Black health issues

When Maternity Wards in Black Neighborhoods Disappear

Experts fear that closures will become a trend nationwide because of the covid-19 virus, devastating an already vulnerable population

Dr. Joi Bradshaw-Terrell provides obstetric care to the majority-black population in Chicago’s Englewood neighborhood, where three nearby maternity wards have shut down in the past year.
Dr. Joi Bradshaw-Terrell provides obstetric care to the majority-black population in Chicago’s Englewood neighborhood, where three nearby maternity wards have shut down in the past year. Credit…Joshua Lott for The New York Times

By Kelly GlassMay 5, 2020

Shamya Bland had both of her children at St. Bernard Hospital in the Englewood neighborhood on the South Side of Chicago. When she found out the hospital would stop delivering babies until further notice “to respond more effectively to the increase in patients who are sick with the Covid-19 coronavirus,” according to an announcement issued on its Facebook page, she was devastated. “It’s heartbreaking,” she said. “It’s in the heart of the hood. Most black people in the neighborhood were going to go there.”

Englewood, which is 95 percent black, is slowly becoming a maternity-care desert, with two other nearby hospitals closing their maternity wards within the past year. St. Bernard Hospital has coordinated transporting women in labor to Mercy Hospital, about six miles north, according to St. Bernard’s media relations representative David Rudd, but transportation is not the main concern for doctors and patients in the neighborhood.

Research has shown that black patients receive better care and communication when they see black doctors. Official statistics weren’t available, but St. Bernard boasts a racially diverse care team, according to staff members like Dr. Joi Bradshaw-Terrell, M.D., an OB-GYN. “There’s a trust factor,” Dr. Bradshaw-Terrell said. “We have black men and women taking care of you. We got you.”

Black women in America are three times more likely to die of pregnancy- and childbirth-related causes than white women are, according to the Centers for Disease Control and Prevention. In Chicago, that tragic disparity doubles, with black women six times more likely than white women to die because of pregnancy and childbirth and even more experiencing injury or trauma.

Bland, 24, came back to Chicago to give birth after moving more than two hours west to a town near the border of Iowa, seeking a doctor she could trust. “I was five months pregnant and having heart palpitations. I knew something wasn’t right, and my doctor kept telling me it was fine,” she said. He told her it was her weight and her heart “pumping for two.”

Bland drove to St. Bernard Hospital to see a black doctor, who quickly ordered EKGs and a CT scan and told her she had a heart condition — the leading cause of maternal death. “I was out there with new doctors and new faces, and I was kind of getting blown off,” she said. “But here I got taken care of and treated as if I actually mattered.”

Her story could have ended differently, and she’s concerned for the fate of the women in Chicago’s South Side neighborhood whose birth stories will soon unfold in a different hospital than they originally planned. Dr. Bradshaw-Terrell shares that concern.

“It’s a big disadvantage to our population in Englewood,” she said. “Black women have more pre-eclampsia, more hypertension, gestational diabetes. People here are high-risk, and to feel like you have abandoned them is a horrible feeling.”

A 2019 study, among others, found that patient outcomes are better when hospitals not only understand but also focus on the experiences of the communities and populations they serve as part of the care they give. Racial bias in health care and consequently black people’s distrust of the health care system are well documented. Hospitals in black communities that employ black doctors and health care workers combat this by reimagining health care to fit the needs of their population, Dr. Bradshaw-Terrell said.

“Half of the time I’m basically a social worker and a psychologist. If you don’t have water at home, I’ll bring you a case of water,” she said. “I don’t have to do that, but these are real-life issues.”

Disregarding the importance of race, poverty, gender and other social factors on health outcomes makes it all too easy for institutions to prioritize the financial bottom line over saving lives, say those who track the connection between race and health outcomes.

Andre Perry, a fellow in the Metropolitan Policy Program at the Brookings Institution think tank and author of “Know Your Price: Valuing Black Lives and Property in America’s Black Cities,”said that as the coronavirus pandemic moves the United States into an economic downturn, cities and states will start looking to cut budgets.

“They’ll create austerity measures,” Perry said. “Oftentimes that means shutting down resources or assets in the black community. Black people and our assets are sort of like sacrificial lambs of this virus.”

Budget-driven closures of both urban and rural hospitals have plagued communities nationwide over the past decade. Since 2010, nearly 130 rural hospitals have closed, leading to an increase in births without proper obstetric care and preterm births in rural areas.

Dr. Laurie Zephyrin, M.D., vice president of delivery system reform at the Commonwealth Fund, an independent health care research foundation, said inner-city hospitals and safety-net hospitals (which see patients regardless of financial or insurance status) tend to run on tight operating margins, putting some of their health care services at risk. “When it becomes about funding and it becomes a budget issue, they forget about the people we’re trying to serve,” Dr. Zephyrin said.

It’s the people — the black women living in neighborhoods marked by poverty, violence and the chronic stress they both cause — that Dr. Bradshaw-Terrell worries about most. “I have a lot of patients say if they wanted to deliver at another hospital, they would have gotten care there. They trust me. They know we’re going to take care of them, and now we can’t,” she said, expressing concern that some patients might skip out on prenatal appointments altogether and show up at an unfamiliar hospital while in labor.

READ MORE AT: https://www.nytimes.com/2020/05/05/parenting/coronavirus-black-maternal-mortality.html

THE DEATH MARCH OF BLACK LIFE CONTINUES

“Pain is God’s megaphone to rouse a deaf world.”
C. S. Lewis

Curtis Marshall, Terence Ray, and Alfonzo Watkins using their professional experience working in government and with the community, will provide insight relating to the DEATH MARCH OF BLACK LIFE on tonight’s edition 4/28/20 of The Black Reality Think Tank.

The program host is Dr. William Rogers.

The African American Community and the Corona Virus-19

The Black Reality Think Tank’s conversation tonight is with an esteemed elder and “Queen Mother” who is also a brilliant and gifted medical doctor. Dr. Janine James will provide our listeners with an in-depth analysis of this deadly virus and its impact on the African American community.

Time for an Awakening with Bro. Elliott Friday 3-20-20 guest ” Minister of Wellness” Nathaniel Jordan

The “Minister of Wellness” Nathaniel Jordan joined us, discussed ways to fight off COVID-19 by building your immune system, and other valuable health information. Information, insights and dialogue from a Black Perspective.

Time for an Awakening with Bro. Elliott, Sunday 3-15-20 Covid-19 Outbreak

A rare Sunday Open Forum with the listeners on the Covid-19 Outbreak and it’s effects on the Black community nationwide. Information, insights and dialogue from a Black Perspective.

Time for an Awakening with Bro.Elliott 7-20-2014 guest Dr. Tyrone Hayes

“Time for an Awakening” program on 7-20-2014, our guest was Professor of Integrative Biology at University of California, Berkeley, Lecturer, Environmental Activist Dr. Tyrone Hayes. Dr. Hayes joined us to discuss his research that the widely used herbicide atrazine is an endocrine disruptor that demasculinizes and feminizes male frogs. The Dr. analyzes the question “COULD THE WIDELY USED PESTICIDE ATRAZINE, THAT HAS BEEN PROVEN TO CAUSE SEXUAL ABNORMALITIES IN AMPHIBIANS AND RATS BE DOING THE SAME THING IN HUMANS?”

Pentagon Admitted to Using Black Soldiers as Human Guinea Pigs in WWII

By David Love – June 24, 2015

Pentagon Guinea pigs

Black enlisted men were used as human guinea pigs in chemical experiments during World War II—not by Nazi Germany, but by Uncle Sam.

As was reported by NPR, 60,000 American soldiers were enrolled in a secret chemical weapons testing program in which they were exposed to mustard gas and the chemical agent lewisite, which causes lung irritation and blisters. Moreover, the U.S. Department of Defense conducted the tests based on the race of the soldiers. Black, Japanese-American and Puerto Rican soldiers were locked in a gas chamber and exposed to the chemicals. White soldiers were used as the control group.

“They said we were being tested to see what effect these gases would have on Black skins,” said Rollins Edwards, 93, of Summerville, S.C. “You had no choice. You did not know where you were going. They didn’t tell you anything.”

Edwards says his skin still falls off in flakes as a result of the testing. For years, the World War II veteran carried around a jar full of flakes to convince people that something had happened to him.

Although the Pentagon had admitted as early as 1991 that the Army tested mustard gas on enlisted soldiers during World War II—and the experiment program was officially declassified in 1993—news about the racial targeting of soldiers was kept under wraps until recently.

This revelation that the Army tested chemical weapons on soldiers of color is both troubling and an outrage, but the concept of Black people being used in medical and other experiments is by no means a new phenomenon. There are numerous examples of Black people being used as guinea pigs in unethical medical experiments. Perhaps the most well-known example is the Tuskegee experiment, in which the Tuskegee Institute and the U.S. Public Health Service studied the natural progression of syphilis in 600 Black men, who were never notified of their condition and were not treated. The tests, which began in 1932, did not end until news reports exposed the inhumane and racist practice in 1972.

But there are other cases beyond Tuskegee. For example, in the early 1800s, Sara Baartman, or “Hottentot Venus,” one of two KhoiKhoi women made into freak show attractions in Europe, was subjected to medical experiments. And modern gynecology was the result of torturous gynecological experiments that J. Marion Sims performed on enslaved women without anesthesia.

Rollins Edwards, who lives in Summerville, S.C., shows one of his many scars from exposure to mustard gas in World War II military experiments. More than 70 years after the exposure, his skin still falls off in flakes. For years, he carried around a jar full of the flakes to try to convince people of what happened to him. Source: AMELIA PHILLIPS HALE FOR NPR
Rollins Edwards, who lives in Summerville, S.C., shows one of his many scars from exposure to mustard gas in World War II military experiments. More than 70 years after the exposure, his skin still falls off in flakes. For years, he carried around a jar full of the flakes to try to convince people of what happened to him. Source: AMELIA PHILLIPS HALE FOR NPR

At the turn of the century, the U.S. Public Health Service conducted experiments on Black prisoners suffering from pellagra, which is a B-13 or niacin deficiency leading to sensitivity to sunlight skin lesions, dementia and death. In 1945, 53-year-old truck driver, Ebb Cabe, was injected with plutonium by the U.S. Atomic Agency after he was taken to the hospital and kept there for six months following a car accident. Cabe received 40 times the amount of plutonium—the key ingredient for a nuclear bomb—a typical person is exposed to over the course of a lifetime. He died eight years later of heart failure.

During the 1950s, the CIA and the U.S. military released half a million mosquitoes with yellow and dengue fever into Black Florida communities, leading to multiple illnesses and deaths. The government wanted to assess the use of mosquitoes as military weapons. Also in that decade, Henrietta Lacks became the first test subject on cloning, without her knowledge or permission, with 20 tons of her cells grown since her death.

During the 1950s and 1960s, poor Black St. Louis neighborhoods were used in Cold War experiments in which the Army, using aerosol blowers mounted on vehicles and rooftops, sprayed a radiation-laced toxin called zinc cadmium sulfide, a fluorescent powder. Thousands likely inhaled the toxins.

In the 1990s, children in Los Angeles were injected with an experimental measles vaccine unapproved by the FDA, and one which had developed a bad reputation for increasing high death rates in Haiti, Guinea Bissau and Senegal.

Between 2006 and 2010, 148 female prisoners in two California prisons—the majority Black and Latino— were sterilized without their consent. Meanwhile, Israel subjected African immigrant women to mandatory contraceptive injections of Depo-Provera, leading to a 20 percent birth rate decline for Ethiopian Israelis.

In 2000, federally funded researchers placed sludge from a sewage treatment plant on lawns and vacant lots in Baltimore and East St. Louis. The communities were told the toxic waste was safe. And in 2012, at least 500 children in Chad were given MenAfriVac—whose side effects include convulsions and paralysis— without notification or parental consent.

Rollins Edwards as a young soldier in 1945 at Clark Air Base in the Philippines. Source: AMELIA PHILLIPS HALE FOR NPR
Rollins Edwards as a young soldier in 1945 at Clark Air Base in the Philippines. Source: AMELIA PHILLIPS HALE FOR NPR

In addition, the CDC hid evidence that Black babies had more than triple the chance of developing autism if they were given an experimental measles vaccine before the age of three.

For years, the Black community has warned of conspiracies against their communities, and were told they were neurotic and imagining things. But as the latest news from the Pentagon shows us, these conspiracies are not theories but reality.

The Secret to Keeping Black Men Healthy? Maybe Black Doctors

In an intriguing study, black patients were far more likely to agree to certain health tests if they discussed them with a black male doctor.

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Dr. ChaRandle Jordan was one of the doctors who participated in the study. “It’s something they don’t teach you in medical school — taking that extra step because you appreciate there have been barriers in the past,” he said. 

Black men have the lowest life expectancy of any ethnic group in the United States. Much of the gap is explained by greater rates of chronic illnesses such as diabetes and heart disease, which afflict poor and poorly educated black men in particular.

But why is that? Lack of insurance? Lack of access to health care?

Now, a group of researchers in California has demonstrated that another powerful force may be at work: a lack of black physicians.

In the study, black men seeing black male doctors were much more likely to agree to certain preventive measures than were black men seeing doctors who were white or Asian.

Although 13 percent of the population is black in the United States, just 4 percent of doctors are black.

The study, published in June by the National Bureau for Economic Research, involved 702 black men in Oakland, Calif., who came to a clinic for a free health screening. They were randomly assigned to a black male doctor or one who was white or Asian.

Neither the men nor the doctors knew that the purpose of the study was to ask if a doctor’s race mattered when he or she advised these patients. As it turned out, the racial effects were not subtle.

Diabetes screening was part of the health check, and 63 percent of the black men assigned to a black doctor agreed to the screening. But just 43 percent of those assigned to a doctor who was white or Asian consented to be screened.

Some 62 percent of black men with a black doctor agreed to cholesterol tests, compared to 36 percent assigned to a doctor who was not black.

“If their first reaction is, ‘No, I’m not interested in that,’ you must explore why they said no and address those concerns.”

Dr. ChaRandle Jordan


Previous studies have been observational — mostly searching earlier data for trends, a substantially weaker form of evidence — and their results mixed.

“It changed the way I think,” said Jonathan Skinner, a health care economist at Dartmouth College, about the new results. “This study convinced me that the effects are real.”

The researchers employed minority premedical students to recruit participants by visiting 20 barbershops and two flea markets in Oakland, offering black men vouchers for a free health screening.

The screening was at a clinic set up by the investigators and staffed by 14 black and nonblack doctors. The men were offered preventive measures like flu shots and screenings for blood pressure, cholesterol and diabetes.

The men who came to the clinic offered equal praise for their black, white and Asian doctors. But the patients were far more likely to consent to preventive care — screenings and vaccinations — when their doctor was also black.

If black patients were to agree to this preventive care at these rates in the real world, the gap in cardiovascular mortality between black men and the rest of the population could be reduced by 20 percent, the researchers estimated.

“I don’t think I have ever had such a strong result, so unambiguous,” said Dr. Marcella Alsan, an associate professor of medicine at Stanford University and an author of the study.

Why would black doctors have such an effect? Perhaps they used more nonverbal cues to communicate empathy, said Dr. Amber E. Barnato, a professor of medicine and health care delivery at Dartmouth College.

In another small study, she used black and white actors to study white doctors’ interactions with patients at the end of life. Although the doctors said similar things to both black and white actors posing as patients, they stood closer to the white patients, made more eye contact, and touched them more often.

In the new study, Dr. Alsan and her colleagues did not record patient visits. But some hints of the differences could be seen in comments the patients and doctors wrote in evaluations of their experiences.

The white and Asian doctors often wrote comments like “weight loss,” “tb test” and “anxiety” — cryptic notations that referred to medical recommendations.

The black doctors often left more personal notes, like “needs food, shelter, clothing, job, ‘flu shot makes you sick,’ he got one.” And “subject yelled at me but then agreed to get flu shot because I recommended it.” And “made patient laugh.”

Black men who saw white doctors wrote comments like, “It was a great and fast experience, doctor was great as well.” And “very informative, very appreciated.”

Those who saw black doctors wrote comments like, “The entire day made me feel very comfortable and relaxed” and “cool doctor” — comments that described an emotional response.

Bridging this racial divide is a fraught matter, noted Dr. Skinner.

“It doesn’t seem so controversial if a woman requests a woman physician,” he said. “If a black patient asks for a black doctor, it’s understandable, especially given this study. But what if a white patient asks for a white doctor?”

A white doctor in this study, who asked that his name be withheld because he has black patients, said he felt his interactions with those who came to the clinic were “normal, comfortable health care visits.” Still, he was not surprised to hear the study’s results.

“Anyone going to see a doctor will be nervous,” he said. “If you face discrimination regularly in life, you will go into a clinic with even more apprehensions. If you see a physician who is African-American, you will feel some relief.”

One of the black doctors who participated in the study, Dr. ChaRandle Jordan, noted that low-income black patients in Oakland tend to be guarded in the doctor’s office.

“When you go into the room, you have to ask them about themselves, establish a rapport with them,” he said. “If their first reaction is, ‘No, I’m not interested in that,’ you must explore why they said no and address those concerns.”

“They might say, ‘Each time my mother had it, she would get the flu,’” he said of patients considering flu shots. “You say, ‘How about you try it this time? I bet you won’t get the flu or it will be less severe.’ You are joking a little bit.”

“It’s something they don’t teach you in medical school — taking that extra step because you appreciate there have been barriers in the past,” Dr. Jordan added.

White doctors can reach out just as well, Dr. Jordan said, adding that a lot depends on how familiar a doctor is with black patients.

Could white doctors have more success with black patients if they carefully watched what black doctors do? “Maybe, maybe not,” said David Cutler, a professor of applied economics at Harvard University.

But now that the researchers showed that a doctor’s race can really matter to his or her patients, he said, the medical profession should take heed.

“The magnitude of the effect is so huge, how can you ignore it?” Dr. Cutler asked.

READ MORE AT: https://www.nytimes.com/2018/08/20/health/black-men-doctors.html

“Time for an Awakening” with Bro. Elliott 7/15/18 guest Dr. Carlton Payne

“Time For An Awakening” for Sunday 7/15/2018 at 7:00 PM, our guest was Psychotherapist, Author, Professor, Dr. Carlton Payne. The discussion centered around violence in the black community, and solutions to move our people forward.

Study shows hair care products targeted to black community contain harmful chemicals

Certain hair products — many of which are used on black girls from birth to help straighten their hair — have been linked to such health issues such as diabetes, cardiovascular disease and breast cancer.

Certain hair products — many of which are used on black girls from birth to help straighten their hair — have been linked to such health issues such as diabetes, cardiovascular disease and breast cancer.

 

Hair products that for years have been targeted at the African American community may be causing health problems for its customers.

Researchers at the Silent Spring Institute, working with epidemiologist Tamarra James-Todd at the Harvard T.H. Chan School of Public Health, measured the concentrations of chemicals in 18 of these products. What they found was that each product contained four to 30 types of chemicals.

Many of the products contained fragrances with phthalates, which have been linked to obesity and increased risk of diabetes, cardiovascular disease, pre-term birth, preeclampsia and gestational diabetes, says James-Todd.

James-Todd says that after Native Americans, black women have the highest prevalence of diabetes in the US. She says they also have the highest proportion of pre-term births and are more likely to be overweight or obese.

“When you’re thinking about a lot of these metabolic or reproductive health outcomes, it’s really important to consider why that might be occurring and not simply attribute it to, ‘Oh, there must be some inherent underlying genetic differences,’” she says.

James-Todd, who is African American, says women in the black community have for decades felt social and cultural pressures “regarding what is seen as beautiful, with straight long hair being kind of the stamp of beauty,” especially in Western culture.

“And so, people will do different things to try to adhere to that standard of beauty,” she says.

What the majority of the public does not know, she says, is that currently there are no laws that require personal care product companies to disclose all of the substances that are going into their products, due to trademark agreements. There is movement in the US Senate to enact the Personal Care Product and Safety Act, which would develop a protocol by which products are tested before being placed on store shelves.

“We’re completely relying on the companies to test for the safety of our products,” James-Todd says. “That seems like a conflict of interest. The company is trying to make a profit … [even though] the average consumer thinks that if it’s on the shelf, it’s safe.”

Seeing the connections

James-Todd became interested in the topic of what chemicals go into hair products while a master’s student at Boston University. She read about a study that compared a magazine advertisement for an anti-aging cream in Ladies’ Home Journal, a publication targeting white women, versus an ad for a placenta-based product  — sheep placenta has become a mainstay ingredient in lots of leave-in conditioners — in Essence magazine, which targets black women.

“I’d walk into a black hair supply or hair care store, and see placenta and just wonder, what exactly is that for? Why are people using that?” she says. “Around that same time, an issue of Time magazine had come out, querying why were girls starting their periods earlier and earlier. And somehow that just kind of clicked for me.”

Shortly thereafter, there was a large study done that reported that 60 percent of black girls had reached their period by age 12, compared to about half of that for white girls.

“As a master’s student, that piqued my interest,” James-Todd says.

When she was working on his doctoral degree at Columbia University, James-Todd led a study around hair products being used in the greater New York metro area. The results backed up her theory: More girls were using hair oils for a longer period of time and those girls were much more likely to have their period earlier, which can significantly increase the likelihood of breast cancer.

Another study that served as inspiration, James-Todd says, was one in which four African American girls, ranging from four months to four years of age, showed they had all been developing breast and pubic hair — all of whom had mothers who were using hair oils and different types of products on them. An independent laboratory test confirmed that there were three types of estrogen found within the collection of products being used.

James-Todd says it is now known that about 50 percent of the products marketed to black women contain these controversial chemicals, compared to only about seven percent of products targeted to white women.

When James-Todd was conducting the hair products study in New York, several men would approach her and ask if they could take part as well. At the time, she was focused on breast cancer relating to women.

“It was kind of an ‘aha’ moment and so the reality is that black men are using these products, too,” she says. “Oftentimes, they wear shorter hairstyles and so if you think about it, the application of some of these products is that much more close to the scalp and absorbed through the scalp, and could have some similar health implications for diseases that are linked to some of these endocrine-disrupting chemicals.”

James-Todd has let her own natural hair be as curly as it wants to be ever since she was a girl growing up in Tennessee and saw her hair fall out after having a perm. She remembers, though, being an undergraduate student at Vanderbilt University and getting judgmental looks from fellow black women for choosing to not straighten her hair. Many thought she was from a different country.

“If I was American, I would not wear my hair this way,” she says of their collective thoughts. “And it’s been beautiful to see people embracing their hair. I am fragrance-free. I’ve been using the same product now for the past 30-plus years. Thank goodness it’s still on the market.”

James-Todd also uses the same product on her young daughter. She is a proponent of minimizing the amount of hair products one uses.

“As far as advocating for other women, I understand that some people don’t feel as comfortable doing that, or they think that it’ll affect their job or other issues,” she says. “But I think as society changes its standards of beauty, it’s been nice to see that being embraced.”

READ MORE AT: https://www.pri.org/stories/2018-06-18/study-shows-hair-care-products-targeted-black-community-contain-harmful-chemicals

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