It is common knowledge that African Americans are not only at a disproportionately greater risk for disease, but we also tend to die at higher rates than those in the general population. African American men, for example, have a 20% higher incidence rate and a 40% higher death rate from all cancers combined than white men. And blacks have almost twice the risk of first-ever stroke compared with whites. In the past, it was believed that such disparities were impacted by economics — especially since poor and uninsured blacks are often unable to afford proper healthcare. A report by the Institute of Medicine in March 2002, however, sheds new light on these statistics. The study found that even with comparable income and health insurance, African Americans received lower quality care in the treatment of major diseases.
And while there are racial, cultural, and historical factors that affect these numbers, it is important that African Americans respond to health concerns more proactively — if not aggressively. “Express your concerns,” states Dr. Robert Williams, an associate professor at the Howard University College of Medicine in Washington, D.C. “Too many times black folks have been intimidated by the physician, or don’t have one with whom they have developed a relationship,” he explains. He says that our efforts to obtain treatment are reactionary, the result of a crisis. “You have to be an advocate for your healthcare,” adds Dr. Lewis Wyatt Jr., who is an assistant clinical professor of obstetrics and gynecology at UCLA Medical Center. Being informed is the first step toward accessing better health services. This health package will help move you toward personal accountability.
Let’s Get (A) Physical
Darryl Adams visited his doctor annually. But when he was confronted with two personal tragedies, he became more proactive in monitoring his health.
“I [recently] lost a close friend to lung cancer. And my father was recently diagnosed with the disease,” says the 37-year-old operations manager for Verizon in Albany, New York. In both cases, the cancer wasn’t detected until chest x-rays were administered. Adams has since stepped up his physical exams to twice a year, requesting chest x-rays, an EKG, and a stress test if he senses anything unusual. He realized that routine exams don’t necessarily find everything.
“When you go to a doctor’s office, you have to be an advocate for your healthcare,” reiterates Los Angeles-based gynecologist Dr. Lewis Wyatt. “Don’t be afraid to ask questions.” Your doctor will determine testing and frequency by your age, health habits, employment (because of stress levels), and personal and family medical history. Wyatt suggests annual metabolic screening, which includes a complete blood count, urinalysis, and, for those who are sexually active, testing for STDs. Additional testing will be driven by symptoms, age, and illness.
–Keisha-Gaye Anderson
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The Comeback Kid
In the early ’90s, Anthony Martin of Jersey City, New Jersey, was on the Wall Street fast track. A financial advisor at the New York City investment banking firm Josephthal, he enjoyed the life of a well-paid, single Wall Street executive. Now a consultant for investment firm Maxim Group L.L.C., Martin shares how what he thought was a stomach ailment threatened his life and almost derailed his career.
In 1995, I found out that I had a health problem. I worked many hours. I would travel [and] hang out. I began having difficulty digesting food. The food would regurgitate while I slept. [Choking] actually became a blessing in disguise, because it was at that point that I went to the doctor. It had been going on for a month.
They discovered something in my kidney area. After the MRI, they confirmed that there was a tumor — cancer. You know something? [That] wasn’t the reason I was regurgitating. The doctors wanted me to have surgery right away. But I wanted to finalize things in the office. That’s the state of mind I was in. My manager and the firm were very supportive.
The surgery was successful. They removed my kidney and the surrounding lymph nodes. I was out for about two months. I lost a tremendous amount of business. People who knew me — but not my colleagues at the firm — went after my clients in a very nasty way. One individual contacted one of my customers, who was also a good friend, and told him that I was very sick and was dying. That bothered me more than anything else.
I ran into other complications that kept me in and out of the office for three to four years, and I occasionally have a problem with one of my legs, which can be very painful.
During this time, it was difficult to generate more assets because my clients didn’t know whether I was going to be in or out of the office. Some clients were completely understanding and supportive. I did lose a few friends, however.
I changed everything after surgery. I only eat fish, kidney beans for protein, and a lot of salads. I drink nowhere near what I used to. I have one kidney. I joined a gym. I spend a lot time getting in touch with who I am and I’m more selective about the company I keep. There were a lot of people in my life who didn’t have my best interests at heart. I consider that to be just as much of a cancer as the cancer itself. I took control of my life and of the people, the food, and the places I go. I don’t worry about the cancer reoccurring. If it does, I’ll fight it like I did the last time. I don’t fold easy.
MAKING A COMEBACK
Seek Counseling: There are professional services that can help with the anxiety associated with a health crisis. For example, the Memorial Sloan-Kettering Cancer Center (www.mskcc.org) offers a Post-Treatment Resource Program, which provides group and individual counseling.
Know your rights: Not everyone returns to a supportive work environment after an illness. Federal legislation, such as the Rehabilitation Act and the Americans with Disabilities Act, offers some protection (800-514-0301). If you’ve been discriminated against, file a complaint with the U.S. Equal Employment Opportunity Commission (800-669-4000).
–As Told to Sonia Alleyne
Nutrition, Anyone?
Danielle Moss Lee grabs meals on the go. As president of the nonprofit Harlem Educational Activities Fund, the 34-year-old’s workdays are short on nutrition. Breakfast, when she has the time, is a bowl of cereal, or a bagel and coffee on the run. Lunch often takes place over meetings or is pushed back to late afternoon. Dinner is spicy Indian, Chinese, or Thai take-out. ”
I know what’s good for me,” says Lee, “but I don’t do the planning necessary to always have good choices available.”
Today, many professionals are working longer days. Unfortunately, many are choosing the wrong fuel, mainly caffeine and sugar. But nutritionists say the right choices will prevent you from running on empty. And it’s not as difficult as you think. For example, at a recent lunch meeting at a Harlem soul food restaurant, she downed fried chicken and waffles. A vegetable-based soup and salad and an entree like grilled fish, chicken, or vegetables would be a better choice, says Lisa Sasson, a registered dietician and assistant clinical professor at New York University. Carbohydrate-heavy meals trigger the release of the neurotransmitter serotonin, which can make you feel lethargic.
Skipping meals can also cause midday fatigue. “Sometimes [I’m] so stretched, I [can’t] keep my eyes open if I don’t get that shot of caffeine,” she admits. Although nutritionists say a moderate amount of caffeine, say one or two cups a day, is OK, caffeinated beverages boost more than energy. A recent study by the American Journal of Clinical Nutrition reports that caffeine can increase the blood levels of homocysteine, a protein component associated with an increased risk of heart disease. Coffee raises levels higher than any other caffeinated drink. Caffeine also acts as a diuretic, causing the body to excrete liquids, which can lead to dehydration and fatigue. If you feel tired, water, herbal tea, seltzer, or decaffeinated tea are better choices.
Althea Zanecosky, a registered dietician and a spokeswoman for the American Dietetic Association, recommends staying away from sugar “treats,” which can cause blood glucose to rise sharply and dip quickly, bringing on fatigue. She suggests snacks like nuts and dried fruits, which provide energy, and yogurt, for calcium. Calcium is an important nutrient, especially for women. Its benefits range from lowering blood pressure to facilitating weight maintenance. In addition to dairy, dark green leafy vegetables, calcium-fortified juices, and canned fish with bones, such as sardines, are also good sources of calcium.
Executives who regularly entertain clients over dinner and cocktails should be aware that too many drinks may cause health problems. Although moderate drinking has been found to promote heart health, excess alcohol blocks the absorption of certain vitamins, depletes others, and can slow the absorption of nutrients. Alcohol can also be high in calories. Sasson suggests choosing drinks that are mixed with nonalcoholic beverages, such as white wine spritzers.
It’s important to recognize that you may not be able to
overhaul your poor eating habits all at once. But it is important to begin making adjustments, from preparing lunch at home, to making time to actually eat it. It may take a little more time and effort, but your health is worth it.–Laura Egodigwe
On the Road Again
Regina Greer crisscrosses almost 23 states as the business service manager for American Water Company, based in Fairview Heights, Illinois. In fact, she’s racked up more than 100,000 frequent-flyer miles.
“You don’t always feel your best, but you have to go,” says Greer, 31. You can’t always combat the health hazards associated with travel, but you can take definitive steps to stay as healthy as possible.
FLYING
Closed quarters, fluctuating air pressure, and time changes can contribute not only to the symptoms of jet lag (irritability, inability to concentrate, diarrhea, constipation, and swollen ankles) but also to colds and sinus problems. “People underestimate [jet lag’s] effects,” notes Dr. David Freedman of the University of Alabama’s Travelers Health Clinic in Birmingham, Alabama. “In fact, some large companies forbid their top executives to sign contracts or to make any major decisions until several days after arriving, so their bodies can adjust.”
REDUCING THE ADVERSE EFFECTS OF FLYING
Watch your medication. Avoid unnecessary, nonprescription medication, which becomes more potent at high altitudes.
Keep hydrated. Cabin air has no humidity, so people tend to lose water. To combat dehydration, drink lots of water and reduce alcohol and caffeine intake.
Eat light. A large meal before or during a flight will cause lethargy making it more difficult to cope with jet lag.
DEEP VEIN THROMBOSIS
Another concern for long-distance travelers is Deep Vein Thrombosis (DVT), which occurs when a blood clot forms in the body as a result of prolonged sitting — on a plane, in a car, or on a train. It can prove fatal if the clot travels to the heart, lungs, or brain.
Here’s how to prevent DVT:
Stretch. For flights longer than two hours, stretch at regular intervals. There are a number of exercises that can be done while sitting. Diana Fairechild, a former flight attendant and the author of Jet Smarter (Flyana Rhyme; $14.95), offers stretching exercises on her Website, www.flyana.com.
Dress comfortably. Avoid tight-fitting clothing as it can restrict circulation.
Give yourself room. Remove any hand luggage that blocks foot movement.
INTERNATIONAL TRAVEL
International travelers may want to consult a Travel Medicine (TM) physician. “The illnesses associated with foreign travel change over time,” explains Dr. William Burmeister, a TM physician based in St. Louis, Missouri. “Patients have died because they weren’t diagnosed quickly enough or because their doctors weren’t aware of diseases associated with a foreign country.” Furthermore, treatment for a disease like malaria in one region may be totally ineffective in another. A TM physician can alert travelers to immunizations required for a particular destination. To contact a TM doctor in your area, go to the International Society of Travel Medicine Website, www.istm.org.
–Linda Lawson
She Seemed So Healthy
When Claudette Ellis woke one morning with
The Columbia, Maryland, resident, now 50, exercised every day, had stopped smoking, and practiced healthy eating habits. “But I was working long hours,” she says. Experiencing shortness of breath, she reported this symptom to her physician during a routine physical and further tests were ordered. Her heart attack occurred within the two weeks between her physical and her testing.
Heart disease runs in Ellis’ family. Her father died from a heart attack before he turned 40. Ellis thought she was taking proper care of her heart through diet, exercise, and routine checkups. But she had two blocked arteries that had gone undetected by previous physicians.
“At the time, the knowledge was just not out there about women my age or younger having heart attacks,” Ellis says. “The symptoms we experience, such as jaw pain or nausea, are different from those of men.”
In addition to watching her diet and exercising regularly, Ellis, an investigator for the federal government, takes up to eight medicines daily. She has also had five angioplasties. More than 40% of African Americans suffer from some form of cardiovascular disease.
Know your risk factors. Age, gender, and heredity are three risk factors. Heart disease is the leading killer of women. In fact, the typical heart attack victim is a 70-year-old woman, not a 50-year-old man. Smoking, high blood cholesterol, high blood pressure, physical inactivity, obesity, diabetes, and stress are commonly cited risk factors.
“Almost a third of African Americans have hypertension versus a quarter o
f Caucasians,” says Dr. Lynne Perry-Bottinger, a New York interventional cardiologist.
Get tested early and often. You must actively pursue testing. Dr. Perry-Bottinger knows a patient who was forced to undergo bypass surgery because her physician, whom she had seen religiously for 30 years, neglected to order screening tests because she appeared healthy.
Recent surveys conducted by the New England Journal of Medicine found that African American patients who suffer a heart attack are less likely to be referred for cardiac catheterization than white patients, whether the physician is black or white. Cardiac catheterization is the gold standard for determining the severity of coronary artery disease and is the required preliminary step for coronary revascularization.
Listen to your body. No one knows your body as well as you do, so don’t ignore abnormal symptoms. Chest discomfort; jaw, back, or arm pain; shortness of breath; breaking into a cold sweat; palpitations; and light-headedness can all be symptoms of a heart attack.
For more information, log on to The American Heart Association, www.americanheart.org; The National Coalition for Women with Heart Disease, www.women heart.org; and the Association of Black Cardiologists Inc., www.abcardio.org.
–Christina Morgan