African American Health Disparities: Disease Prevention, Advocation and Survivorship
While efforts have gone into decreasing the health disparities in the African American community, there is still ample work to be done. African Americans still experience decreased life expectancy, increased infant and maternal mortality, increased incidence of cardiovascular disease, and higher incidence of many other diseases. What I find most challenging is that the African American population experiences higher death rates even if diagnosed with the same disease and of equal likelihood to contract the disease for many diagnoses. An example is if an African American and a White counterpart both contracted Covid from the same place. The African American is at greater risk of death from the disease than the white individual. Of note, we use Covid only as a basic example to set up a point, however this article does not cover death rates amongst African American and White individuals during the pandemic.
So we see here we have 2 major disparities in health care. In many cases African Americans are more likely to contract these diseases, then once diagnosed they are more likely to die from them. We then have to ask, what are the reasons African Americans are contracting diseases more? And why are they not surviving like their white counterparts once they enter the health care system for treatment? This article will highlight changes that can be made to help prevent contracting disease in African American individuals and highlight strategies to advocate for yourself within the healthcare system to increase life expectancies and survivorship.
Especially when implemented as a child, daily diet and exercise have been shown to have major impacts on preventing diseases later in life. According to the American College of Sports medicine it is recommended that adults between the ages of 18-65 do a minimum of 30 mins of moderate aerobic exercise 5x a week and/or 20 mins of high intensity aerobic exercise 3x weekly along with 2x of strength exercise weekly. This coupled with a healthy and consistent diet can have major impacts on health whether you have been diagnosed with a disease or not. Most challenges in this department usually come from access and lifestyle. While almost everyone loves a good fried chicken, for years the African American culture has been socialized and told that this is “their food” and foods like leafy greens and kombucha were not. This historic socialization is one way the community has been challenged to live a healthy life. In addition, most predominantly African American neighborhoods are not in close proximity to healthy food stores. Couple this with the general pay gap in the African American population we see a few barriers that have already presented themselves. Supporting initiatives like “Mudtown Farms” in Watts, Los Angeles, a community farm that provides healthy food and teaches community farming, right in the middle of one of the world's largest projects is a great example of ways to be part of changing these obstacles for the African American community.
The next factor brings up alot of human rights issues we are still facing today. Why is it that an African American individual is at a higher likelihood to die when given the same circumstances as their non-black counterparts? Is it biased? Is it poor education on African American indications in the health care community? Is it a value of life issue? Or does it stem back to lack of funds for health care? This challenge can be approached with 2 different lenses. The first is through the lens of the patient.
We highly encourage all patients to advocate for a thorough and detailed medical exam when entering the healthcare system.
Ask for your notes from the visit, and keep careful documentation of what was said and the course of action being taken for your medical care.
Next is to do your own research. In my world of physical therapy and rehab I find more often than not that the patient knows what's going on with them before they even meet with me. In these circumstances my job is to further educate, help connect the dots, and guide them on specific treatments for what they have. Only you know your body and its history to an intimate level. Majority of the time what you think is happening is the right answer.
Then, seek multiple opinions. Remember that healthcare professionals are people too! They will have days where they are not on their A game and are just trying their best to get through the day. Unfortunately you may be 1 of 30 people they have seen that day and may get the short end of their bandwidth or attention. I will say as a health care provider who used to work in insurance based practices, health insurance can have a large impact on how a provider's time is split between patients. So especially with serious issues/diseases, make sure you explore your options.
The 2nd lens is from the healthcare provider. We have to be better as health care providers. Amongst the taxing and highly saturated work we do, we have to strive to treat everyone equally regardless of resources and background, and fight for the health and survivorship of each of our patients. The health care community will also benefit from incorporating more education on specific implications related to the African American body and how to better treat them. As a patient you have the opportunity to help with this! Be open and honest about the challenges of your issue so your provider can truly understand how your background has affected your journey with your health.
My hope is that in time there will be positive changes and our African American community will survive and thrive equally.
Dr. Melodie Daniels, PT, DPT, MS, CPT, RYT
References:
National Center for Biotechnology Information. (2017). Heart disease and cancer are the leading causes of death for adults in the U.S. National Institutes of Health. https://www.ncbi.nlm.nih.gov/books/NBK425844/#:~:text=Heart%20disease%20and%20cancer%20are,disease%20(CDC%2C%202014a).
Office of Minority Health. (n.d.). Black/African American health. U.S. Department of Health and Human Services. https://minorityhealth.hhs.gov/blackafrican-american-health#:~:text=Finally%2C%209.0%20percent%20of%20non,HIV/AIDS%2C%20and%20homicide
Artiga, S., & Hinton, E. (2022). How present-day health disparities for Black people are linked to past policies and events. Kaiser Family Foundation. https://www.kff.org/racial-equity-and-health-policy/issue-brief/how-present-day-health-disparities-for-black-people-are-linked-to-past-policies-and-events/#:~:text=Today%2C%20Black%20people%20face%20persistent,births%20between%202017%2D2019).
Artiga, S., & Hinton, E. (2022). How recognizing health disparities for Black people is important for change. Kaiser Family Foundation. https://www.kff.org/policy-watch/how-recognizing-health-disparities-for-black-people-is-important-for-change/#:~:text=Reflecting%20these%20inequities%2C%20Black%20people,pandemic%20levels%20(Figure%208).
U.S. Department of Health and Human Services. (n.d.). Black history month reading list. https://www.hhs.gov/black-history-month/reading-list/index.html#:~:text=Non%2DHispanic%20Black%20women%20are,birth%20than%20their%20white%20counterparts
Berde, A. S., Romero, L., Kamdar, M. J., Kennedy, M., Agrawal, R., & Parsons, S. K. (2023). The impact of childhood cancer on family dynamics and relationships: A qualitative analysis. Journal of Pediatric Psychology, 48(4), 375-387. https://doi.org/10.1093/jpepsy/jsad018
American College of Sports Medicine. (n.d.). Physical activity guidelines for Americans, 2nd edition.https://www.acsm.org/education-resources/trending-topics-resources/physical-activity-guidelines/lists/guidelines-resources/physical-activity-guidelines-for-americans-2nd-edition
