This is Part II of the series examining the health concerns of African women over age forty. Last time, our discussion highlighted the top five maladies affecting this group, with the intent to review the causes and most common therapeutic approach(es) for each.
Finally, we will become managers of our own wellness by retaining what is most useful from Western medical practice, and then seek best practices from what is referred to as alternative, natural or holistic medicine. Because my education and training is informed by a Western/allopathic tradition, I will seek credible information from practitioners of alternative health care systems. Hopefully it will provide insight for all.
The medical definition of stress is:
“…an organism's total response to environmental demands or pressures.”
In humans, it results from interactions between persons and their environment that are perceived as straining or exceeding their adaptive capacities and threatening their well-being.
Risk factors for stress- related illness are a mix of personal, interpersonal and social; including lack or loss of control over one’s physical environment, or lack or loss of social support networks.
People who are dependent on others (e.g., children or the elderly) or who are socially disadvantaged because of race, gender, [or] educational level, are at greater risk of developing stress-related illnesses.
While the emphasis is mine, the intent is to focus on what some health providers believe is the origin of many health problems in the American African community.
Consider Africans in America as a people under siege (both observed and/or experienced); beset by low wages, low income, police harassment and violence, crime, violence, underperforming schools, with their quality of life devalued and undermined worldwide.
The impact of stress on African women is observed in subtle ways and in the usual places: hospital emergency rooms. Hypertension and cardiac ailments affect American black women twice as much as any population in this country; obesity from stress overeating claims many, while drugs and alcohol become the de facto means of treatment.
Many black women subscribe to the myth of the “Super Woman”, feeling obligated to solitarily manage a crisis and provide others a safe bridge, (over her very back if necessary!); all the while ignoring her own needs. Under colonialism it is almost a luxury for African women to consider our own health because our role as caregivers and nurturers, to others, is often seen as the primary responsibility. As an African woman, mother, grandmother, wife and professional, I have experienced this. This behavior, however, leaves one exhausted, angry, confused, depleted, more unwell and more stressed.
The Physiology of Stress
When discussing the psychic and emotional toll of stress, remember that the body operates in a complex, integrated way. The condition of the body operating in balance and harmony is called homeostasis and represents the normal state of a smoothly operating organism. The external conditions faced by Africans deliver stressors creating a negative impact on heart rate, blood pressure, and as ingesting a toxic substance, moves the body away from homeostasis.
Above is a schematic diagram of your body*2, showing the effects that the Autonomic Nervous System (ANS) has on selected organs. The ANS is a subdivision of the entire working nervous system. We move muscles voluntarily, as one part of the function of our central or peripheral nervous systems, but we have no conscious control of the ANS-it is autonomic or automatic in its response. It has two divisions: the PNS or Parasympathic Nervous System, managing the body during times of rest and relaxation. Food is digested, energy stored, breathing and heart rate is slow and steady. The Sympathetic Nervous System (SNS), releases chemicals under stressful and dangerous conditions. You may have heard it referred to as the “fight or flight” response. Hear noise in the night? This system stimulates some organs to slow down, re-route blood supply and send it to the large leg muscles so you can run away, or if trapped in a corner, the rush of energy required to mount resistance-to fight. Heart rate is elevated, pupils dilate, lungs are available to breath more air; the very hairs on your body are at attention (goose bumps/ gooseflesh). You become alert and attentive as the brain responds to increased blood flow. The chemical epinephrine, commonly known as adrenaline, stimulates this cellular response. In the short term, an adrenaline surge is invaluable when facing some challenges. It may mean the difference between survival and death.
Imagine, however, a constant influx of this chemical and its effect on your body. Ask what effect an overdose of amphetamines might have? (As most amphetamines are synthetic versions of adrenaline). A body facing such conditions experiences constant stimulation. In addition to the release of adrenaline, another hormone, cortisol, is released. It too, is helpful short term, but acts to suppress functions not required during times of stress- including cellular repair, energy storage, and digestion. The longer-term effects of a continuous surge of cortisol are so damaging that they eventually have a crippling effect on the body.
Consequences include exhaustion, impaired judgment, hyper vigilance (leading to exhaustion and impaired judgment!), glucose intolerance, (precursor to diabetes); fat and sugar overload and ultimate mismanagement (leading to obesity, diabetes and heart disorder); an over stimulated cardiovascular (CV) system correlates to stiffening of the arterial system, and plaque build-up along arterial walls. The stomach lining is damaged due to slow cellular turnover, allowing for ulceration, as protection from stomach acids is no longer present.
Too much cortisol impacts memory and affects behavior negatively. After observing many of the stressors confronting African women in this country, it is miraculous that they retain function at all!
Conclusion- Finding Competent Self-Management of Stress
We have reviewed some effects of stress on the human body. Not all stress is harmful. Humans require small amounts of stress (eustress) to remain motivated and develop life skills for survival.
African women in midlife are often in positions of leadership in our places of worship, community organizations or the workplace. We provide advice and mentoring to our sons, daughters and extended family members who are taking on their roles. It is essential that we learn, while operating under the system of global capitalism, to effectively manage our own health and well being in the face of an often indifferent, inaccessible or hostile health care system. But ultimately the goal must be to destroy parasitic capitalism so that we can live better and healthier lives. The African Nation is faced with disparaging health outcomes all over the world and we must understand that if it were not for colonialism (direct foreign control over our lives) we would be able to develop cures for living and not for profit and have better health management systems.
In future discussions, we will discuss what this looks like. Meanwhile, I refer interested readers to a primer for African women in midlife; Prime Time: The African American Woman’s Complete Guide To Midlife and Wellness, by Marilyn Hughes Gaston, M.D., and Gayle K. Porter, Psy.D.
There is no substitution for preparation, and from this point onward, we begin the task. Review what Drs. Gaston and Porter have to say. And remember: the goal is to live the remainder of our lives in as healthy, productive and creative a manner possible. That act is the most revolutionary thing we can do.
Michelle Strongfields, MD, is Director and Founder of IAMM Science Education Group, devoted to insuring the increased representations of youth of color in the sciences. She has more than 30 years experience as an educator, physician and advocate of quality health care and the elimination of health disparity. She has trained and worked in the U.S., Cuba, South America, Africa and throughout the Caribbean. She is a professor of Anatomy and Physiology, a community health advocate and health consultant. She is a longtime associate of the Philadelphia Black Women’s Health Alliance and the National Black Women’s Health Imperative, and an active participant in the Imperative’s longitudinal study of Black women’s health in the United States. She has lead the training of community health workers in the U.S. and abroad, and is associated with the Health Committee of the All African People’s Development and Empowerment Program (AAPDEP), led by her daughter, Dr. Aisha Fields, PhD. A wife, proud mother of four and grandmother of five, Dr. Strongfields believes that good physical, mental and spiritual health is a divine human right.