of them remain uninsured.
There has been other progress as well. In recent years the life expectancy of African American women expanded. It has actually increased by ten years since 1960, from an average longevity of 68 years to 78 years. In addition, between 2008 and 2010 new HIV infections among black women actually fell by a remarkable 21 percent. Also, teen-age pregnancy rates have dropped precipitously—down over 20 percent in just over two years.
In spite of this progress, however, a National Center for Disease Control, Department of Health Disparities and Inequalities Report recently highlighted a number of significant health disparities that continue to exist between African Americans and other racial and ethnic populations.The report proved that despite some gains, African American women are still a long ways from attaining parity with their white counterparts as it relates to health. According to the report, “. . . statistics are striking and apparent in death rates, infant mortality, and other measures of health status and risk conditions and behaviors.”
These realities weigh disproportionately heavy on the nearly 28 percent of African American women who, according to a 2011 report on Women in Poverty, were most likely to be single heads of households as compared to only 9.4 percent for white women. Also, over 30 percent of families in households headed by African American women live in poverty.
As detailed in the report, women classified in this group not only included single mothers but also single women with a parent or other close relative living in their home. Based on these statistics, with so many people dependent on them, it is easy to see how health problems experienced by African American women have such a broad impact on entire communities.
The triumphs in African American women’s health mentioned above are encouraging; however, for the most part these women remain at risk from cradle to grave. A report by the Center for American Progress presented stark and troubling data which showed not only are African American infants 2.4 times more likely as white infants to die before their first birthday, it also highlighted how here in America, black women still risk death in their quest to give life as they are four times more likely to die from pregnancy-related causes, such as an embolism and pregnancy-related hypertension than any other racial group.
Childbirth is not the only area where African American women face perilous outcomes. According to the CDC, heart disease is the leading cause of death for African American females of all ages. The heart disease related death rate for African American women in 2011 stood at 23.4 percent. In spite of their risk in this area a breath-taking study published in the New England Journal of Medicine stated African Americans are less likely to be referred to specialists for their heart conditions. According to the report, “African-Americans with heart failure are more likely to be taken care of in a primary care practice even though the data would suggest that the best care — the care that decreases hospitalizations and improves mortality rates — happens in cardiologists’ offices.”
Also, hypertension is more prevalent among African American (AA) women than any other group of women—46 percent of AA women 20 years of age and older suffer from hypertension compared to only 31 percent of white women and 29 percent of Hispanic women.
In regards to one of the most frightening diagnosis any woman can receive, that of breast cancer, it has long been understood that white women are more likely to receive the diagnosis than black women; however, black women can be diagnosed with more deadly forms of the illness and have higher overall mortality rates from the disease.
Sadly, according to experts, an average of five African American women succumbs to breast cancer every day in this country. Contrary to popular belief, the difference in mortality rates is not the result of black women receiving mammograms less frequently. Data proves they receive the scans on par with their white counterparts. A recent study, however, proved the breakdown actually occurs after the breast cancer diagnosis. According to the analysis, it is common for black women to experience lengthy delays in receiving follow-up care and treatment.
AA women are also worse off than their counterparts of other races in the area of sexually transmitted and female specific diseases. Both Chlamydia and Gonorrhea infection rates are nineteen times higher for African American women than those of white women. AA women also have higher rates of the human papilloma-virus (HPV); and, they experience cervical cancer with mortality rates that are double those of other women. In addition, according to a 2014 Kaiser Family Foundation report, the rate of new HIV infections per 100,000 showed black women, at 38.1, had the 3rd highest rate of new infections overall and the highest rate among women in general.
Another disturbing fact is that AA women have the highest rates of being overweight or obese in the nation. Four out of every five black women fall into these categories; and, at least 16 percent of those identified with these conditions actually struggle with extreme obesity.
In the final analysis, although the state of black women’s health has attained modest triumphs in some areas, it has remained tragically disappointing in many others. In spite of the opportunities now available as a result of the Affordable Care Act, African American women still struggle to overcome a legacy of healthcare injustice.
Several factors continue to impact the health status of these women. Included among them are many of the same issues that have worked against African American women in perpetuity in America—the old co-conspirators of discrimination, unemployment, underemployment, poverty, poor diet. In some cases it can be an issue of literacy and/or lack of trust in the health care system; while in others it may be a lack of access to health care—particularly in rural areas or in metro areas where public transportation is costly, limited or inadequate.
The efforts required to mitigate these concerns are as numerous as the issues are varied and complex. One of the greatest ways to create change on the issue of black women’s health is to leverage political power—black women have it and they should maximize its use as a force for change. Results indicate African American female voters outperformed all other demographic groups during the most recent election cycles. African American women must demand more from their elected representatives; and they can begin by firstly, electing candidates who make African American health care a priority; and secondly, by holding those they elect accountable on this important issue.
Other mitigating factors include education; good lifestyle choices such as a healthy diet and exercise; smoking cessation; safe sex; stress reduction; wellness checks; prenatal care; and as the saying goes—let each one teach one about the value of preventative care.
As Ida B. Wells, the African American civil rights leader, journalist and newspaper editor stated, “The way to right wrongs is to turn the light of truth upon them.”
Want to know more? Parkview Community Hospital Medical Center and The African American Advisory Board will be hosting the 2015 Health Series on Thursday, June 11 from 6:00 p.m. to 7:30 p.m. at Parkview Community Hospital Founders’ Center, 3865 Jackson Street, Riverside featuring Board Certified Obstetrics/Gynecology, Dr. Leita Harris as the speaker. RSVP by calling 951.688.2211 ext. 3337 or email firstname.lastname@example.org.