I went for my annual checkup and screening with my then OBGYN: “You don’t need to worry about osteoporosis, because you’re African American.” she said. Actually, I’m Afro-Caribbean and half Indian. My maternal grandmother died from osteoporosis complications and my paternal lineage is also vulnerable. All the doctor saw was Black.
Women of color are at the tragic intersection of sexism and racism, doubling the effects of stress on our bodies and minds and leaving us vulnerable to lack of treatment for a plethora of debilitating illnesses. Mis and disinformation are deadly; their impacts live in our cells, even our DNA. They kill Brown and Black women- by lingchi, “death by a thousand cuts” in the form of micro-aggression and other harmful insidious forms of racism and neglect.
According to the National Council on Aging, health disparities put Black women “…at risk for developing and suffering complications from the disease.” We suffer worse outcomes after sustaining hip fractures, are less likely to be screened for early detection, less likely to receive medication to treat it, and less likely to receive physical therapy after a hip fracture. Black women are the LEAST likely to be screened of all groups. Native American women have similar risks of osteoporosis as white women, yet statistical information on their health outcomes is conspicuously sparse.
The dramatic and well-documented health disparities do not end with osteoporosis. Some alarming statistics paint a picture of the health disparities of Native People in heart disease, cancers and alcoholism- all way above the national average and compared to those of whites. As Edgar Villanueva asserts in “Decolonizing Wealth”, 1 in 3 Native American women is raped in their lifetime, 2.5 times that of all US women, and as of 2020 the mortality rate for Native People during COVID-19 was 2 times that of whites. Native mothers are 4.5 times more likely to die from pregnancy and childbirth and their children two times more likely to die by their first birthday than whites. African American mothers’ maternal mortality rate as of 2020 is 2.9 times that of whites. Black and Brown women are less likely to be offered preventive care through early screenings and other methods, and their outcomes are worse once they have been diagnosed. Black women have 40% higher mortality rate and younger age distribution for breast cancer than white women. What’s more, while we are up to 50% more likely to die from heart disease than white women, we do not receive preventive therapy.
Why? Mis and dis information from racial biases. In a 2016 study on racial bias in pain treatment and management, it was determined that “…a substantial number of white lay people, medical students and residents hold false beliefs about biological differences between blacks and whites…” These include black skin is thicker and black people are less sensitive to pain. We are “systematically undertreated” for pain compared to white Americans. Even when we experience pain, we are treated differently. We are less likely to be listened to at a doctor’s visit. Dr. Susan Moore’s tragic death from COVID-19 shows us that even with education, knowledge, and self-advocacy, we are dying. A medical doctor, she asked for potentially lifesaving treatments and was tragically ignored, and undertreated.
Our poor health outcomes are not only the product of neglectful physicians, mis and disinformation and the microaggression they spurn create day-to-day experiences of trauma, microtrauma, and stress in our bodies that are transgenerational. This daily microaggression puts our health at great risk. Black women experience faster cellular aging due to faster telomere shortening. “Culturally specific responses to gendered racism and racial identity, developed early in life and shaped over the life course, are important psychosocial determinants of cellular aging among African American women,” and all women of color. Microtrauma, cellular aging, and inflammation all leave us more vulnerable to preventable diseases.
Some stress is good and an inevitable part of life as it enables us to adapt to an ever-changing world. However, prolonged, chronic, unmitigated stress is deleterious, harmful, and deadly. The physiological effects of chronic stress on health are well documented. High levels of C-reactive protein in the blood indicate inflammation, and one cause is chronic disease. Like stress, inflammation is a protective, and like stress, if left unchecked, inflammation can wreak havoc, leading to heart disease, diabetes, cancer, arthritis, and more – diseases for which women of color are at greater risk. Because we face disproportionate stress in the form of microaggression, and racialized mis and dis information, our bodies suffer.
George Orwell wrote: “Who controls the past controls the future. Who controls the present, controls the past”. Our history as women of color was not written by us or for us, but our future needs to be. We must create our own community networks of advocacy, trusted information, and medicine, and seek help to address the stressors that put us at risk. If you are a non-brown or Black person, actively question your assumptions and perceptions of Brown and Black women, particularly if you are in a position of power. Our health reflects the conscience of the collective.
I eventually found a great OBGYN who regularly discusses screenings and preventive care with me- I am one of the lucky ones.