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Tackling Health Inequities for Black Women

By Tiffany Aquino

In spite of high quality infrastructure and healthcare, the U.S. still struggles with health disparities. Minority populations in the U.S. have a disproportionately greater chance of being uninsured, developing chronic diseases such as diabetes and heart disease, as well as infections from diseases such as HIV and Tuberculosis.[1][2]   Even more astonishing is the enormity of some of these gaps. According to the CDC, the infant mortality rate for non-Hispanic Black women in the U.S. is 2.4 times what it is for non-Hispanic white women.[3]  Black women are nearly four times more likely to die from pregnancy related complications than white women.[4] Black Americans also continue to have a shorter life expectancy by an average of 5 years.[5]

Many are working in the trenches, tackling health inequities on a variety of fronts - from health education and health care access programs, to lobbying for policy changes to be based upon data which reflects the true diversity of our country. One such organization is the Black Women's Health Imperative (BWHI). Ms. Linda Goler Blount, BWHI’s President and Chief Executive Officer, recently opened up about BWHI and her work in health equity. We are excited to share insights gained from Ms. Goler Blount, whose example gives hope for the future, through tools and tangible steps towards our shared goal of tackling disparities in women’s health.

Tiffany (T): Thank you so much for sharing your story with Ova Woman today! Here at Ova Woman, we are passionate about creating a platform for women's intimate health stories to be discussed and taboos to be broken down. Through this, we hope to also tackle disparities in women's health, so we are thrilled to connect with you about the Black Women's Health Imperative (BWHI) and the important work you and your team are doing around women's health. 

To kick us off, can you tell us a bit more about BWHI’s core initiatives? What role does BWHI play in the greater healthcare system?

Ms. Goler Blount (GB): “The Black Women's Health Imperative is the only national organization dedicated to the health and wellness of the nation's 21 million Black women and girls. Some of our core initiatives include My Sister's Keeper, an advocacy and leadership-building initiative for women at Historically Black Colleges and Universities; Change Your Lifestyle. Change Your Life, our diabetes prevention program - for both women and men; and Let's Talk About PrEP, our HIV prevention initiative. We also do advocacy and mobilize and engage individuals and organizations around reproductive justice, breast health and other women's health issues. 

One of the things I'm most excited about is IndexUS, the first comparative index of Black women's health based on healthy Black women. We created the Index as the new evidence base for achieving health equity. It translates 20 years of research from the Black Women's Health Study into the business case for investing in the health and wellness of Black women. We will have a grand reveal of the index later this year.
Our role in the greater healthcare system is to make sure health care providers, researchers and organizations take into account the lived-experiences of Black women in their work - the physical and environmental factors that contribute to health inequities for Black women.”

T: Can you share with us the BWHI origin story? What was the context for the founding of BWHI and how has the organization changed over time?

GB: “Health care activist and MacArthur Genius Grant winner, Byllye Avery, founded our organization after she brought 2,000 Black women to Spelman College in 1983 to talk about our health and the importance of self-care. It was originally called the National Black Women's Health Project, but the name was changed to the Imperative to reinforce the need to move beyond merely documenting the health inequities that exist for Black women and to focus on actionable steps to eliminate them. The primary focus of the organization - ensuring the health and wellness of Black women and girls - has remained the same over our 33 years.”

T: What was your path to BWHI and what keeps you motivated?

GB: “My path to the Imperative was a bit of a zigzag but ultimately made perfect sense. I began in public health at the US Centers for Disease Control and Prevention focused on HIV/AIDS. From there I left the country to live and work in the Caribbean and South Africa, Zimbabwe and Malawi. I took a slight detour to work for the Coca-Cola Company and then returned to health as the first ever National VP of Health Disparities of the American Cancer Society and then to run programs for the United Way of Greater Atlanta. What I learned was we in public health do a lousy job of communicating health. At the Imperative, we know how important it is to go to where women are, we don’t make them come to us.

What keeps me up at night and what gets me up in the morning is the working mother who decides to join a lifestyle change class after discovering she was at risk for diabetes. I am motivated by the woman more at peace with her finances, because she attended a webinar on money management.

I am motivated by the tweet from one woman to another about facing breast cancer. I am motivated by the late night phone call from one board member to another about how to translate 20 years of data on healthy Black women into policy.
I am motivated by our grandmothers, daughters, sisters and mothers gathering for a conversation about living longer and being healthy.”

T: What do you think are the big levers of change around black women's health?

GB: “Black women suffer from misperceptions about how they view themselves and their health. This affects what kind of information is made available, what kinds of services and treatment options are offered and what kinds of advancement opportunities are offered. Research, clinical practice, social and economic programs must take into consideration the lived-experiences of Black women. We make changes to screening mammography guidelines based on studies that don’t include any Black women and don’t take into account the differences in breast cancer between Black women and other women. Reproductive health policies are implemented that ignore the reality of what it means to be Black in this society.

When we fund research, practice medicine and frame policy in the context of what we know about the experience of Black women, then we will come to value them and see them for who they really are: inherently strong, resilient and passionate about our health. And the Black Women’s Health Imperative is committed to doing everything we can so Black women live longer, healthier more prosperous lives.”

T: What progress have you seen over the last decade that gives you hope?

GB: “Fortunately, there has been progress. Black women lead all women in employment even among those with children. We are granted the majority of advanced degrees which bodes well for employment. Black women are entrepreneurial. According to the latest American Express report, the rate of new business startups is highest among Black women. And, we’ve seen some improvement in our health. For example mortality rates from breast and cervical cancer have dropped in the past 10 years. Also, Black women have become keenly aware of their political power. The presidential elections of 2008 and 2012 have demonstrated the collective power that Black women have to advance a social, economic and political agenda. The Black Women’s Health Imperative has been at the forefront to ensure women understand the connection between policy and their health. We helped women vote like our health was at stake.

But we have a long way to go.”
T: What do you feel is the biggest challenge ahead in the next 10 years for black women's health?

GB: “Inequalities in access to quality health care and information mean that Black women don’t have the tools at their disposal to make the best health care decisions for themselves and their families. Provider bias has been well documented and shown to increase morbidity and mortality from preventable diseases. Each year 18,000 Black women die due to inequalities in health care.

The lack of pay equity means that Black women earn on average 62 cents for every dollar earned by white men. Our program Access.Coverage.Action helps women not only understand what health insurance is, but also how to use it. And, it connects health insurance to financial stability to help women avoid the leading cause of bankruptcy – medical expenses.

We must continue to advocate for equal pay, paid family leave and child care if women are to have the resources to care for themselves and their families. When we eliminate inequities in income and wealth, then we can eliminate inequalities in health outcomes.”

T: How can individuals and other organizations support the work of BWHI?

GB: “You can support our work in several ways. One of the easiest is to follow us on social media (Facebook, Twitter and LinkedIn) and share our content. Subscribe to, and share, our blog. If you have your own health story that can put a face on our work, you can help by allowing us to share your story. Connect us with like-minded organizations in your community. Those are just a few possibilities. If you want to support us in another way, simply email us at imperative@bwhi.org. And of course, you can also make a one-time or recurring donation. No amount is too small.”

We are grateful for your time and are honored to share this information with our audience.
We look forward to further solutions oriented conversations within the Ova community about the disparities in women’s health. We would love to hear from you about your experience with the healthcare system. Comment below or connect with us here.

[1] http://www.cdc.gov/nchhstp/healthdisparities/

[2] http://www.cdc.gov/mmwr/preview/ind2013_su.html#HealthDisparities2013

[3] http://www.cdc.gov/nchs/data/databriefs/db74.htm

[4] http://www.cdc.gov/reproductivehealth/maternalinfanthealth/pmss.html

[5] http://www.cdc.gov/mmwr/preview/ind2013_su.html#HealthDisparities2013

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