Cardiovascular disease is the leading cause of death of both men and women in the United States (“Heart Disease Facts & Statistics”). It is also the leading cause of death among African Americans and kills about one in every four women (“Women and Heart Disease Fact Sheet”). Many black women face many obstacles when dealing with their health ranging from lower economic status to racism within the medical field. This intersectionality, as described by Deborah King in, “Multiple Jeopardy, Multiple Consciousness:
The Context of a Black Feminist Ideology”, is a major cause for the increased stress among black women.
According to Mayo Clinic, some of the major risk factors of cardiovascular disease are poor diet, high blood pressure, diabetes, and stress. It is not surprising that black women, as well as other ethnic minority women, are at a greater risk of heart disease than white women (Winkleby, et al.). Lack of healthy food options, stress, and racism within the medical field are just three causes for the increased risk of cardiovascular disease among black women.
Many lower class black women are less likely to have a healthy diet. These poor communities are less likely to have stores that provide healthy choices such as fruits and vegetables (Hendrickson, et al. 371-372). This can make it difficult for lower income families of all races to obtain the diet necessary for a healthy life, even if they could afford it. Traveling far distances to obtain healthy foods is often something people within lower class communities cannot do.
It can simply be an inconvenience to travel a farther distance to a store when one is much closer to their home. They also may not have the means, or the time, to travel a farther distance to a store to buy healthier, more costly foods.
On page 160 of “Food Insufficiency and the Physical and Mental Health of Low-Income Women,” the authors state, “Poor women with children, and especially poor women of color, are at increased risk of food insecurity.” The authors go on to say that their study found with lower levels of education, which is often linked to lower economic status, were also related with increased reports of poor health. Education is also an important step in leading a healthy life, and black women with lower levels of education may not have learned how to live a healthy life, nor the importance of doing so. These unhealthy diets can have huge implications on health, including a higher risk of cardiovascular disease (“Heart Disease Facts & Statistics.”).
The socioeconomic status of black women can also greatly impact their stress levels. On page 388 of “Racial Differences in Physical and Mental Health: Socio-Economic Status, Stress, and Discrimination,” the authors state, “The structural location of blacks in society would lead them to have higher levels of stress than whites.” Black women within the lower class have an added level of stress that makes it difficult for them to relieve as it is very difficult to remove one’s self from the lower class.
Once in the lower class, it becomes difficult to pursue higher education because it costs money that people within the lower class often do not have access to. Without this higher education, it again becomes more difficult to move into the middle class which leads to a lifetime of stress. Everyday stresses such as having to pay bills and raise children, if they have them, can also be increased for black women within the lower class. The stress of a black woman’s socioeconomic status is just one jeopardy in their life where many jeopardies collide. The term used to describe this collision of jeopardies is intersectionality.
Intersectionality describes all the different stresses within a black women’s life. It includes issues of race, gender, class, and many other things that may impact their lives on a day to day basis. Another jeopardy that black women face is being a single mother. 29% of single mother households were head by black women and 46.2% of those families were in poverty in 2010 (Damaske, et al). This can cause a huge stress for black women because they not only have to be the single bread winner, but also have to take care of their child/children without leaning on a significant other for support. It may also be difficult for them to find quality jobs due to their race or gender. This can make for long, unrewarding days at work followed by raising children to the best of their ability.
Married black women also have stress in their lives that they may receive from their husbands due to sexism. Black women in the United States have often been a key part in bring in money for the household. This can cause strain between black couples because black men then feel as though they are being emasculated. This can cause marital strain and more stress on black women to both help support the household and not step on her husband’s toes (King 50-51). All of these increased stress levels raise black women’s risk of cardiovascular disease (“Heart Disease Facts & Statistics”).
Finally, racism within the medical field causes a disadvantage to black women seeking medical care for cardiovascular diseases. The racism within the medical field causes fear within black women that keeps them from receiving the quality of care that they need. Henrietta Lacks is a prime example of why many black women fear the medical field. Lacks had a long term fear of the medical system that was brought to light in Rebecca Skloot’s book The Immortal Life of Henrietta Lacks. On page 16, Lacks’ medical chart showed that on five different occasions a doctor recommended that she receive further treatment and all five of those times Lacks either refused or did not show up. Also on page 16, Skloot says that Lacks feared the hospital because she didn’t understand what they were saying, and that she feared that the doctors may remove her womb so she could no longer have children. Then, the medical field took advantage of Lacks and performed research on her cells that she did not give permission for. Stories like Henrietta Lacks’ often spread quickly and strike fear into many black women who may need medical treatment.
Lacks is not the only black woman to fear the medical field. In a study done to find out why black people within the United States were not participating in clinical trials, it was determined that one reason was mistrust between those in the black community and the medical field. When asked open ended questions about clinical trials, the subjects gave reasons such as fearing clinical trials and not wanting to be treated like “guinea pigs”. This fear has been felt among black Americans for a significant amount of time now. From the 1930s-970s, the Tuskegee Syphilis Study became another example of racism within the medical. Within this study, black men were involved in a controversial study of the lifelong effects of syphilis. These black men were not made aware of, nor given, a treatment for syphilis although one became available after the study had begun. This instance of racism continues to cause mistrust between black people and the medical field and is often still pointed to as a significant mistreatment of black people within the United States. (Harris).
Black women with cardiovascular disease are being directly affected by this racism within the medical field. The study “Quality of Care by Race and Gender for Congestive Heart Failure,” conducted in 1999 compared the quality of care of black people with congestive heart failure with their white counterparts. This study also compared the quality of care that women were receiving for congestive heart failure as compared to their male counterparts. This study found that when qualified professionals, such as doctors and nurses, examined the cases, both black people and women received lower quality of care than their counterparts. This study shows the racism within the hospitals by proving that black women did not receive the same quality of care as their white male counterparts. (Ayanian, et al. 1261-1265).
In 2014, Elizabeth Gay wrote “Report: Racial Discrimination Severely Undermines Black Women’s Health” detailing the discrimination against black women by their doctors. One woman, in the article, was stereotyped by her doctor, and another was denied care while in labor. These more recent accounts show that racism continues to be a problem within the medical field in present day. This not only affects the quality of care black women receive, but also adds to the stress of intersectionality being exemplified through their health care experiences.
The stress caused by intersectionality and mistrust of the medical field as well as not having a healthy diet can have an impact on the heart. According to the article from Harvard Health “Reduce Your Stress to Protect Your Heart”, stresses caused by the workplace, finances, and being a caregiver all increase the risk of cardiovascular disease. Many black women experience at least one, if not all three of these factors as well as the many others included within intersectionality. These stresses can cause higher blood pressure and raise cholesterol levels which leads to a higher risk of cardiovascular disease (“Stress and Heart Health.”). A poor diet can also be detrimental to the heart. A study called “Association Between Dietary Factors and Mortality From Heart Disease, Stroke, and Type 2 Diabetes in the United States” found that 53.1% of cardiovascular related deaths among blacks were associated with poor diets (Micha, et al.). This shows the detrimental affect a poor diet can have on the heart as well as the increased risk of cardiovascular disease.
Black people within the United States have a higher chance of developing a cardiovascular disease than white people (Van Dyke, et al.). Lack of healthy food options, stress from intersectionality, and racism within the medical field are some of the major causes for this increased risk. In order to improve the health of black women, these factors need to be examined and solutions need to be made to fix these issues. Providing easier and more affordable access to healthy foods can help black women achieve healthier diets. Helping black women get out of the lower class and reducing sexism and racism in their everyday lives can reduce their stress caused by intersectionality. Education of doctors and other healthcare providers about the biases within the health care system can lead to less mistrust between the medical field and the black community and can lead to better quality of care for black people, including black women. Reducing the impact of these three factors can greatly reduce black women’s risk of heart disease and can lead them to longer, healthier lives.