Illnesses Affecting the Black Community

African descendants  are 1.8 times more likely to have diabetes as non Hispanic whites

One in four black women over 55 years of age has diabetes.

Maybe it’s your mother, grandmother, father, aunt, brother, sister or even a close friend. Studies have shown that diabetes is 33 percent more common among Blacks than Whites, and that the highest rates are among black women. It is extremely important to learn more about this very common illness. You can take steps now to either prevent the onset of diabetes or to better manage the illness if you have already have it.

What is Diabetes?

Diabetes, commonly referred to as "sugar diabetes," is a condition in which the body is unable to properly process the carbohydrates (sugars and starches) we eat. As you may know, diabetes is characterized by high levels of glucose (sugar) in the blood. Let’s take a moment to go over the basics of the problem before we go any further.

Normally, digestion converts the carbohydrates we eat into glucose in the bloodstream. The body responds to elevated glucose levels by releasing a hormone called insulin from the pancreas. Insulin is responsible for reducing the glucose level in the blood by transporting it to cells in the body where it is used for fuel. People with diabetes suffer from either a lack of insulin production or an inability to properly use the insulin that their body makes.

Diabetes can be associated with serious medical complications. Fortunately, there is a lot that people with diabetes can do to reduce the likelihood that major complications occur.

Types of Diabetes

There are 4 major types of diabetes.

• Type 1 (also called juvenile-onset diabetes or insulin dependent diabetes)
  
  Type I diabetes usually develops before age 20 and is caused by a lack of insulin production. A small number of black people (5-10% with diabetes) have Type I and this is treated with daily insulin injections.
• Type 2 (also called adult onset diabetes or non-insulin dependent diabetes)
  
  This type of diabetes usually develops in adults and is responsible for 90-95% of the diabetes in Black people. In Type II diabetes, the body produces inadequate amounts of insulin. Additionally, the insulin that is produced is not effectively utilized in the body.
• Pregnancy Associated Diabetes (Gestational Diabetes)
  This refers to patients who develop elevated blood glucose levels during pregnancy. Glucose levels usually return to normal following delivery, but these women have an increased risk for developing diabetes later in life. Gestational diabetes is 80 percent more common in Black people than Whites.
• Medication Induced
  People can sometimes develop elevated levels of glucose in the blood after taking certain medications like steroids such as Prednisone.

What are the Signs and Symptoms of Diabetes?

Increased glucose in the blood and in the urine leads to the classic symptoms of diabetes, which include:

• Frequent Urination
• Increased Thirst
• Increased Appetite
• Blurred Vision
• Weight Loss
• Extreme Hunger

Complications of Diabetes

Black people experience higher rates of complications from diabetes than do White people. Perhaps you know a family member or friend who has experienced kidney failure, eye disease, or even an amputation as a consequence of diabetes. By increasing your knowledge about diabetes, you will be able to take steps now that will decrease the likelihood that you will suffer from the complications of this disease.

• Blindness: Black people are almost 50% as likely to develop diabetic retinopathy compared to other populations.
• Kidney Disease: Black people are 2.6 to 5.6 times as likely to suffer from kidney disease with more than 4,000 new cases of End Stage Renal Disease (ESRD) each year.
• Amputations: Black people are 2.7 times as likely to suffer from lower-limb amputations.
• People with diabetes can develop a disease affecting the blood vessels of the eye called "Diabetic Retinopathy" which leads to impaired vision and ultimately blindness.
• Nerve Dysfunction: Many diabetics develop numbness, tingling and/or generalized decrease in sensation. Often, these symptoms begin in the feet and may migrate to other parts of the body. Careful attention is required to prevent the development of ulcers (especially in the feet).
• Atherosclerosis (Hardening of the Arteries): a disease of the arteries (blood vessels) that eventually leads to obstruction of blood flow. Atherosclerosis is more common in diabetics and this leads to increased rates of heart attacks, stroke, and poor circulation throughout the body.

How can you be tested for diabetes?

Diabetes can be easily diagnosed by measuring the amount of glucose (sugar) in a blood sample. There are a few different ways that this simple test is done (a lot depends on how recently you have eaten before the blood sample is drawn !) Your health care provider will be happy to give you further information.

Treatment Options

Type II Diabetes: In the early stages, patients can be treated by adhering to a diet low in sugar and by increasing exercise. Weight loss may increase the effectiveness of insulin, allowing for better glucose control. If diet and exercise cannot adequately control Type II diabetes, then oral medications can be prescribed. Finally, if the oral medications are not enough, insulin injections are required.

Type I Diabetes: As stated above, Type I diabetes has its onset in childhood and patients require insulin to maintain normal blood glucose levels.

Empowerment Points

1. You Can Make a Difference!

Healthy lifestyles are particularly important for people who are at increased risk for developing diabetes. The most common form of diabetes can often be prevented with weight control through healthy eating and participating in regular exercise such as walking, running, swimming or other aerobic activity.

2. Get Tested

If you are overweight, have a family history of diabetes, are over 40, have hypertension, increased cholesterol and/or have the classic symptoms of diabetes (increased thirst, increased urination, and blurred vision) you are at increased risk for diabetes and should be tested.

3. If You Have Already Been Diagnosed With Diabetes

It is imperative that you measure your blood glucose (sugar) on a daily basis. Studies show that aggressive management of diabetes greatly reduces your likelihood of suffering from the complications of this disease.

Also, remember to schedule regular examinations with your doctor. The examination should include:

• A yearly eye exam,
• Tests to evaluate your kidney function,
• An exam of your feet to look for changes in sensation or the development of skin lesions, infections or ulcers,
• Your blood pressure should be measured at every routine diabetes visit. If your systolic blood pressure is greater than 130 mmHg or your diastolic blood pressure is greater than 80 mmHg you should have blood pressure confirmed on a separate day, so schedule another appointment.

Also, you are encouraged to lose weight and eat more fruits and vegetables and less fattening foods. (Yes, you can do it!)

 

Facts about Alcohol Abuse

Alcohol abuse is a serious problem in many countries throughout the world. Those afflicted with alcoholism suffer from a variety of problems that negatively impact upon many aspects of their lives. It is estimated that between 9 to 13 million people suffer from alcohol abuse. The statistics are quite frightening. Alcohol is responsible for half the annual deaths due to automobile accidents, and for more than 70% of adolescent suicides (Landy, 1987).

Over time, alcohol abuse leads to a variety of serious health problems. These can include chronic liver disease, decreased sex hormone production, pancreatitis, kidney disease, and brain damage. Psychiatric problems include depression, paranoia, and low self-esteem. It is difficult for individuals with alcohol problems to be productive and many lose jobs or cannot be successful in their area of work. Perhaps the most devastating effects of chronic alcohol problems are the social problems which manifest directly from alcoholism: domestic violence, child abuse, marital conflict, deconstruction of the family and of community cohesion.

Alcoholism Defined

There is a difference between alcoholism and problem drinking. Alcoholics are bothphysically and psychologically dependent, while problem drinkers are psychologically dependent.

The physiological dependency can be seen in the high tolerance that drinkers develop - that is, the need to drink more and more to obtain the same effects. Research has shown that over time (with regular alcohol use) the body adjusts to having the chemical in its system. The body then becomes “normal” only with alcohol. The alcohol is required for basic functioning, and many alcoholics need a drink in the morning just to get out of bed.

The physical nature of alcoholism is also seen in compulsive behaviors (the inability to stop drinking once started). This is what is referred to as the “out of control” behaviors of the alcoholic.

One of the psychological aspects of dependency is the obsessive thoughts about drinking. Another is the use of alcohol to relieve tension and anxiety. Typically the heavy drinker has difficulty coping with negative feelings and discovers that alcohol relieves worry and distress. A pattern of drinking to ease daily tension and life problems escalates leading ultimately to physiological dependence. In this way, the problem drinker becomes an alcoholic.

Alcoholism and Black Women

Those at risk for developing alcohol addiction are individuals who experience a lot of stress in their lives, have difficulty coping, have easy access to alcohol, and are encouraged to drink by their social environment. Alcoholism is especially likely when individuals grow up with one or more alcoholic parents.

While the rates of alcoholism are relatively low amongst Black women, they do face the challenge of coping with the alcoholism of their male spouses. It is suggested that they may be affected by “codependency”, the tendency of family members to protect the alcoholic and take on alcoholic-like characteristics, such as denial, blaming, and rationalizing dysfunctional behaviors.

Black women must also be aware of some of the stresses and sources of depression unique to them which contribute to turning to alcohol as a coping mechanism. Causal factors of stress and depression for Black women often cited are racism, sexual exploitation, alienation from traditional African values (such as spirituality and community), and increasingly poor relationships between Black women and men.

Could You Be in Danger of Alcoholism?

If you or someone you know is questioning whether drinking habits are a problem, then it will be worthwhile to complete the test found below. How you answer the questions may give you the answers you seek.

Directions: Please take a few minutes to respond to the following questions by answering “yes” or “no.”

Yes	No
___	___	1. Do you occasionally drink heavily after a disappointment, a quarrel, or when the boss gives you a hard time?
___	___	2. When you have trouble or feel under pressure, do you always drink more heavily than usual?
___	___	3. Have you noticed that you are able to handle more liquor than you did when you were first drinking?
___	___	4. Did you ever wake up on the “morning after” and discover that you could not remember part of the evening before, even though your friends tell you that you did not “pass out?”
___	___	5. When drinking with other people, do you try to have a few extra drinks when others will not know it?
___	___	6. Are there certain occasions when you feel uncomfortable if alcohol is not available?
___	___	7. Have you recently noticed that when you begin drinking you are in more of a hurry to get the first drink than you used to be?
___	___	8. Do you sometimes feel a little guilty about your drinking?
___	___	9. Are you secretly irritated when your family or friends discuss your drinking?
___	___	10. Have you recently noticed an increase in the frequency of your memory “blackouts?”
___	___	11. Do you often find that you wish to continue drinking after your friends say that they have had enough?
___	___	12. Do you have a reason for the occasions when you drink heavy?
___	___	13. When you are sober, do you often regret things that you have done or said while drinking?
___	___	14. Have you tried switching brands or* following different plans for controlling your drinking?
___	___	15. Have you often failed to keep the promises that you have made to yourself about controlling or cutting down your drinking?
___	___	16. Have you ever tried to control your drinking by making a change in jobs, or moving to a new location?
___	___	17. Do you try to avoid family or close friends while you are drinking?
___	___	18. Are you having an increasing number of financial and work problems?
___	___	19. Do more people seem to be treating you unfairly without good reason?
___	___	20. Do you eat very little or irregularly when you are drinking?
___	___	21. Do you sometimes have the “shakes” in the morning and find that it helps to have a little drink?
___	___	22. Have you recently noticed that you cannot drink as much as you once did?
___	___	23. Do you sometimes stay drunk for several days at a time?
___	___	24. Do you sometimes feel very depressed and wonder whether life is worth living?
___	___	25. Sometimes after periods of drinking, do you see or hear things that are not there?
___	___	26. Do you get terribly frightened after you have been drinking heavily?

Scoring: Those who answer yes to any of these questions may have some symptoms of alcoholism and should seek help. Yes answers to several of the questions indicate these stages of alcoholism:

Questions 1-8: early stage

Questions 9-21: middle stage

Questions 22-26: beginning of the final stage.
_________________

Source: From the brochure, What are the Signs of Alcoholism? Published by the National Council of Alcoholism.

Seeking Help

Treating the alcoholic woman requires an understanding of the complex nature of her problem. For one thing, alcoholics are in need psychological healing. This includes developing a better self-understanding, increased “emotion regulation” skills, and improved impulse control. Given the obstacles every African American woman must face, adequate coping skills are critical for prevention of alcohol problems. Positive social supports are needed as well.

Because the alcoholic often compromises her principles and morals due to her compulsive behavior, she can feel spiritually empty. The alcoholic drinker experiences feelings of guilt and shame due to her inability to keep promises to herself (and others) not to drink. In addition, because she has used alcohol to escape negative emotions, she may have failed to learn how to be responsible and may be emotionally immature. Most alcoholics tend to be in denial of their problem and blame and manipulate others to maintain their lifestyle and avoid consequences of their drinking.

 

At the beginning of the 21st Century black women find themselves achieving new heights and reaching new milestones. Education and hard work has enabled them to achieve successful careers and respect in mainstream society. Despite this good news, Black women still find themselves lagging behind Whites and other women in health and mental health indices. For example, the depression rate among black women is estimated to be almost 50% higher than that of Caucasian women.

Black people account for a large % of the mental health needs in this country and to  make matters worse, only 2% of the nation’s psychologists are Black.

The rates of mental health problems are higher than average for Black women because of psychological factors that result directly from their experience as Black Americans. These experiences include racism, cultural alienation, and violence and sexual exploitation.

Attitudes Toward Mental Health

It has historically been difficult to treat mental health problems in black women. One reason for this is that Black women tend to minimize the serious nature of their problems. Many believe their symptoms are “just the blues” and are not proactive in changing their condition. There also exists a stigma placed on mental health problems within the black culture that they are a sign of personal weakness, not a sickness.

Black Women and the Mental Health Profession

Black women tend to rely on supports other than mental health services. There is a strong reliance on community, the support of family, and the religious community during periods of emotional distress. Black women seek mental health care less than White women; and, when they do seek it, do so later in life and at later stages of their illness. Part of the explanation for this is the poor service they often receive from mental health professionals who, historically, have consistently under-diagnosed disorders like depression and over-diagnosed disorders like schizophrenia in the black community. In addition, because of socioeconomic factors Black women have limited access to health care compared to Whites.

The Importance of Black Psychology

Black Psychology is the study of the psychological functioning of Black people. Some of the exciting and important research Black psychologists are doing today includes studying the importance of racial identity as a protective factor against depression and stress, studying the detrimental effects of racism and evaluating the effects of the media on the Black psyche. Other research includes the evaluation of therapies appropriate for people of African descent, and the implementation of prevention programs for inner-city youth.

African American women are among the originators of important Black psychology concepts. Psychologist Dr. Linda James Myers is well known in the field for her contribution of “Optimal Psychology.” This emphasizes achieving maximum mental health through three main concepts: 1) holistic-spiritual unity; 2) communalism; and 3) proper consciousness. It assumes that reality is spiritual and material at once an idea congruent with traditional African healing (Myers, 1991).

Dr. Francis Cress-Welsing is a well-known psychiatrist who provides insights into the processes by which African Americans are made to feel inferior. According to Dr. Cress-Welsing (1991) these include cultural beliefs such as women and Blacks being inferior, media images which suggest that the closer to White skin and hair texture, the more attractive one is, and 3) education and miseducation in the school systems which train youth to believe that there are no significant Black contributions to religion, technology, art, and other aspects of civilization.

Among the first Blacks in the U.S. to receive doctorate degrees in psychology, Dr. Mamie Clark and her husband Dr. Kenneth Clark, in the 1930s asked how growing up in an environment of racism affected the psyche of Black children. They found that Black children typically identified White dolls as desirable and Black dolls as ugly. These same children also stated that they resembled the undesirable Black dolls. This provided clear evidence that the racist environment of Black children negatively affected their self-esteem. Their research was instrumental in the landmark 1954 Brown vs. Board of Education Supreme Court decision effectively overturning legal racial segregation in U.S. schools.

How to Improve Mental Health

To improve ones mental health, Black psychologists and other mental health professionals agree that spirituality is a necessary concept in healing. Emphasizing spirituality creates attitudes that embrace hope and positivity. Some keys to optimal mental health include:

Know Thyself. A healthy identity is critical for overall good mental health. For women of African descent, this means seeing themselves as the recipients of generations of collective wisdom and experience from African and African American culture.

Use Social Supports. Using social networks found in the family, neighborhood, church, mosque, temple and community is how Black women seek healing through others with similar experiences. Currently, many independent support groups for Black women are being created around the country.

Build Self-Confidence. This comes from action. Those who put forth effort to achieve their positive ambitions must overcome fear and work hard. Regardless of how successful we are in the end, it is our determination and sense of control that gives us confidence in self.

Recognize Symptoms. No two people experience mental disorders in the same manner. Symptoms will vary in severity and duration among different people. For example, while feelings of worthlessness is a common symptom of depression in White women, changes in appetite is cited as a common sign of depression for Black women.

Develop an Attitude of Optimism. Those who think positively are greatly immune to the stress and feelings of depression common in everyday life.

An Ounce of Prevention is Worth a Pound of Cure. Maintain a good health especially when not sick. Most illnesses of the mind can be prevented by following the above daily so always practice being hopeful, forgiving others, and resisting stress.

 

WOMEN AND FIBROIDS

What are Fibroids?

Fibroids are growths (tumors) that develop from the smooth muscle layer of the uterus. They are the most common growths of the uterus and female pelvic organs. One study found that approximately 50% of women have them. Most often they are benign. Very rarely they can become cancerous (less than 0.5% of the time).

The growth of fibroids is dependent on estrogen production. This is the reason why fibroids have the potential to enlarge during pregnancy (when increased levels of estrogen are present) as well as to regress after menopause (when there is decreased levels of estrogen). They can be multiple or exist as a single large growth. They can be located on the surface of the uterus, in the wall of the uterus, or in the uterine cavity.

Most fibroids do not cause any symptoms and many women are unaware that they have them. When they do cause symptoms, it ranges from abnormal bleeding to pelvic pressure.

* * * * *

Fibroids in black women

Fibroids are more common in black women than in women of other racial groups. One study showed that fibroids are three times more common in Black women than in Caucasian women. Additionally, fibroids tend to be larger and occur at an earlier age in black people. It is unclear as to why such differences exists.

* * * * *

What are the signs and symptoms of fibroids?

What are the signs and symptoms of fibroids?

1. Abnormal menstrual cycle

	· Abnormally heavy menstrual bleeding.
	· Abnormally heavy menstrual periods that come more frequent than your normal cycle (less than every 28-30 days).

2. Pelvic pain/pressure

	· Painful menstrual periods.
	· Pain during or after sexual intercourse.
	· Pressure on the bladder which can cause frequent urination.
	· Acute or severe pelvic pain from twisting of the fibroid on its stalk, or from degeneration of the fibroid.

 

* * * * *

Complications of fibroids

The most common complication is heavy bleeding which can lead to anemia. The anemia can be so severe as to necessitate blood transfusions, and/or an emergency surgery such as a hysterectomy.

Very infrequently, fibroids may be a cause of infertility and/or pregnancy loss.

* * * * *

How can you be evaluated for fibroids?

Fibroids can be diagnosed during a physical exam by your doctor. He or she can often feel an enlarged, irregular uterus. Your doctor may use other tests (ultrasound, hysterogram) to help confirm the diagnosis, and/or to determine the best treatment option for you.

 

Lots more information to follow... please check back in a few days.

 

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