Tracey Brown, Stacey Stewart, Angela Williams, Linda Goler Blount have created a Call to Action to ... [+] close the health gap for Black Americans.

For 20 years, Carol Fleming has lived with diabetes. In 2016, Fleming, who is now 66, joined Change Your Lifestyle, Change Your Life, a health-improvement program. Located in Flemings hometown of Detroit, Mich., the program was run by the Black Women's Health Imperative, a nonprofit organization created by and geared toward Black women to help protect and advance their health.

This program, among others at the Black Women's Health Imperative, is used to help Black women get healthy and address the underlying reasons for health disparities impacting their communities in America. Through advocacy on a federal level, the organization fights stereotypes about why diabetes, maternal mortality, breast cancer, and other often deadly, chronic health issues seem to plague the Black community.

"It's not in genes; it's due to systemic racism and bias that has created and still creates structural barriers for Black people in America to receive proper health care. Four hundred years of oppression, and what that has done to the way our bodies function brings us to where we are today," said Linda Goler Blount, the president, and CEO of Black Women's Health Imperative.

"These health disparities are what we should have expected based on the way people are treated and have been treated in this society, and where resources go and where they don't go and who has access and who doesn't."

Goler Blount and three other Black female CEOs for nonprofits in the health space are signaling a 'call to action' to address the health gaps for Black Americans. Currently, the health disparities impacting Black Americans, specifically Black women, are startling and have resulted in alarming statistics:

-Black women have three to four times higher rates of maternal mortality compared to white women. In New York City, its up to 12 times higher.

-Black Americans are 50 percent more likely to have diabetes and two and a half times more likely to die from the disease.

- Black women have a seven to eight times higher rate of diabetes, according to Goler Blount, and higher rates of mortality from diabetes, cardiovascular disease, and hypertension.

-Black women have 40 percent higher breast cancer mortality rates.

-Black women have, on average, about 15 percent more cortisol in their bloodstream than white women. Cortisol is a stress hormone. Elevated cortisol is associated with inflammatory and metabolic changes and raises the risk of diabetes, hypertension, and cardiovascular disease. The high cortisol in Black women is because of chronic racial and gender discrimination.

"These health disparities are unconscionable, and there is absolutely no reason for us to live this kind of reality," Goler Blount said. "It's going to take all of us to come together to speak truth to power about our lived experiences, and the impact of racism and gender discrimination on our health, and to apply the political pressure, and the moral pressure to change these systems."

Goler Blount argues the disparities can be found through the entire health system, from the person who works at the front desk of a doctor's office to the medical professionals themselves. She says an unconscious bias frequently results in Black women not being listened to; their fears and symptoms are often dismissed. Goler Blount also says Black women often receive less adequate care than their white counterparts, and they are often left out of clinical research studies. She even went as far as studying and co-publishing a paper on systemic racial bias in artificial intelligence in scheduling algorithms. Goler Blount found that hospitals and provider's scheduling systems were double and triple booking Black patients.

"The thing that everybody should contextualize about this, you know, if we pick something like breast cancer: in 1981, Black women and white women had the same breast cancer mortality rate. Well, what happened in 1981? We learned how to detect breast cancer; we learned how to treat it. So what we see now is a reflection of who had access and who didn't."

Keelee Moseley, a 40-year-old mother of three, says she believes systemic bias almost cost her life and her baby's life.

Keelee Moseley believes systemic bias almost cost her life and her baby's life.

In 2018, Moseley was pregnant with her third child. She went to an OBGYN checkup. The doctor noticed leakage, and her cervix was dilated. But Moseley was only 21 weeks pregnant.

"He said, you know, your pregnancy isn't viable. The baby is not going to survive," Moseley said. "He recommended abortion."

Moseley refused to accept that answer. She went home, where she spoke to her mother-in-law, who had been a nurse for decades, who recommended Moseley go the next morning to talk to an advanced maternal medicine doctor. The next day, she was admitted to the hospital on bed rest.

Moseley made it one more week before undergoing a cesarean section.

"He survived, you know, they didn't give him any chance," Moseley said. "And even when he was born, they said maybe you know, one percent chance of survival."

"But Adrian survived."

After the C-section, Moseley was in intense pain; but the doctors sent her home, saying the discomfort was normal. But the next day, it got even worse.

While Moseley and her husband were at the hospital visiting their newborn in the NICU, she began to feel lightheaded. Nurses took her temperature and discovered she had a fever. Moseley was taken to the ER and then back to Labor and Delivery, where they determined she had a high white blood cell count. Her stomach was swollen, red, and hot to touch. The hospital admitted her.

"I stayed the night, and I was still in a lot of pain. The second day it got worse, and I started to decline, Moseley said. "And then that evening, I vomited."

The doctor checked on Moseley, who explained her pain and symptoms. But the doctor said her stomach was swollen because it was irritated by her pajama pants that were too tight. He gave her Benadryl and left.

But Moseley believed something was more seriously wrong, so she kept taking photos of her swollen, red belly. And then, she found black blisters.

Doctors rushed Moseley into exploratory surgery. When she woke up, she was in the ICU with a large bandage around her stomach and a tube through her nose. She was informed her kidneys were failing and that she received multiple blood transfusions. The culprit was necrotizing fasciitis or a flesh-eating disease in her C-section incision.

Moseley spent over four weeks in the hospital recovering. Her baby was in the NICU for 144 days. She believes she wouldn't have been in this position undergoing multiple surgeries because of a flesh-eating disease had doctors taken her concerns seriously. She also believes if she were a different race, doctors would have worked harder to save her baby from the beginning, instead of first encouraging Moseley to have an abortion.

"I felt like, even if my voice wasn't enough, there were clinical signs that showed that I was in some distress and trouble," Moseley said. "And I felt like if doctors would have recognized that earlier, it may not have been so severe."

"Also, if I would have listened to my doctors, I would have never, never got to where I am today with Adrian. His birth was hard, but now he talks, he runs."

After some complications, doctors recommended Keelee Moseley have an abortion. Two years later, ... [+] Moseley's son is a thriving, healthy baby.

According to Stacey Stewart, the president and CEO of March of Dimes, there has been a maternal and infant health crisis for all women in the United States for several years. The U.S. is among the most dangerous developed nations in the world to give birth. But it is compounded and even worse for people of color.

Every year, Stewart says, 700-900 women die in the United States due to pregnancy and childbirth complications, and another 50,000 women come close to death in what are called 'near misses.' Black women die at a rate of three to four times compared to white women.

"We have had generations of systemic racism and discrimination that is embedded in the system. Black women often articulate that they don't feel respected and heard. Often, they present with symptoms, and their symptoms are dismissed. They are often not heard and not responded to in the same way that other women are," Stewart said.

"And then, of course, the pandemic comes, and then all these things are even more exacerbated."

The Covid-19 pandemic has disproportionately impacted Black and brown Americans, increasing the health inequity gap. According to AMFAR, the Foundation for Aids Research, as of August, 45 percent of Covid-19 cases, and 51 percent of Covid deaths, are in 22 percent of counties that are disproportionately Black. Black Americans are dying at more than twice the rate of white Americans from Covid-19.

Many of the reasons are related to social determinants of health like income, housing, food, and employment. A large percentage of Black Americans work what have become known as essential jobs - in the food industry, health services, etc. So while they may still have their job, it puts them at greater risk of getting sick. Many Black Americans would have to quit their job to protect their health, which puts them at greater risk for economic insecurity. Black Americans also often have health conditions, like diabetes and pre-existing conditions, that put them at greater risk.

But according to Goler Blount, we can't talk about the social determinants of health without talking about the inequalities that Black Americans have faced for decades, which are now being highlighted and made notably visible by the pandemic health crisis.

"The way people talk about data, they would lead people to believe that 'Oh, it's because they're Black [that they have a certain condition],' Goler Blount said. "Black women have 40 percent higher breast cancer mortality rates, and it's not because they're Black, it's the experience of being Black."

"Racism is the risk factor, and gender oppression is the risk factor."

Racism and gender oppression have significantly impacted the Black population in America when it comes to diabetes, according to Tracey Brown, the CEO of the American Diabetes Association. Brown, who has diabetes herself, says Black Americans and Hispanics are 50 percent more likely to have diabetes; she also says people of color are two and a half times more likely to die from diabetes.

"You can't talk about health in this country without talking about wealth wealth is health and you look at the number of people who are below the poverty line, 76 percent of those people are people of color," Brown said. "Genetics is a small portion of why people may have diabetes; the rest of the story is systemic racism and the social determinants of health."

"What we have to help people understand is we've got to attack these systems, these policies, these procedures if we want to seriously start to talk about changing health outcomes for people of color in this country."

Angela Williams, the CEO of Easterseals, a nonprofit that provides services for people with disabilities and their families, is advocating to improve Black disabled Americans' lives.

Black people with disabilities face higher rates of police violence and find themselves disproportionately impacted by the school-to-prison pipeline. Black children with disabilities often have their behaviors interpreted as aggressive and violent instead of a disability diagnosis. They also have a more challenging time getting access to much-needed early-intervention and services.

"What I want people to know is that we need to raise awareness, that this is, in fact, an American issue that must be addressed," Williams said. "Secondly, research institutions, corporations, and foundations must partner with organizations like Easterseals to solve these problems."

The American Diabetes Association, March of Dimes, The Black Women's Health Imperative, and Easterseals are all working towards changing policy and legislation at a federal level to improve Black Americans' lives and health.

At the Black Women's Health Imperative, they fund chronic disease prevention work across the country. They are working on policy with the Congressional Black Caucus and The Caucus on Black Women and Girls. They have also implemented anti-bias training for obstetric providers.

March of Dimes is instituting programs to reach moms at their homes through telehealth. They, too, created an implicit bias training program for healthcare providers and launched #BlanketChange, to demand policymakers, candidates for office, and community leaders take immediate action to fight for the health of all moms and babies.

The American Diabetes Association and Easterseals have advocated for change and improvements to Black Americans' healthcare through conversations with policymakers and spreading awareness on social media.

Meanwhile, Fleming, the woman from Detroit with diabetes, improved her health through the program at Black Women's Health Imperative. Today, she eats healthier and even walks three to five miles a day.

Carol Fleming has improved her health thanks to the Black Women's Health Imperative.

She is proud of how far she's come as an individual but says that, to see real change and improve all Black Americans' lives and health, there needs to be a societal overhaul.

"Doctors don't always believe that we're the same as people that are not of color," Fleming said. "I had always thought it was my genes, and I inherited diabetes from my family, and there wasn't anything I could do about it."

"But if you have diabetes, if you have heart problems, if you're obese, it's not something you have to take."

"We can fix this disparity through education."

Link:
Four Black WomenAll CEOsHave Created A 'Call To Action' To Close The Health Gap For Black Americans - Forbes

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