FEBRUARY BLOG

BLACK HISTORY MONTH

BLACK AMERICAN HEALTH ISSUES

Let’s talk a little about “Our Health!”

Health care disparities are more pronounced between Black Americans and white Americans in the case of several deadly diseases.   Fighting back means genetic research, changing the system for new drug testing and improving health education.   It also means overcoming the disparities in health care by targeting the health care needs of black Americans which evidence shows will pay health dividends not just for racial minorities, but for everyone.

Genetics and the environment play a role where people live, socioeconomic status -- and, yes, racism, says Clyde W. Yancy, MD, Associate Dean of Clinical Affairs and Medical Director for heart failure/transplantation at the University of Texas Southwestern Medical Center.  “All humans have the same physiology, are vulnerable to the same illnesses and respond to the same medicines.”   Diseases and the body’s response to their treatment vary for each individual, but there are unique issues that affect black Americans.  The only problem, we're closer to the beginning of the fight than to the end. 

Poor nutrition, lack of exercise, smoking, high blood pressure, high cholesterol and family history are the major contributors to these diseases.  Dr. Fowler says that proper nutrition and exercise are key starting points in taking control of better health!   A diet that includes eating fish like salmon, tuna and mackerel which contain omega 3 fatty acids can help significantly. 

Black Americans' social and economic status lags behind that of Caucasians," Graham says. "And low socioeconomic status is linked to more disease."  It's not a simple question of access to health care itself, but access to specialists.  Even within HMOs, Graham says, blacks get specialist referrals less often than whites.

In Black Americans:

• Diabetes  is 60% more common than in white Americans.  Blacks are 2.5 times more likely to endure limb amputations and 5.6 times more likely to suffer kidney disease.   3.2 million African Americans have diabetes, yet more than 33% do not know it. 
• Experience a higher likelihood of dying from asthma than white Americans.
• Deaths from lung scarring -- sarcoidosis -- are 16 times more common than whites. 
• Men are 50% more likely than white men to get lung cancer, despite lower tobacco exposure. 
• Strokes kill 4 times more between the ages of 35 to 54 year-olds than white Americans. Blacks also experience twice the first-time stroke risk of whites.
• Endure high blood pressure earlier in life, with higher blood pressure levels than whites.  Nearly 42% of black men and over 45% of black women, ages 20 and older, have high blood pressure.
• Cancer treatment is equally successful for all races, yet black men have a 40% higher cancer death rate than white men.  Black women have a 20% higher cancer death rate than white women.

WOMEN’S ISSUES

Heart disease, stroke, and diabetes -  7.6 % of black women have heart disease, compared to 5.8 % of white women and 5.6 % of Mexican-American women, according to Centers for Disease Control and Prevention data from 2011-2013.  In 2016, 46 of every 100,000 black women died from strokes, while 35 of every 100,000 white women did.   While white women's diabetes diagnosis rate is 5.4 per 100, that number is almost double at 9.9 per 100 for black women, according to CDC data from 1980-2014.

“It’s the foods we eat—many communities don’t have easy access to healthier options," Dr. Hutcherson says.  A 2013 study in Preventive Medicine found that "poor, predominantly black neighborhoods face…the most limited access to quality food."  Dr. Hutcherson also cites stress and adds that a lack of exercise can be a problem, too, if it’s hard to get access to a gym or the neighborhood isn’t safe.

Breast cancer - Black women have a 1 in 9 chance of developing breast cancer; for white women the odds are 1 in 8, according to the American Cancer Society.  Black women, 1 in 31, are more likely to die from the disease while the probability of dying for White women is 1 in 37.  “The reasons why black women have a higher probability of dying than other groups is very complex,” Adrienne Phillips, M.D., oncologist at Weill Cornell Medicine and New York-Presbyterian, tells SELF, citing “an interplay between genetics, biology, and environment.” 

Black women are more likely to get triple-negative breast cancer—a particularly aggressive form of the disease—than women of other races.  BRCA mutations may be higher in black women than experts previously thought. 

Cervical cancer- Research published in the Journal Cancer , in January, found that not only are black women more likely to die of cervical cancer than women of other races.  Cervical cancer is absolutely preventable in this day and age,” says Dr. Phillips.  The HPV vaccine is excellent at preventing infection of certain strains of human papillomavirus that can go on to cause cancer. 

As of August 2016, only 6 out of 10 girls ages 13 to 17 and 5 of 10 boys in the same age range had started the vaccine series, which doctors recommend getting before age 26 for optimal results.  Racial disparities are relevant here.  A 2014 report from the CDC showed that 71 % of white girls 13 to 17 had completed the three-shot series, compared with 62 % of black girls in that age group.

Fibroids! - Human Services Office on Women’s Health. Fibroids are largely genetic, and there's no known way to prevent them.  Fibroids, leiomyomas or myomas, are muscular tumors that can grow on the uterus.   They rarely turn into cancer.  Fibroids are more prevalent, show up earlier and grow quicker in Black women than white women in African-Americans. 

I totally agree!  After having no symptoms of Fibroids and proud of a 1-1/2 day menstrual cycle, working in a non-traditional job changed all that.  I experienced growths from the size of an egg to a grapefruit, with the latter the cause of a ruptured uterus! 

"Most of the time, women don’t know they have fibroids because they don’t have symptoms,” Dr. Hutcherson says.  “But when fibroids grow or increase in number, they cause a number of problems, from pain, extreme bleeding, miscarriages, problems with urination and bowel movements.”  A Myomectomy can remove the fibroids or other techniques such as Uterine Artery Embolization and Radiofrequency Ablation to either block fibroids from getting nutrients or shrink it.

One study found diets high in sugar may be linked to a higher risk in some women.  Another study found that eating fresh fruits and cruciferous vegetables like arugula, broccoli, cabbage, cauliflower, collard greens, and turnip greens could lower your odds. Cruciferous vegetables are rich in beta-carotene, folate, vitamins C, E, and K, and other minerals. They’re also full of fiber.

Regular exercise also can lower your chances of uterine fibroids.

Sickle Cell Anemia - Sickle Cell is a collection of inherited, lifelong blood disorders that 1 of every 365 black babies is born with, according to the CDC.  The disease is caused by sickle shaped hemoglobin, the protein that carries oxygen to the red blood cells, instead of being circular.  These sickle shaped cells can get destroyed in the blood stream, causing patients to become anemic.  These cells clog blood vessels, which lead to infection, chest pain and strokes.  Pregnant women with Sickle Cell have increased probability of miscarriage, premature birth or low birth weight.  With proper care and caution many with the disease live healthy, happy lives.  It's essential for parents to get the proper education about how to keep their children safe. 

Sickle Cell has been known since the 1950s, but for generations this disease has not had the funding and research attention it deserves.  "There are more Americans with Sickle Cell than Cystic Fibrosis, 65,000 to 80,000 cases versus 35,000 to 40,000 cases, but the amount of money spent on cystic fibrosis research outstrips sickle cell anemia.  

Sexually Transmitted Diseases - Good news!  The rate of chlamydia cases in blacks decreased 11.2 % from 2011 to 2015, according to the CDC.  The same decline trend has been observed in gonorrhea, which declined 4 %.  According to the CDC, in the U.S in 2015, 4,524 black women were diagnosed with HIV, while 1,431 white women and 1,131 Hispanic/Latina women received the same diagnosis.   Black women still outpace other groups in new diagnoses of these diseases. 

Mental Health - Mental illness issues, economic insecurity and racism can negatively impact mental health in the black community.  The major problem is the black community is wrestling with the stigma of seeking help for mental distress!

The reduced access to counseling and the prohibitive expense of mental health care can also be a deterrent.  Many practicing in the health care industry don't accept health insurance, which also deters blacks from getting help.  Black women are especially vulnerable trying to deal with their mental health issues, yet we continue to take care of everyone’s health,” Dr. Phillips says. 

MEN’S HEALTH

Heart disease and stroke disproportionately affect Black Americans. Why?  “A very high incidence of high blood pressure," Dr. Yancy says, which is the precursor to more heart disease, kidney disease, and stroke.  Black men account for 100,000 more cardiovascular disease deaths than Caucasian men.   Stroke targets more than 3 million men.  Between 1999 and 2010, heart disease and stroke contributed to more than 2 million years of life lost among black people

High Blood Pressure - The presence of high blood pressure or Hypertension, in Blacks is the highest in the world.  Hypertension increases the risk of heart disease and stroke and contributes to permanent damage to the heart before you even notice symptoms.

Research suggests Blacks may carry a gene that contributes to a higher sensitivity to salt.  “You can’t do anything about your family history, but you can control your blood pressure,” Dr. Gandy said.

High blood pressure is common in males under the age of 45, with the life expectancy for black men, 75.5 years, vs. 79 years for white men, according to a review of more than 300 studies.  Clinical trials show blacks and whites respond differently to treatments for high blood pressure.

Vitamin D Deficiency - Low Vitamin D has been associated with several types of cancers and certain autoimmune diseases such as lupus.   Although Black Americans have larger amounts of melanin, which determines skin color and protects the DNA against UV radiation from the sun,  there are few sources of Vitamin D other than sunlight and milk. To make4 matters worse, many Black Americans are lactose intolerant!  So the options are limited through foods and Vitamin D supplements are the most likely answer.

Cancer—Lung, Colon, Prostate - Black American men are 35% more likely to die from prostate or colon cancer than Caucasian men.   Dr. Fowler says that the medical and family history, screenings such as colonoscopy, chest x-ray and blood tests for these diseases on a regular basis is essential. Dr. Fowler strongly recommends screenings for colonoscopies for Black men at age 45.

COPD and other respiratory diseases - Each year more men are diagnosed with and develop lung cancer than in years past.  Black men have a higher risk of dying from the disease compared to other ethnic groups.  Many respiratory diseases start with an innocent “smoker’s cough.”  Over time, that cough can lead to life-threatening conditions, such as lung cancer, emphysema, or COPD.  All of these conditions interfere with your ability to breathe.

Black Americans are hospitalized more frequently for asthma attacks than any other race.  33% of those hospitalized are children!   Parents who smoke are at the highest risk pool for contracting asthma and early death.

• Black Americans are 3 times more likely to suffer sarcoidosis, lung-scarring, than white Americans. The disease is 16 times more deadly for blacks than for whites.
• Black American children are 3 times as likely as white American children to have sleep apnea.
• Black American babies die of sudden infant death syndrome (SIDS) 2.5 times as often as white American babies.
• Black American men are 50% more likely to get lung cancer than white American men.
• Black Americans are half as likely to get flu and pneumonia vaccinations as white Americans.

Cigarette smoking is declining faster among blacks than among whites, still die of lung diseases more frequently than white Americans.  This could be due to health care disparities.  Often times, blacks are diagnosed later, when the diseases are harder to treat or its just simply due to genetics.

Hepatitis C - Is more prevalent in the Black population and can leads to chronic liver disease and liver cancer.  The biggest danger is an infected person may not have symptoms and liver protein tests frequently come back normal.

Depression—Black Americans have a high incidence of depression which can lead to suicide. Many people never discuss mental health with their physicians. Dr. Fowler recommends talking with your doctor about everything that is ailing you--both physically and mentally. Depression is treatable with medications such as anti-depressants as well as psychoanalysis.

Obesity - African-Americans are affected more by obesity.  Among non-Hispanic Blacks 20 years and older, 63 % of men and 77 % of women are overweight or obese.  If carrying extra weight, Dr. Gandy suggests focusing on the quality of your diet throughout the day, not only during mealtime.

Limit the intake of red meats in favor of lean meats such as chicken or fish, and watching portions on carb heavy foods, such as pasta and rice.  Add more whole grains vegetables.  Dr. Gandy cautioned that even things that are healthy can pack in calories.  “If you’re thirsty, drink

Who isn’t trying to eat healthy these days?

Dr. Fowler says, ""One major aspect to preventing as well as controlling most diseases is nutrition. Eating more fruits, vegetables, grains and nuts such as walnuts and almonds, and less red meat can help to decrease the incidence of many diseases. And don’t forget exercise.”

After all, it can help reduce your risk of heart disease, stroke and lots of other things you’d rather avoid. The good news is, eating right doesn’t have to be hard or require you to give up things you love. It’s all about making smart choices to build an overall healthy dietary pattern.

Here are some suggestions to include for eating healthier:

• Fruits and vegetables
• Whole grains
• Beans and legumes
• Nuts and seeds
• Fish (preferably oily fish with lots of omega-3 fatty acids), skinless poultry, and plant-based alternatives
• Low-fat and fat-free dairy products
• Healthier fats and non-tropical oils

Limit the intake of:

• Sweets and added sugars, especially sugary drinks
• Sodium and salt
• Saturated fat
• Fatty or processed meats – if you choose to eat meat, select leaner cuts

Herbal remedies

• Heart

1. Vitamin E – has been used for treating and preventing diseases of the heart and blood vessels, such as hardening of the arteries, heart attack, chest pain, leg pain due to blocked arteries and high blood pressure.
2. L-arginine - a strong neurotransmitter, assisting blood vessels with relaxation and improving circulation.  Evidence indicates L-arginine also facilitates improved blood flow in the arteries inside the heart, which aids in improving clogged arteries, angina and coronary artery disease

• Stroke

1. Ashwagandha has been used in India for conditions such as stress, anxiety and immune support, notes WebMD. 
2. L-arginine - a strong neurotransmitter, assisting blood vessels with relaxation and improving circulation.  Evidence indicates L-arginine also facilitates improved blood flow in the arteries inside the heart, which aids in improving clogged arteries, angina and coronary artery disease.

• Diabetes

1. Vitamin E is also used for treating diabetes and its complications. It is used for preventing cancer, particularly lung and oral cancer in smokers; colorectal cancer and polyps; and gastric, prostate, and pancreatic cancer.
2. Maitake mushrooms - Early research suggests that taking maitake mushroom polysaccharides (MMP) internally by mouth may assist in lowering blood sugar in people with diabetes.   Medications for diabetes may need adjusting by your healthcare provider.
3. Ashwagandha - Studies indicate lowering of blood sugar in Type 2 diabetes patients and with lowering cholesterol.

• Breast cancer

1. Ashwagandha - Studies suggest that may also slow cancer cell growth in the lungs, breasts and colon.
2. Hormone therapy uses drugs and medications to prevent hormones from encouraging growth of breast cancer cells. Drugs include:   estrogen, Medicines before and after menopause include - tamoxifen, Nolvadex, Soltamox and aromatase inhibitors -  anastrozole (Arimidex), exemestane (Aromasin), and letrozole (Femara) for postmenopausal women. Side effects can include hot flashes and vaginal dryness.

• Mental health

1. Ashwagandha has been used in India for conditions such as stress, anxiety and immune support, notes WebMD. 
2. Catnip is a gentle but potent sleep-inducer for humans that calms and reduces stress without affecting you the next day. It soothes the nervous system. 
3. Passionflower is a natural remedy to treat a variety of ailments, including anxiety, asthma, fibromyalgia, gastrointestinal upset and narcotics withdrawal. Passion flower may increase levels of the neurotransmitter GABA, which helps provide relief to the brain, notes Tranquilitylabs.com.  It can also be used as a pain reliever and anti-inflammatory aid.  In small amounts, passionflower is safe but can cause side effects when taken in large doses.

• Cancer—Prostate

1. L-arginine – alternative benefits include the easing of erectile dysfunction, as arginine helps blood flow increase by relaxing the arteries.

• Depression

1. Valerian tea is widely popular herbs used in treating anxiety and stress.
2. Kava Kava – has a calming effect which assists in relieving anxiety, restlessness, sleeplessness and stress-related symptoms such as muscle tension or spasm.  When taken for anxiety or stress, kava does not interfere with mental sharpness. Kava should never be taken with these prescription drugs.  Avoid using alcohol.
3. B-5 or PANTOTHENIC ACID - widely found in plants and animal:  meat, vegetables, cereal grains, legumes, eggs, and milk.  B-5 is frequently used in combination with other B vitamins in B complex formulations.  It is orally for dandruff, depression, diabetic nerve pain, enhancing immune function, improving athletic performance, tongue infections, gray hair, headache, hyperactivity, low blood sugar, trouble sleeping (insomnia), irritability, low blood pressure, multiple sclerosis, muscular dystrophy, muscular cramps in the legs associated with pregnancy or alcoholism, neuralgia, and obesity.
4. St. John's Wort is successful improving symptoms of mild-to-moderate depression with fewer side effects.  It can be dangerous  taken with  antidepressants and certain medications used in  treating HIV, cyclosporine, a drug used in organ transplant patients, or anticoagulant drugs. It can also interfere with  oral contraceptives and medications used for heart disease and seizures.
5. Ginkgo Biloba is typically used as an "alternative medicine" strategy that might help to improve memory and ease confusion. 

• High Blood Pressure

1. L-arginine - a strong neurotransmitter, assisting blood vessels with relaxation and improving circulation.  Evidence indicates L-arginine also facilitates improved blood flow in the arteries inside the heart, which aids in improving clogged arteries, angina and coronary artery disease.
2. Black Currant seeds carry four times the Vitamin C as oranges and double the antioxidants of blueberries.  Black currants have a high concentration of: anthocyanins, polyphenolic substances, antioxidants, vitamin A, C, B-1, B-5, B-6, E and gamma-linolenic acid or GLA.  People take blackcurrant to assist with:  blood flow, immune system, eye health, gut health and kidney health.  Blackcurrant extracts have shown to reduce risk factors for metabolic conditions such as type 1 and 2 diabetes.  Blackcurrant leaves also have a range of properties, including:  antimicrobial, anti-inflammatory, antiviral, antitoxic, antiseptic and anticancer. 

ALWAYS CONSULT YOUR PERSONAL HEALTH CARE PRACTITIONER

• https://www.healthline.com/health/top-10-health-risks-for-men#heart-health
• http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/African-Americans-and-Heart-Disease_UCM_444863_Article.jsp#.WmeQ_XlG21s
• https://www.mdvip.com/physicians/primary-care-model-outcomes
• https://www.self.com/story/black-women-health-conditions
• https://www.webmd.com/hypertension-high-blood-pressure/features/why-7-deadly-diseases-strike-blacks-most#1
• https://www.webmd.com/heart-disease/news/20171023/heart-disease-stroke-cutting-black-lives-short
• https://www.webmd.com/vitamins-supplements/ingredientmono-954-VITAMIN+E.aspx?activeIngredientId=954&activeIngredientName=VITAMIN+E&source=0
• https://www.webmd.com/stroke/default.htm
• https://www.webmd.com/women/uterine-fibroids/uterine-fibroids#1
• https://www.anniesremedy.com/nepeta-cataria-catnip.php?gc=94&gclid=EAIaIQobChMI9dzs0__72AIVhbXACh2HkgH2EAEYAyAAEgJlm_D_BwE
• https://www.webmd.com/depression/guide/understanding-depression-treatment#5-10