BACKGROUND Because racial discrimination is a form of chronic psychological stress that might unfavorably affect health, we examined whether perceived experiences of racism among black women are ...associated with mortality. METHODS We followed 48 924 participants in the Black Women's Health Study (mean age, 40.5 years) for 8 years to assess the risk of all-cause mortality associated with perceived experiences of racism. Subanalyses of cancer and cardiovascular mortality were also conducted. Perceived racism was evaluated by 8 questions about institutionalized racism (unfair treatment on the job, in housing, or by the police) and everyday experiences of racism (eg, others acting as if the woman was not intelligent). We estimated the relative risk of death with Cox proportional hazard models, adjusting for traditional and socioenvironmental risk factors. RESULTS During 412 224 person years of follow-up from 1997 to 2005, there were 920 deaths, including 277 due to cancer and 195 due to cardiovascular causes. All-cause mortality was not associated with institutionalized racism (relative risk, 1.0; 95% confidence interval, 0.8-1.2) for the highest category vs the lowest or with everyday racism (relative risk, 0.9; 95% confidence interval, 0.8-1.2) for the highest quartile compared with the lowest. Risk estimates for the highest categories of perceived racism relative to the lowest were greater than 1.0 for cancer deaths and less than 1.0 for cardiovascular disease death but were not statistically significant. CONCLUSIONS In this large prospective study of black women, reported experiences of racism were not significantly related to mortality. Longer follow-up of this relatively young cohort and further work is warranted in this complex area of research because continued race/ethnic disparities in mortality are not entirely explained by traditional risk factors.Arch Intern Med. 2010;170(10):896-904-->
Objective: The incidence of breast cancer in Black women is lower, but their mortality rate is higher, compared to White women. Lower rates of mammography use among Black women in the past may have ...resulted in later diagnosis of breast cancer, leading to shorter survival periods and higher mortality rates. We assessed recent mammography use in a large national study, the Black Women's Health Study. Design: In 1995, 27,632 US Black women aged 40-69 years completed mailed questionnaires, which included questions on mammography use. Results: Seventy-three percent of women aged 40-49, and 82% of those aged 5069, reported having had a mammogram within the previous three years. Use was greater among women with higher levels of education, and among those who had cystic breast disease or a mother or sister with breast cancer. Conclusions: The high rate of recent mammography use among participants in the Black Women's Health Study agrees with national data. If breast cancer mortality rates in Black women continue to exceed those in White women, despite the lower incidence among Black women, reasons other than differential mammography use must be sought.
The incidence of hypertension in black women is two to three times that of white women, and rates are similar to those values of the next age decade of white women. Established risk factors, such as ...family history, cigarette smoking, physical inactivity, and obesity, do not adequately explain this disparity. Epidemiologic findings suggest that social and genetic risk factors may account for the excess burden of hypertension in black women. The three studies described herein examined the relationship of social factors with hypertension, and lay the groundwork for future genetic studies. All three studies utilize data from the Black Women's Health Study (BWHS) a cohort of African-American women established in 1995. The first study prospectively examined the relationship between incident hypertension and experiences of racial discrimination. Nine questions measuring exposure to racism were asked on the 1997 BWHS follow-up survey. Incident cases of hypertension were reported on the 1999 or 2001 surveys. Positive associations were observed among women who were born outside of the United States, and among women who grew up in a predominantly white neighborhood. The second study prospectively examined the influence of neighborhood socioeconomic context on the incidence of hypertension. Census block groups from the 2000 US Census were used to proxy subjects' residential neighborhood. Incident cases of hypertension were reported on the 1997, 1999, or 2001 BWHS surveys. The rate ratio of hypertension for women living in the most deprived neighborhoods was 1.30 (95 CI: 1.17–1.45) compared to those living in the most affluent neighborhoods. The third study compared approaches to participants and methods of collecting buccal cell samples by mail in the BWHS. Participants were randomized to four groups: Groups 1 and 2 used the cheek swab method and Groups 3 and 4 used the mouthwash swish method. Groups 1 and 3 were mailed collection kits together with consent forms, whereas Groups 2 and 4 were mailed a kit only after returning a signed consent. Participation rates were similar across all four groups. However, higher DNA yield and Polymerase Chain Reaction success made the mouthwash method preferable for collection of buccal samples by mail.
PDF
