Glaring disparities in health conditions and outcomes for women of color have been widely documented. This population is disproportionately affected by chronic diseases and conditions, including:
Black women are more likely to develop heart disease – the #1 killer in the United States. According to an article entitled, “The Heart Truth for Women” from the Department for Health and Human Services states, “For African American women, the risk of heart disease is especially great. Heart disease is more prevalent among black women than white women—as are some of the factors that increase the risk of developing it, including high blood pressure, overweight and obesity, and diabetes.”
African-Americans with type 2 diabetes have been shown to present with more severe features, including increased obesity, dyslipidemia, hyperglycemia, and vascular disease. Scientists have published research articulating, “they also are more likely to experience fatal and non-fatal cardiovascular events related to diabetes” Specific to women, gestational diabetes mellitus (GDM) is the most common complication of pregnancy and is associated with an increased risk for type 2 diabetes. Racial/ethnic minority populations (like black women) are at a higher risk than non-Hispanic white populations of developing type 2 diabetes after GDM.
Studies from the American College of Obstetrics and Gynecology show that “fibroids occur more often in African American women than in white women. They also seem to occur at a younger age and grow more quickly in African American women.” And in the words of a study entitled, “Racial Influence on the Polycystic Ovary Syndrome Phenotype,” “race has been shown to influence the PCOS phenotype”
Black women are three to four times more likely to die from pregnancy-related causes than white women. The CDC points out that while most pregnancy-related deaths are preventable, racial and ethnic disparities in pregnancy-related deaths have persisted over time.
A unique sociological factor is the uneasy relationship that many black women have with health providers. A 2018 study notes how “the legacy of medical experimentation and inadequate healthcare coupled with social determinants has exacerbated African American women’s complex relationship with healthcare systems.”3
So how does this play into Covid-19?
The impacts of COVID-19 are exacerbated by underlying health conditions, immune system inhibitors, and other hindrances of health and wellness. These elements are already uniquely prevalent for women of color, providing fertile ground for the devastation of COVID-19 to take root. Let’s briefly examine areas where this pandemic and adjusted lifestyles impose greater risks for women of color.
- Covid-19 infection and death have taken an especially heavy toll on communities of color. Mental health is impacted by the stress of one’s own infection or that of a loved one. Science shows that when mental health is affected other parts of health are also affected. This often leads to women making poor nutrition choices which further exacerbate underlying medical conditions or weaken the immune system. For example, sweet/sugary desserts or snacks or fried comfort foods are often go-to’s during times of stress and boredom. However, research shows that refined processed foods and sugar weaken the immune system, triggering inflammatory pathways in the body.
- Weight gain can result from excess snacking due to stress, anxiety, and depression. Exercise routines may have been disrupted, making matters worse. The impact of weight gain may be more pronounced for black girls and women. Being overweight increases the risk factors for issues that black women are already more susceptible to, including infertility, hormonal issues, gestational diabetes, difficult delivery, and difficult post-partum recovery.
- Increased blood pressure raises the risk of diabetes, heart disease, preeclampsia etc. What causes increased blood pressure? A combination of many lifestyle factors, including lack of sleep, untreated stressed, sedentary lifestyle, dietary insults such as heavy consumption of processed, convenient or takeout/dine out food in combination with lack of fruits and vegetables – all prevalent during the pandemic.
- Staying home can mean isolation and feelings of loneliness and boredom, driving increased alcohol consumption. This increases blood pressure and risk of heart disease, while also negatively impacting reproductive health.
A Danish cohort study found that, “compared with women who drank no alcohol, women who reported consuming 1–5 drinks per week, in addition to those who consumed more than 10 drinks per week, had a decreased chance of achieving a clinical pregnancy.” Furthermore, studies in humans and animal models have found alterations in ovulation and menstrual cycle regularity with chronic/prolonged alcohol intake” In addition, “Heavy alcohol use may diminish ovarian reserve and fecundability in women.” (Alcohol and Fertility: How much is too much).
Chronic Home Stress
Stress is known to be a significant factor in health, wellness, and quality of life. In addition to common stressors that have uniquely plagued black girls and women, there is also the new reality of crafting an adjusted home life, particularly with children.
Chronic stress leads to illnesses. More specifically, studies have shown that “chronic stress has a significant effect on the immune system that ultimately manifest an illness” It suppresses the immune system, raising the risk of viral infection. It also increases risk for diabetes, ulcers, and clogged arteries.
- Home-schooling or managing children who are normally outside of the home is difficult. Some women say they feel they must choose between careers and their children, even more so now than before. Managing a child’s day, preparing meals, and tending to the house while still making time for a career, oneself and a spouse is tricky. Some things just won’t get done, which in itself can be an additional stressor.
- Having to utilize child-care options outside of the home also adds stress. The potential exposure of a child to Covid-19, the possibility of sickness to follow, family spread, and quarantine can weigh heavily on the psyche.
Preventive care has been shown to greatly reduce health risks for women and is already often overlooked or not readily available for black women and girls.
- As Covid-19 surged in some areas, some health centers could not safely accommodate needs of every patient. Some women lacked the ability or willingness to get routine 1:1 visits. Dental cleaning, ObGyn annuals and routine blood work are neglected by some women because of the risk of exposure to Covid-19. We know that routine health & wellness visits are vital for preventing the diseases for which black women are already at risk (fibroids, PCOS, diabetes, gestational diabetes, heart disease).
- During Covid-19 many hospitals are decreasing length of stay after delivery of a baby, impacting continued care, such as breastfeeding support. Lactation consultation is usually given soon after birth to support mothers’ breastfeeding needs but with Covid-19, follow ups are done virtually. Black babies die at two times the rate of white babies. Breast feeding decreases this mortality rate by 50%. The Academy of Pediatrics supports one-on-one breast feeding even if mothers have Covid-19. Shorter hospital stays make this harder.
What Can You Do Right Now?
- Keep a variety of antioxidant rich foods in the house, aka, fruits and vegetables, whole grains, legumes, nuts and seeds. Remember to refrigerate and freeze appropriate foods to stretch its shelf life naturally. Make more meals at home. Sign up for cooking classes or work with a registered dietitian nutritionist to help you create healthy desserts or comfort foods that won’t sacrifice taste or tons of time. For information on this topic including plant-based menus, meal prepping, cooking, storing, freezing to optimize your health based on your lifecycle needs contact 360GirlsandWomen.com
- Keep active indoors by taking breaks to stretch, going up and down stairs, running around the house or playing musical chairs with your kids. Join an online platform to engage in workouts. For personalization, contact a certified trainer women’s specialist to create an exercise plan with a bonus accountability partner or coach. This is something offered by many companies including 360GirlsandWomen.com
- Practice self-care. Go to bed earlier. Spend time in silence and prayer. Spend time in nature -fresh air and sunlight are therapy. Start a garden (indoor or outdoor). You may find it’s a great way to relax and take a break from the day, and it also provides fresh food.
- Eliminate alcohol and other unhealthy behaviors/lifestyles. If you need help join a support group like Alcoholic Anonymous -aaa.org. Get counseling (social workers, mental health counselors, pastors) or join professional support systems as needed.
- Advocate for yourself at doctor’s visits, write down questions. Ask for a copy of labs, images, or records. Follow up and get second opinions when needed. Make sure a family member or friend is also following up and checking in on you before and after medical visits.
Remember that regardless of circumstances, black girls and women should continue striving to implement best practices that achieve the best health outcomes.