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What Healthy Black Women Can Teach Us About Health 700 Pennsylvania Avenue, S.E. – Suite 2059, Washington, DC 20003 | 202.787.5930 | www.bwhi.org What Healthy Black Women Can Teach Us About Health © 2019 Third Edition PUBLISHER Linda Goler Blount, MPH EDITOR Valerie Boyd WRITERS Tamara Jeffries Robin D. Stone LEAD RESEARCH ADVISOR Kanika A. Harris, PhD, MPH BLACK WOMEN’S HEALTH STUDY Traci Nicole Bethea, PhD Julie R. Palmer, ScD RESEARCH ASSISTANCE AND CONCEPTUAL GUIDANCE Édeanna Barbirou, MA Yanique Redwood, PhD, MPH H. Shellae Versey, PhD, MPH PHOTOGRAPHY Phelan Marc Media DESIGN Dana Magsumbol Design BLACK WOMEN’S HEALTH IMPERATIVE STAFF Linda Goler Blount, MPH President & CEO Tammy Boyd, JD, MPH Chief Policy Officer Angela Ford, PhD, MSW Chief Program Officer Zsanai Epps, MPH, CHES CONTENTS Manager of Special Projects Ryan Robison Letter From the Publisher . 4 Health Policy Analyst Still Gotta Get Up in the Morning: Joy Chibuzo Health Policy Fellow Stress and Mental Health . 7 Tamea Williams Health Policy Intern Our Black Bodies, Our Full Selves . 19 The High Price of Health . 31 Sexual Healing . 43 Nothing But a Number? Healthy Aging . 51 Published by the Black Women’s Health Imperative, the only Why Black Women’s Health Matters to You . 60 national organization dedicated to improving the health and wellness of our nation’s 21 million Black women and girls— physically, emotionally and financially. Your Role in Black Women’s Health . 61 We Have Cause for Concern . 64 9% 70+ About IndexUS:22% What Healthy34.5% Black Women Can Teach Us About Health is the first health index focused exclusively on 60-69 Under 50 healthy Black women. It’s based on 20 years of data from the Boston University Black Women’s Health Study (BWHS)— specifically, information from 38,706 BWHS participants who reported their health as excellent or very good. In 2013, when they responded to questions about their health, the average age of women in this study was 55. 34.3% 50-59 BY THE NUMBERS 9% Age 70+ 31.8% were overweight 34.5% 48.6% 22% Under Age 50 had completed college were obese Age 60-69 28.9% 34.3% 66.5% 88.4% Age 50-59 had never smoked had access to health care INDEXUS 3 “There is far more right with Black women than wrong.” What’s We have reason to celebrate. behavior. This is what we see in media and read RIGHT We at the Black Women’s Health Imperative in the language of research reports. Medical have reached millions of women, sharing providers accept this narrative and, as a result, the latest research, life-saving programs and often do not offer Black women aggressive With Us health-promoting policies. The 21 pictures treatment or pain medication. Researchers on the cover represent the 21 million women accept this narrative and don’t ask questions and girls in the US whom we serve. It has of data, or they don’t collect data that might been our privilege. But it is a rare opportunity change the narrative. And policy-makers to get to listen to Black women talk about fail to advance legislation that would make their health; their voices, sorely needed, are engaging in healthy behaviors easier. seldom heard. Thanks to ESSENCE Magazine Despite the constant narrative that something and the investigators of the Black Women’s is wrong with us, Black women see ourselves Health Study (BWHS), we have a unique quite differently: More than 50 percent of and incredibly valuable opportunity to look women in the BWHS view their physical and at Black women’s health, what is important mental health as very good or excellent. That to them—to us—and, most important, what is something to celebrate! we are doing to maintain and improve our Black women exercise, we eat healthy, we’re health. IndexUS is a result of listening to Black educated and we work hard. It’s time to change women—almost 60,000 strong, beginning the narrative. It’s time for our story to be told with ESSENCE Magazine subscribers. For in a way that shows who we really are when it more than 20 years, they—you—have answered comes to our health. We do not see ourselves all manner of questions about physical and as broken—stressed, yes, but not broken. We mental health, diet, exercise, lifestyles and are inherently strong, resilient and passionate the stresses of everyday living. about our health. We are not defined by disease, BWHS, led by researchers at Boston University, obesity or poverty. has contributed more than any study to the IndexUS is the first time our health story is understanding of Black women’s health and being told from a position of strength. Instead wellness and the differences from White of studying what makes us sick, IndexUS takes women and others. Over the past 20 years, as more than 20 years of research in the BWHS these differences have been examined, we’ve and explores what keeps us healthy. This report often learned that Black women’s health is presents those findings in a way that we all can worse than White women’s. And, we have understand. We don’t have to be physicians, learned that most of these differences are epidemiologists or health professionals to know not due to genetics or biology, but to systems what this means for us and what we can do. and structural barriers that prevent Black We hope policy-makers, funders and business women and low-income women from choosing leaders will read the report. There is valuable behaviors that help them to be as healthy as information here to understand the lived possible. And so, over time, we’ve come to experiences of Black women and what this accept a narrative that equates Black women means for research, programs and policies. with poor health, and poor health with poor But, the most important reader is us: the 4 BLACK WOMEN’S HEALTH IMPERATIVE everyday Black woman, doing her level best to be healthy and keep her family well. Each section presents data, of course, but also real-life stories of everyday women, our triumphs and trials. Sweet Honey in the Rock sang Still Gotta Get Up in the Morning, and don’t we know it? More than anything, Black women want inner peace. We define our health in emotional terms. We real face on health and economics. We talk with The operative word is healthy. In this report, want to be in control, confident and calm. After experts who explain how the medical system is we look at sex through a justice lens; if we can’t that, we want financial peace. We want to take organized and why it works against us. They also have policies to ensure access to contraception care of our families, keep a roof over our heads talk about the very close relationship between care, abortion care and non-judgmental medical and send our children to good schools. Only health and wealth. The fact is, the wealthier you care, then we can’t be completely healthy. And if then do we focus on our physical health. In the are, the healthier you are. And your ZIP code society continues to view people living with HIV first section ofIndexUS , we explore the everyday can determine not only how well you live, but and survivors of sexual violence as somehow stressors Black women face, the impact on our how long you live. weak or irresponsible, then we eliminate any lives and what we can do to rise above those How many of us have seen the sister, well into chance for all of us to experience justice. We stressors to get closer to confidence and calm. her 60s or 70s, who just looks good? We wonder, need to heal. The Sexual Healing section helps Too often, Black women’s bodies are vilified. “how does she do it?” There is some truth to us along the path of caring for ourselves and We’re stereotyped as being fat and lazy. Some of the saying age is “all in your head”—but not achieving personal justice. us find ourselves in a no-win situation. Former First Lady Michelle Obama, for instance, was criticized for being too muscular, her workout “ We are inherently strong, resilient and routine too unladylike. Yet she set a wonderful passionate about our health. We are not example of healthy eating, nutrition and physical activity. So which is it? Every day, Black women defined by disease, obesity or poverty.” are made to feel inadequate about our bodies by the media, well-meaning health providers, always. Black may not crack on the outside, but The Black Women’s Health Imperative began employers, friends and family. Our Black Bodies, we can pay the price on the inside. In Nothing 33 years ago as a self-care movement. We continue Our Full Selves challenges this narrative and But a Number, we explore what Black women that movement today. There is far more right shows women in all their glorious shapes and say about aging and how stress can speed up with Black women than wrong. We know that sizes and the simple, easy things we can do to the aging process. Luckily, there are things we to be true, and we want every woman to believe improve our nutrition and physical activity while can do to slow ourselves down and slow the it as well. This report tells the stories of everyday accepting that we are valuable just because we aging process.

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