Black & White: Death & Dying by Race & Ethnicity

Is health black and white?

Before you answer… Did you know that there are differences in death rates based on race? On average, at birth a white person may expect to live 5 years longer than a black person in the United States. This gap grows to a 10 year difference when comparing life expectancy of white women (81 years) to black men (71 years) [1, 2].

Why is this the case?

Well for starters, the leading causes of death differ down both race/ethnicity and gender lines. For instance, homicide makes the list as one of the top five killers of black men, but does not make the list for white men (nor either group of women). Diabetes makes the list as one of the top five killers of black women, but does not make the list for white women (nor either group of men) [3]. However, when comparing death rates between blacks and whites for the same disease, blacks still tend to have worse health outcomes. In fact, according to 2012 data, the U.S. Department of Health and Human Services Office of Minority Heath states “the death rate for African Americans was generally higher than Whites for heart diseases, stroke, cancer, asthma, influenza and pneumonia, diabetes, HIV/AIDS, and homicide” [4].

But really, why is this the case?

It comes down to what researchers refer to as ‘social determinants of health’. This term translates into how where you live, work, and play shapes your health. Moreover, these differences may in part be explained by health inequity, “difference or disparity in health outcomes that is systematic, avoidable, and unjust” [5]. For instance, it is common knowledge that many black people in America are living in poverty. This fact is tied to societal oppression dating back to slavery. Poverty manifests in predominately black neighborhoods, leading to limited access to resources such as healthy food, safe environments for physical activity, and quality health care services. As declared by Dr. Martin Luther King Jr., “of all the forms of inequality, injustice in health care is the most shocking and inhumane.” BUT, poverty does not explain it all. Even when a 2015 study compared breast cancer survival rates between low socioeconomic status white women with high socioeconomic status black women, black women still suffered from worse health outcomes [6]. Thus, factors beyond poverty, such as racial discrimination (e.g. subconscious differences in treatment by health care professionals) must be considered.

What can be done?

First and foremost, health education and health inequity awareness must become common knowledge. Children and adults, men and women, black and white must all understand what constitutes health, so that health is not only seen as the physical absence of a pathogen, but more holistic and inclusive of mental, emotional, environmental, and social health. Professionals and patients must work together to actively address gaps in sociocultural competence/humility through being open and honest with each other. Particularly, physicians have a responsibility to treat “humanity as [their] patients” [7]. Thus, systematic discrimination must be deconstructed for the assurance of ‘justice for all’. While health policy should be at the forefront of the conversation to combat these issues of social justice, communities must also consider their power in determining their destiny. Black communities, as they have done in the past, must begin to gather, organize, and mobilize to persevere.

Now, with all of this in mind… you tell me, how long should health continue to be black and white?

Rhoda Moise is a graduate of Pennsylvania State University with a B.S. in Biobehavioral Health and a passion for health promotion. She has been trained to approach health from an interdisciplinary perspective from proteins to people. Through her doctoral studies as a PhD student at The University of Miami, she intends to combat health disparities by conducting research which provides empirical evidence that demands alteration in standing policy.

References

1 http://www.cdc.gov/nchs/nvss/mortality_tables.htm

2 http://www.cdc.gov/nchs/data/dvs/LEWK3_2009.pdf

3 http://www.cdc.gov/nchs/nvss/mortality_tables.htm#lcod

4 http://minorityhealth.hhs.gov/omh/browse.aspx?lvl=3&lvlid=61

5 http://www.cdc.gov/nchhstp/socialdeterminants/definitions.html

6 Keegan, T. H., Kurian, A. W., Gali, K., Tao, L., Lichtensztajn, D. Y., Hershman, D. L., … & Gomez, S. L. (2015). Racial/ethnic and socioeconomic differences in short-term breast cancer survival among women in an integrated health system. American journal of public health, 105(5), 938-946.

7 http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/declaration-professional-responsibility.page

Black & White: Death & Dying by Race & Ethnicity

Health Isn’t One-Size-Fits-All

By: Delphine Gervais, LCSW

This May will mark five years since my mom was “officially” diagnosed with stage 4 breast cancer and two years since she transitioned.  There were plenty of days that I replayed the rush to the hospital, the exposure of her upper body to the doctors, the shock at what I saw. I remember the doctor questioning my mother, “When did you feel the first lump?”  I remember hearing my mother respond, “four years ago”. (hence my reference to the word “official”).  My mother was a resourceful Haitian woman, who never missed a doctor’s appointment and who never missed out on an opportunity to eat healthy.  Olive oil was a staple in our home.  Processed food was not.  She did everything she knew how to live a fit life.  In her mind, that lump negated every effort,  and it was then that her life completely changed.

For the purpose of conversation, I opt to turn my lense to black women and what their attitudes towards receiving services imply for their ultimate well being.  The stats are not favorable for communities of color.  Heart disease, cancer, hypertension, mental health–people of color lag behind in prevention and are dying at faster rates for lack of both prevention and intervention services.  In the case of breast cancer, although screenings among black women tend to be on level with those of their white counterparts, follow-ups for negative results were much lower.  Death rates among black women are 42% higher than their white counterparts.  It is one thing to schedule and conduct one’s mammogram every year.  Everyone can do that.  It’s another thing to follow up after receiving some not so favorable results.

I didn’t believe my mother loved me and my brother less because she didn’t seek the help she needed.  It couldn’t have been an easy pill to swallow to suffer in silence. Help seeking behaviors among African-American and Afro-Caribbean women have historically been a point of concern among those in the health profession.  The cultural construct surrounding help seeking behavior for physical or mental health concerns boils down to “it’s nobody’s business but mine.” If you couple that with the religious and spiritual impact on decision-making and you likely have a woman who will keep secrets from her loved ones and bear the entire emotional burden of disease.  To say that women of color reject the notion of prevention or intervention services is a fallacy.  It is best to first understand that normalizing health seeking behavior is the first order of business.

Imagine walking into a space where medical jargon is thrown at you left and right.  Machines are beeping.  People hurry about their work day, some stay long enough to inquire as to your well-being, while others just come long enough to poke and prod and leave with nary a word.  A person who speaks the king’s English would have a hard time navigating the health system.  A person who speaks limited or no English would drown in fear and embarrassment.  There is also the matter of inequitable access to services in the communities of color.  Are clinics within walking distance or near a bus stop? Do those who provide services understand the complexities of a person of color coming to their spaces in search for help?  Are they immediately placed at ease?  Are there people present in these spaces who can walk among the emotional minefields of their patient’s mind?

I remembered offering to take my mother to a cancer support group comprised of Haitian women.  The social worker in me thought it would be best for her to be among others who were grappling with similar issues.  She gave me a blank stare and a firm “No”.  I never brought it up again.  At times, we professionals believe we know what’s best for those who need help.   Imposing our norms and expectations lessens the opportunity for the person to establish personal ownership of their circumstances.  They’ve heard about the church member who became ill, went to the hospital and never came back home.  Walking into foreign spaces and experiencing a new normal is difficult for the average human being.  Being a woman of color compounds those feelings of helplessness.  When the strong black woman mystique had been challenged and the figurative “S” was off her chest, my mother didn’t want a support group.  Attendance at weekly church services was support enough.

There cannot be a one size fits all approach to healthcare.  My mother’s doctor knew well enough not to say the big “C” word in sessions.  She was delicate and respectful in her approach, she maintained deference in her tone and she left the hard discussions during one-on-ones with me.  At times she would practice her Creole on my mom.  This would make my mom smile.  The feeble attempts at seeking commonality met with ultimate respect.  For my mom that was enough to keep her committed to returning every month.  Even when the blood work started coming back with less than positive news, she kept her appointments without fail. Being seen by doctors and nurses who knew her name and smiled with their eyes made the trips that much bearable.  Half the battle is won when communities of color are provided with opportunities to maintain their personal dignity while seeking the help they so very much deserve and need.

This is not a mandate to learn a new language or join Doctors Without Borders.  It is however a call to action for professionals in the healing arts to take stock of how they approach their patients of color.  What works for Jane Doe may not work for Marie Pierre and Mary Johnson.  Cultural norms play a big part in how they each approach seeking help.  Knowing Jane’s cultural constructs and not Marie/Mary’s should cause one to pause and assess their effectiveness in providing service.  As the Haitian daughter of a Haitian woman I thought I knew all there was to making sure my mom received the services she needed.  My westernized approach to therapeutic intervention failed miserably.  I should have known that my mother cared less about support groups than ensuring she had a nurse aid to provide meals.  She cared less about the blood work coming back negative and more about when the bus would come to take her to her prayer service.  It didn’t take me long to stop hitting my head against the proverbial wall.  It was less of what I wanted and more about what she needed.  Once I made peace with that, it was smooth sailing.

Delphine is a licensed clinical social worker with experience in education, health, social welfare, community development, and individual/family/group intervention services. Her professional background emphasizes a special focus on community involvement and service; utilizing social networking for the purpose of bridging the gap between those with established needs and those with access to the resources to meet those needs. Read more on her blog.

Source:  American Cancer Society http://www.cancer.org/

 

Health Isn’t One-Size-Fits-All

Superwoman Syndrome and the Millennial Black Woman

To be considered a millennial you would have to be born between the early 1980’s until the early 2000’s. By definition you would be narcissistic, always have a need to be treated special, over confident, extremely pressured, sheltered and conventional. Most of the case studies for Generation X and Y were biased to only affluent white children and when people of color (i.e. Black, Latino or Asian) were asked how these traits pertained to them the response was unrelatable.

Now that we have tackled that terminology…

Year after year black women are faced with some new type of stereotypical hoopla, but the one that has stood the test of time is of course none other than the Superwoman Syndrome. These women are not only the forefront of the household but the rock of our entire community. We raise the children, run the office, console the family, balance the check books, entertain guest and stroke the male ego all in 24 hours. She is known to be fearless and unapproachable, masculine and submissive, all while maintaining a composed and happy demeanor.

So how does a black millennial manage a superwoman personality?

Unlike our white millennial counterparts, we face distinctive defining issues. Take myself, I am a mentally ill black millennial woman, so I rarely feel the need to be narcissistic. I don’t think highly of myself and I was not sheltered growing up. I like many black women was taught to suck it up and don’t cry about everything. Most of my teen days were spent cooking for myself, handling adult issues and worrying about the bills.

My mother always pushed me to be independent, but to think outside of the box at the very same time. She wasn’t a textbook conventional parent. She always reminded me that I would not only have to be 100 times better than the males around me, but I would also have to be 1000 time better than the women around. I was constantly pushed to the limit my education, often being intensely punished for mediocre performance. She taught me to speak my mind and demand respect. She was grooming me to do it all because in her mind there would never be anyone who would support me in doing anything.

By the time I was 18, I was running the show in every organization, I was dismissing men in the blink of an eye and I was overworking myself into a world of anxiety, depression and PTSD. I was so concerned with keeping it so­called together I was falling apart at the seams. I was trying to balance being fearless with the want of being treated specially. Eventually, I broke! And even months later I was back to working 2 jobs, supporting my mother, trying to love emotionally detached men and completely running myself crazy. Just to keep up not with the Joneses, but to follow in the footsteps of some fictional character. So why do we keep doing this to ourselves?

As a black millennial, we are more computer literate, independent, free spirited and on a constant search for love. Which describe the same attributes of the black superwoman. The main issue is the sense of control can not go hand and hand with being emotionally detached. If we’re not in control of every situation there is a sense of it just won’t get done. Whether it be financial, emotional or spiritual. We have to be the driving force of success.

In our society (not community) we are told to be important you have to be everything. You must always follow the invisible instruction manual while conjunctively putting your thoughts, feelings and need last. That the only thing that matters is having the money, the man and the mission to bring you happiness. Yet being a black woman means your journey that happiness can not be attained by help or support. The society is not set up for black women ( especially the black superwoman) to succeed. It has been so well coaxed in our everyday life that our entire community thinks black women are not “real women” if we don’t display these attributes. It is all one huge revolving door. If we are a community then we need to be a community. We need to uplift each other, share stories and help each other thrive not just survive. Being so called strong does not equate to happiness or stress­free. Indeed… it is the exact opposite.

There are many factors and, of course, environmental reasons for every individual case. However, the millennial black woman still wants the American dream. She still wants to be loved and appreciated. The question is after saving Clark Kent, the kids, the family and the corporation where is the time to be one with yourself? When do you say enough is enough and think about your feelings first? How do you separate taking care of and providing for? When is being human simply enough?

This is a guest post by Lindsay Anderson. Lindsay is a Mental Health Advocate, Blogger and YouTube Creator. Originally from Savannah, Ga she is currently residing in Greenville, SC. She is the founder of lindsaywittaa.com a journal website that discusses mental health, open transparency and mental wellness support. When she is not writing she is creating informational mental illness videos on Youtube. You can follow her on twitter @lindsaywittaa or email her at lindsaywittaa@gmail.com. 

Superwoman Syndrome and the Millennial Black Woman

LoveHER: The 3 R’s: Refocus, Reinforce & Reboot

 

Delicately purposed for the nation’s Black women; brown girls, black girls; light-skinned, brown-skinned, and dark-skinned:

Many of us have set goals for the year 2016. Whether it was to lose weight, eat healthy, budget finances, pursue a degree, seek guided counseling; whatever change you wanted to experience this year was on your mind. Some of us may be doing great with our goals and others may be experiencing roadblocks. As I have wondered and I’m sure others can relate, how can I refocus, reinforce, and reboot my goals?

Refocus your goals. This simply means adjusting your priorities. For example, one of my goals for 2016 was to manage my calendar more effectively. I am realizing that it is not so much of me writing down everything in my planner, it’s more about prioritizing. Refocusing your priorities better shape how you will attain your goals that you have set. A great way for me to prioritize and still meet my goal of managing my calendar more effectively is labeling my priorities for each day. You can label, color code, and or only write down what your priorities are. I believe acknowledging your priorities will allow room for things that happen in the spur of the moment.

Reinforce your enthusiasm. Just because you have not been on track to reach your goals thus far or if you are and you feel you are losing momentum, take some time to not only refocus but to strengthen your enthusiasm. You may feel all over the place as if you have no direction but the support and encouraging words of friends or family may help you realize that it’s only January, there are eleven more months in 2016!

Reboot your game plan. In order to reach your goals, you should have a timeline of objectives. Objectives allow you to measure your progress in attaining your goals. If you are in a similar situation that resembles mine, I am definitely off track with my timeline. It’s nothing wrong with being off track because things happen! The best way to keep your enthusiasm in reaching your goals is to reboot the plan. This may mean adjusting your timeline to reflect when you have refocused priorities, reinforced enthusiasm and are ready to reboot.

January is almost over and you still have eleven more months to blossom in 2016. Just remember to Refocus, Reinforce, and Reboot to reach your goals!

Signed,

EnviableZsanai

 

 

LoveHER: The 3 R’s: Refocus, Reinforce & Reboot

IS IT REALLY SUCCESS?

Is It Really Success?

Having traveled for many years to various parts of the world I have gained a much broader perspective as to what success, in life, really is. I am blessed with a number of extremely poor friends and partners, however, many of them have relationships to be envied because of the obvious value and depth of love and kindness contained therein. I am also blessed with extremely wealthy and famous friends who have no relationships of value per se. I have even had friends who have reached the pinnacle of their given fields, only to be removed from this life prematurely because of poor health conditions.

I FIRMLY BELIEVE THAT TRUE SUCCESS IS MORE HOLISTIC THAN FAME OR MATERIAL ACCOMPLISHMENT!

  • SPIRITUAL SUCCESS
    Where there is a design, there is always a designer. It is clear that the Creator designed each one of us differently, and on purpose. I believe that our differences are what give us the capacity to fulfill distinctive design. When our lives are spent accomplishing the intent of our designer, I would call that a success.
  • RELATIONAL SUCCESS
    To gain the world, then to have no one to share it with is futile. True success is not to be gained despite family and friends. In fact, I believe that it is family and friends that help us to maintain personal balance and keep us grounded as we rise.
  • PHYSICAL SUCCESS
    What good is money, if one is too sick or feeble to enjoy it. Solid healthy choices should accompany any ambition to accomplish good or gain in life.
  • MATERIAL SUCCESS
    It is impossible to help the poor, if you are one of them. While I do believe in material success, the greatest joy in life comes from giving to others, knowing that they can do nothing for us in return.

IN ALL OF YOUR SEEKING – PURSUE HOLISTIC SUCCESS

Dr. Mark T. Jones Sr.
Sincerely Seeking

IS IT REALLY SUCCESS?