Black Women’s Health: Crisis or Success Story? (Revisiting “Where have all the black men gone?”)

The other day, I posted excerpts from Jonathan Tilove's article, by the above title. The article is an important piece of journalism, which reports that there are 2 million more Black women than Black men in the US, pointing to a major crisis in Black men's health. Over at Cynthia's Interests, I came across information about Black women's health that one would not expect after reading Tilove's article.

After Tilove runs through the factors that contribute to such a low proportion of Black men to Black women—among young men, high homicide and AIDS rates and among older men, cardiovascular disease and cancer—he adds that another reason for the disparity in numbers is that Black women's health is improving:

In the March/April issue of Health Affairs, Dr. David Satcher, surgeon general under former President Bill Clinton and now the interim president of the Morehouse School of Medicine in Atlanta, exposes the core of the problem: Between 1960 and 2000, the disparity between mortality rates for black and white women narrowed while the disparity between the rates for black and white men grew wider.

But Cynthia picked up an article by Kendra Lee from Alternet (via Cyrus) that should cause serious alarm about Black women's health, too. Lee reports on a study that found that

from 1991 to 2000 they discovered that more than 800,000 African Americans died during that decade because they didn't receive the same health care as their white counterparts.

Based on the study, Lee observes that

Black women are in the vanguard of those receiving inferior health care, with greater incidence of and mortality from nearly every major disease, including diabetes, heart disease, HIV/AIDS, hypertension, and some forms of cancer:

* Diabetes rates have tripled among African Americans over the past three decades. Nearly 12 percent of black women over 20 and 25 percent of those over 55 have this condition.

* Forty percent of black women have high blood pressure.

* Black women are 69 percent more likely to have heart disease and heart attacks, and they have a 70 percent greater chance of dying of heart disease.

* Black women accounted for 69 percent of new HIV diagnoses from 2000 to 2003 and have a rate of HIV/AIDS infection that is 18 times higher than that of white women.

* Although cancer is the second-leading cause of death for all women, black women have the greatest number of deaths from cancer of the breast, colon, pancreas, and stomach.

I guess that if things really have gotten better in Black women's health, things are still bad enough that the data cited by former Surgeon General Satcher should not make us complacent. Either that or there is something funny going on with one or the other of these studies. Is there somebody more knowledgeable about public health in the house?

One last thing: In my original post about Tilove's article my title made the ironic suggestion that Black men need to watch their weight and I then referenced discussion at Alas, A Blog about the much trumpeted obesity public health "crisis." Because readers may not be familiar with the arguments against viewing obesity as a dire health problem, and because Cynthia amplifies Kendra Lee's assertions that obesity is a major factor in Black women's health issues, I would like make sure you have the link to Amp's posts in the fat, fat and more fat category. As a teaser and to make the basic point, I leave you with this excerpt from his most recent post along these lines:

That the CDC “fat crisis” studies don’t adjust for the effect of age on mortality is enough, by itself, to justify throwing them into the garbage. However, there are other reasons to doubt the CDC’s high obesity death counts.

The original 300,000 statistic wasn’t based on weight at all ; former Surgeon General C Everett Koop simply misrepresented a study of deaths associated with unhealthy eating and inactivity as being a study of deaths caused by obesity. (Outside the world of anti-fat hysteria, this is called “lying.”).

In the years since, studies have tried to match Dr. Koop’s lie, using what the editors of the New England Journal of Medicine describe as “weak or incomplete data.” In addition to the flaws described in the Scientific American article quoted above, the CDC’s high-fat-death studies failed to account for confounding factors like socio-economic status, discrimination, eating habits, history of yo-yo dieting, body shape, and activity levels - factors that haven’t been accounted for even in Flegal’s better-designed study. Accounting for these factors could easily lead to a massive reduction of the “obesity death count.”

I hope that makes the point well enough, though that isn't even the half of it. The whole long post is well worth your time.