By Merville C. Marshall, Jr., M.D., F.A.C.P., F.A.C.E.

Addressing Behavioral Risk Factors to Improve the Health of African Americans 

African Americans have a higher probability of developing high blood pressure, heart disease, diabetes, and breast cancer than Americans of European, Hispanic, or Asian descent.  Mortality rates for cardiovascular disease are higher among African Americans than among white Americans, and the prevalence of high blood pressure among African Americans is the highest in the world.  

Why?

Although findings to-date have not been conclusive, many studies show that a combination of genetics and behavioral risk factors contribute to an increased risk of these diseases among African Americans.

As a caregiver, clearly you can’t change your loved one’s genes, but there are steps you can take to change unhealthy behaviors that will help reduce risk factors associated with chronic conditions and improve his/her overall health. 

Benefit from Preventative Care

The Centers for Disease Control and Prevention report that African Americans are less likely to receive an early diagnosis of chronic conditions such as angina, hypertension, and diabetes. In addition, the rate of hospitalization among African Americans is higher than any other ethnic group.

These findings are attributable, at least in part, to fewer African Americans obtaining preventative care, including annual check-ups. With preventative care and earlier diagnosis of chronic conditions, potentially fewer African Americans would require hospitalization and more patients would have positive outcomes. 

As a caregiver, it’s important to take charge of your loved one’s health and make an appointment for a check-up at the doctor.  If possible, you should know the health history of your loved one; including the last date he/she had a check-up, diagnostic tests performed, and medications prescribed. If you don’t have this information, make an appointment for your loved one to get a “baseline” physical. Then, keep track of all of this information in one place, so you have it handy for future appointments. Also be sure to note your loved one’s immunizations, medications, and therapy treatments as part of his or her health record. If you’re caring for a woman, find out when she had her last Pap smear and mammogram and include that information in the health record.

Take Your Loved One To the Doctor

You may find it difficult to get your loved one to go the doctor’s office. Sometimes, this is a result of a previous bad experience with a doctor or health professional. Some people have a mistrust of physicians and medical facilities in general. To help alleviate any stress and apprehension of your loved one, plan to accompany him/her to all appointments (or as many as you can), and spend time talking about what to expect at the appointment ahead of time.  Often, knowing you will be there throughout the appointment process may calm your loved one, and help them to feel more comfortable about seeing a healthcare professional.

Make Healthy Food Choices

Obesity is disproportionately higher among African Americans. It is estimated that 80 percent of black women and 60 percent of black men are overweight or obese.  If your loved one is overweight or obese, developing a healthy diet is critical to helping him/her control weight; moreover, doing so will help protect him/her from high blood pressure, diabetes, and heart disease—all chronic conditions related to obesity.

Some of the “traditional” African American foods, including “soul foods,” are prepared with hydrogenated vegetable oil, lard, or pork fat. These ingredients can be unhealthy and may need to be swapped for healthier substitutes.

It may take some time to change your cooking habits and your loved one’s preferred tastes.  The key is to take small steps first. Try substituting healthier ingredients, such as olive or canola oils, for unhealthy fats to prepare chicken, sausage, beef, and fish.  Also, get in the habit of reading food labels, particularly for fast, processed, and canned foods. Choose foods with low salt or sodium. Other healthy choices you can make that benefit you, your loved one, and the whole family include: 

• Avoiding fried foods whenever possible.  When necessary, substitute with “healthier” cooking oils
• Drinking lots of water and fewer sugar-added, carbonated beverages
• Eating only low-fat dairy products, such as low-fat milk and yogurt
• Serving fresh fruits and vegetables as snacks and at mealtime
• Controlling portion sizes—bigger isn’t better; smaller servings are a healthier choice
• Consuming alcohol in moderation—two drinks per day maximum for men, and one for women

Get Moving

The Centers for Disease Control reported in November 2006 that African Americans cite painful joints as a leading reason for not being more physically active. Arthritis is the third most common problem among African Americans. And the knee, which is important for walking and climbing stairs, is reported as the joint that causes the most pain.  

If the one you love complains of joint pain, don’t dismiss it as a common sign of aging. It could be the onset of arthritis. See that your loved one visits his/her physician to determine the source of pain. Or, if the one you love has arthritis that is preventing him/her from physical activity, talk with the doctor about what can be done. Treatments include medication, surgery, and physical therapy, to name just a few.

It may be difficult for your loved one to be physically active, particularly if they experience joint pain. Yet, physical activity can help prevent joint pain, and help prevent any existing joint pain from getting worse.  Ask your loved one’s doctor about appropriate exercises your loved one can perform. If your loved one is able to walk, consider going for a walk together at the park or inside a shopping mall. Try to establish an exercise routine that you both look forward to. This will help keep you motivated. If possible, work up to approximately 30 minutes of exercise daily—which can be broken up into three 10-minute or two 15-minute segments. 

Quit Smoking 

Some studies have shown that African Americans are disproportionately exposed to cigarette-smoking advertisements. This has contributed to excess smoking among the African American population. Smoking kills. It is harmful to the smoker and makes breathing difficult for all others in the household, especially young children and the elderly.  As a caregiver, you want to create the healthiest environment possible for your loved one, other family members, and you. So, if you or anyone else in the household smokes, quit! If anyone in your household is struggling to kick the habit, seek help. 

Lead a Healthier Life

If you can apply the suggestions in this article for a living a healthier lifestyle, you’ll help reduce risk factors for chronic disease not only for your loved one, but also for you, and everyone in your family.