Many concerns -- and some hope -- in health data on blacks in the region
This article first appeared in the St. Louis Beacon, Dec. 4, 2013 - Sherrill Jackson is a 21-year breast cancer survivor. Shermane Winters-Wofford is a two-time stroke victim. Isadore Wayne and Mellve Shahid are coping successfully with prostate cancer.
All four are known less for their adverse health experiences than for sending uplifting messages to black communities, dispelling myths about their illnesses and encouraging people to take advantage of medical screenings and other programs that can save lives.
Jackson is founder of the Breakfast Club, which educates the public about breast cancer and support services available to those coping with the disease. Winters-Wofford is one of a dozen people chosen last year to speak with community groups on behalf of the National Heart Association’s Go Red campaign against heart disease-related conditions, such as stroke, among women. Wayne and Shahid founded the Empowerment Network, which seeks to combat the high incidence of prostate cancer among black men in St. Louis.
Researchers credit some of the work by these and other individuals and community groups, along with institutional policies, for helping the region make progress in reducing death rates from three chronic medical conditions: diabetes, heart disease and cancer. Progress was measured by changes in death rates for the three conditions between 2000 and 2010, based on goals set by the federal Healthy People program.
Information on the changing death rates is contained in the last in a series of briefs from a report called “For the Sake of All,” funded by a grant from the Missouri Foundation for Health. Authors of this final brief are Bettina F. Drake, an assistant professor of surgery at the School of Medicine at Washington University; and Keith Elder, chair of the Department of Health Management and Policy at Saint Louis University.
The two scholars noted that blacks in the region are more likely to suffer from chronic diseases and related complications, but they also found a glimmer of hope in the data.
“The health of African Americans in St. Louis has improved over the last 10 years, but there is still much work to be done,” the researchers say, noting that the region and state had met the federal Healthy People benchmark of reducing the heart death rate by at least 20 percent between 2000 and 2010. The rate dropped by 24 percent each for blacks and whites in St. Louis, and it dipped more for blacks than for whites in St. Louis County and across Missouri.
While the region and state didn’t reach the Healthy People benchmarks for cancer and diabetes, the researchers pointed to the progress that blacks and whites did make. In at least one case, however, the black-white gap was striking. In St. Louis County, the diabetes death rate for whites was reduced by 36 percent between 2000 and 2010, compared to a reduction of only 3 percent for blacks.
Still, Elder, the scholar from SLU said, “I think that the numbers are quite encouraging. The goal was met for heart disease, and cancer is trending in the right direction.”
Drake, the other scholar, also noted that the region didn’t meet the benchmark on two of the diseases. But she says the death-rate reductions that did occur mean “something is happening. That’s why I say community-based activities are important.”
Community groups she praised included the Breakfast Club, which points women to resources such as mammograms, works with academic organizations to support medical research and spreads the word “about how breast cancer can be addressed through testing and screening.”
She also singled out the Empowerment Network, whose members “actually walk the streets and knock on doors and talk about prostate cancer and inform residents about the value of prostrate cancer screening. It’s not just about meetings. These organizations are very active. They are literally on the ground.”
Jackson, president and founder of the Breakfast Club, says the need never seems to end. She recalled that she was 46 when diagnosed with breast cancer. “But we have women in the Breakfast Club who are in their 20s and 30s. The thing that I am seeing is that younger African-American women are being diagnosed with specific types of breast cancer that are difficult to treat.”
A certified pediatric nurse practitioner, Jackson said she used to think there would be less of a need for groups like hers over time. “But even in 2013, there is still a lack of education. There are still women who are afraid to talk about breast cancer. There is still a lot of work to be done.”
The club evolved as a handful of women got together to talk about breast health. The meetings eventually morphed into one of the area’s most extensive support groups, having educated more than 12,000 people about breast health and provided support services to more than 500 breast cancer survivors.
While the Breakfast Club started in 1997, the Empowerment Network is much younger, beginning about six years ago through a meeting between Wayne and Shahid. It enjoys broad support, hosting about 60 events a year aimed at encouraging more men to make use of testing and screening for early detection of prostate cancer among men 35 and older.
Walter Prichard, who handles public relations work for the network, says black men pose a bigger challenge because, “We’d rather watch football games than go to the doctor. We take our health for granted, and don’t take our medications. But the Empowerment Network is spreading the message that knowledge can save your life. We are raising awareness through programs and resources.”
In addition to knocking on doors, participating in health fairs and hosting regular meetings, the network also reaches out to black men through a weekly radio program on WGNU 920 AM.
Winters-Wofford, the two-time stroke survivor, said recently that education continued to be important, adding that many unhealthy habits among blacks stem from culture. “We are not watching what we eat. We are not watching our exercise habits. I watched my grandmother cook with lard. If it didn’t have smoked jowls in it, I didn’t think it tasted good. Everything was deep fried. And it almost killed me. She tells audiences now that, “all we have to start doing now is taking little bitty steps to make lifestyle changes.”
Lots of work still needed
While praising the progress toward the Health People benchmarks, the brief by the scholars reinforce some of Winters-Wofford observations, noting that while people cannot do anything to change family history on diabetes, for example, there still are things they can do to help prevent this chronic disease. They point to research that says that one-third of all deaths nationally are due to three behaviors: smoking, lack of exercise and poor nutrition.
“Each of these can increase your risk of developing many chronic diseases,” according to the brief. The work ahead includes reversing the 46 percent obesity rate among African Americans in St. Louis County and the 37 percent obesity rate in St. Louis.
The scholars says it’s in the region’s interest to reduce chronic diseases for many reasons, including the impact of illnesses on the economy. In 2011 alone, the region’s cost for hospital care for diabetes, heart disease and cancer was $1.1 billion. Put another way, the report says the cost amounts to buying three Edward Jones Domes each year.
The report says the region should pay more attention to chronic disease prevention and management and invest in new or existing recreation centers, parks and places for exercise and play. That’s one reason the scholars point to the value of the construction of the O’Fallon Park Rec Complex operated under contract by the YWCA.
Other strategies, according to the report, should include luring grocery stores and other facilities that sell healthy foods into communities that are considered food deserts. In addition, the report advises that the region take health issues into account in decisions made by business leaders, policy makers, and community organizations.
Elder, the scholar from SLU, says the message he hopes people take from the report is that the document “informs us that what St. Louis city and county are doing is working. But we need to increase our effort, enhance what we are doing through community partnerships with hospitals and public health agencies and continue the effort through appropriate funding.”