On an overcast, humid morning, Antonice C. Woodfork grabs an umbrella and sets out from her home in a far-from-gentrified neighborhood in the District of Columbia and starts marching to the nearest grocery store, seven-tenths of a mile away.
Woodfork, 42, who is African-American, could take a bus with one transfer, but the buses don’t run as frequently in this part of town, in deep Northeast Washington, as they do downtown. That means it may take her as long as an hour to get there, so she starts moving. It’s not the safest neighborhood — her street is a couple of blocks from where, a week earlier, four masked gunmen jumped out of a car and opened fire. A 10-year-old girl, Makiyah Wilson, was fatally shot. Woodfork is accustomed to living with the specter of violence; she knows which streets to avoid. Besides, walking will do her good. At 5 feet 9 inches tall and just south of 300 pounds, Woodfork is obese, but she’s in much better shape than she was two years ago. That’s when Woodfork started consistently attending wellness classes offered by AmeriHealth Caritas District of Columbia, a Medicaid managed care organization serving nearly 120,000 members in the District. Medicaid is a nationwide federal and state health insurance program for low-income and poor people. Since she started attending wellness classes routinely, Woodfork has dropped a little more than 100 pounds.
Before dropping the weight, “I had to get on the big peoples’ scale,” Woodfork says, explaining that most scales in health care settings she went to topped out at about 350 pounds. “I hated getting on the big peoples’ scale. I was miserable.” Woodfork, who has four adult children, wants to lose another 30 or so pounds while managing an array of health challenges. She takes 10 medications daily: for her high blood pressure, for the arthritis in lower back, for her asthma and other chronic conditions. Walking assists her effort to lose weight, and it also helps her manage stress. That she has plenty of: In addition to the anxieties of paying the monthly rent on her three-bedroom home while unemployed, Woodfork is dealing with the recent deaths of her boyfriend and of a newborn grandchild. Her boyfriend died in late May after dealing with a host of chronic health conditions. Woodfork’s grandson, the child of her only daughter, died in early July, 10 days after he was born. An autopsy is pending, she says. Staying physically active helps shield her from feeling depressed. “When I get depressed, I just stay to myself and do nothing,” Woodfork says.
The multiple health challenges Woodfork faces are emblematic of the hurdles faced by millions of blacks nationwide. Among blacks ages 65 and older, deaths from cancer, heart disease and stroke have declined significantly since 1999, the Centers for Disease Control and Prevention reported in 2017. But among other age groups, health disparities for blacks persist. Even some high-earning blacks are more vulnerable than well-off whites to a host of chronic diseases because of their race, research suggests.
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Poor and working-class blacks like Woodfork are particularly at risk for troubling health outcomes, says Karen M. Dale, market president for AmeriHealth Caritas District of Columbia. People who live in distressed neighborhoods are more likely to focus on surviving day to day than on their health, says Dale, who’s also a registered nurse. The stress of dealing with racial discrimination can lead to chronic stress, which can put people at risk of numerous health problems, including anxiety, depression, digestive issues, headaches, heart disease, weight gain and memory and concentration impairment, according to the Mayo Clinic.
“It’s a vicious cycle,” Dale says. “Let’s take a hypothetical Miss Jones. She’s a low-income earner who lives in a poor neighborhood and has a chronic disease. Miss Jones needs to strategize how to improve her health and have the energy and focus to concentrate on her disease, but instead she’s putting out fires, figuring out how to pay this month’s rent or how to buy groceries for the week. Things get worse, and she feels worse, so she’s in this cycle of anxiety and depression. She starts to have symptoms of depression — she has difficulty falling asleep, starts waking up very early. Stomach problems set in. This is the body saying, ‘I can’t cope’ with all of this unrelenting stress,” Dale says. And, she notes, research has shown that stress can contribute to a multitude of chronic health problems, such as cardiovascular problems, obesity, hypertension, cancer and diabetes. “Our minds are not meant to be on such high alert all the time,” she says.
A raft of studies verify that, even before birth, U.S. blacks face a multitude of serious health problems:
— Non-Hispanic blacks have an infant mortality rate more than double that of non-Hispanic whites, according to the U.S. Department of Health and Human Services Office of Minority Health. In 2014, the infant mortality rate for non-Hispanic black infants was 11 per 1,000 births and 5 per 1,000 live births for non-Hispanic whites. The leading causes of infant death for non-Hispanic blacks were low birth weight; congenital malformations; maternal complications and sudden infant death syndrome. African-American mothers were more than twice as likely than non-Hispanic white moms to receive late or no prenatal care, according to the HHS.
— Large numbers of non-Hispanic black children have obesity, according to the National Institute of Diabetes and Digestive and Kidney Diseases. For non-Hispanic black kids between the ages of 6 and 11, the rate of obesity is 22 percent for girls and 21 percent for boys. Among African-Americans between the ages of 12 and 19, the obesity rates are 24 percent for girls and 21 percent for boys.
— The percentage of African-Americans with obesity doubles in adulthood, according to the NIDDK. Overall, 48 percent of non-Hispanic blacks are obese, and 12 percent are morbidly obese according to the NIDDK.
These and other negative health conditions aren’t exclusive to African-Americans who struggle to make ends meet. Research published in 2016 in the journal Preventive Medicine suggests that racial disparities exist even for blacks who earn a six-figure salary. The study found that for blacks and other racial and ethnic minorities who earned $175,000 annually, there were disparities compared to whites when it came to diabetes, hypertension, high cholesterol and self-reported excellent or very good health. “We do find health disparities even between highly affluent African-Americans and other groups such as white Americans,” says Thomas LaVeist, dean of the School of Public Health and Tropical Medicine at Tulane University in New Orleans.
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For moderate- to low-income blacks like Woodfork, the challenges of living a healthy lifestyle are particularly acute, says Kate Griffin, vice president of programs for Prosperity Now, a nonprofit that works through education and advocacy to help low-income people in the U.S., especially people of color, achieve financial security.
“Until we fix some of these underlying structural issues and develop healthy neighborhoods that offer easy access to fresh fruits and vegetables, quality jobs, affordable banking and financial services, and good health care, you’re never going to see those health disparities close in any significant way,” Griffin says.
As she heads to the grocery store, Woodfork is aware of her stress. She plans on going to therapy — which she says AmeriHealth Caritas will pay for — to help her deal with the trauma of losing her boyfriend and grandchild. At the store, she heads straight for the produce section, where she puts a container of freshly cut mango chunks into her cart. She praises the health benefits of cucumbers, which are low in calories and fat, and plucks two fresh ones. In the frozen foods section, she points to a package of broccoli cauliflower pasta with cheddar cheese. “I used to eat stuff like this all the time,” she says. One serving has 400 calories and accounts for 50 percent of the recommended daily allowance of saturated fat, according to the label.
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Woodfork walked to the store in 25 minutes, but it took an hour to get home. She catches the first bus right away, but has to wait about 45 minutes for her transfer. She’s been looking for work as a hair stylist and had one lead, but renting space at the salon and paying for transportation would cost $115 a week, which she couldn’t afford. Asked what one change in her life’s circumstance would help improve her health, Woodfork doesn’t hesitate to name the one thing that would relieve much of her stress. “A good job,” she says.
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How Being Black in America Is Bad for Your Health originally appeared on usnews.com
