Holloway:
Tonight, on Black Issues Forum, we'll show you how race and gender go hand-in-hand with issues of living healthy, next. [MUSIC] Good evening, I'm Jay Holloway. Welcome to Black Issues Forum. Generally speaking, the life expectancy is longer for women than men and longer for whites than blacks. Also, when we take a look at the rates of cancer, heart disease, hypertension, and other health indicators, such as being overweight or obesity, in many cases blacks are at a higher risk than whites. The good new is that you can increase your life expectancy, improve your chances of living healthy, by the choices you make. So, tonight, we'll try to help you make some of those healthy choices. Our guests, first, are Kathy Donnelly. She's a Health Promotion Nutritionist. Welcome, Kathy.

Donnelly:
Thank you.

Holloway:
And, also, Rondette Jones, who is Health Educator with the Southeast Raleigh Center for Community Health and Development, and they're both here to discuss these healthy issues tonight. We appreciate you being with us. Let's talk, first, about the life expectancy. I made a statement opening that generally-most people know women's life expectancy is longer than man's but also that life expectancy-there is a race issue there, too. Kathy, would you care to comment on that?

Donnelly:
I don't know. Maybe Rondette can help me out here in terms of life expectancy. I know that in terms of being overweight, black women tend to be heavier than white. There's also an issue of being sedentary-that they don't exercise as much as white women and that fitness level tends to sort of increase the issue of weight. In my work as a nutritionist, weight's always a main topic and I've found in reviewing some of the information that weight seems to be a central part, being overweight, in increasing your risks. So, if black women tend to be heavier then their risks are higher for heart disease, diabetes, cancer.

Holloway:
Well, we talk about all these diseases and illnesses-and Rondette, jump in here-ultimately, the life expectancy for blacks then becomes, because we're at high risk, less than those of whites. I guess I'm just starting off with that to say that there is a difference here. Is that true?

Jones:
Yes, there is a difference between the life expectancy for whites and blacks, and I think that one of the issues is that black people certainly have to look very carefully at the type of behavior and make some serious lifestyle changes in order to really make a dent and improve the life expectancy. I think that we are faced with a lot of different issues that we have to deal with that impact our health. Certainly, the hypertension is an issue, the stress of day-to-day life is an issue, discrimination, racism-all of those things collectively impact the health of a person because health is certainly more than the absence of disease. It's a person's wholeness-their spiritual, physical, and mental health.

Holloway:
Well, let's talk about some of these physical health diseases or illnesses now. When we speak of cancer, we know that black women have a higher rate of breast cancer and black men have a higher rate of prostate cancer. Let's talk about those and why is that the case?

Jones:
Well, I've found that with breast cancer for African-American women, we have a higher rate of death from breast cancer, as opposed to a lower rate of actually getting cancer in comparison to white women. I think part of the problem is that we are showing up when the cancer has advanced to a later stage. So, that gets at the issue of there needs to be more screening programs for women. We need to do more of breast self-examinations and we need to have more mammograms done. More community education is needed to let women know that at the age of 40 you should get that initial mammogram. We should talking about breast cancer more and not be afraid. I think a lot of times people are afraid to even mention the word cancer but prevention is certainly something that needs more attention, as opposed to treatment, because if you could prevent it from occurring, then you wouldn't have to deal with the treatment issues.

Holloway:
Let me ask again. You said earlier that black women have a higher rate, a mortality rate, but don't have as many cases. So, in other words, you're saying when they get it, in many cases, they die at a higher rate but not as many get it?

Jones:
Right. Just based on sheer numbers of a population of black women versus white women but the issue is, when we're showing up at the doctor's office with the cancer, what is the result? Because we're late getting screened or late in our diagnosis, the prognosis is not as favorable when the cancer is discovered at a later stage.

Holloway:
What have you seen in your area, Kathy, in terms of women coming in for the screenings or is this discussion-do you find this a lot in your travels?

Donnelly:
Right, I do. It seems to be-there's a group that I work with that's really trying to get out and do some screening and/or actually get women to come in for screenings and there is a certain amount of-whether it's stigma or-it's just something that women don't want to really look at and they've really pushed and struggled to get women in, especially African-American women.

Jones:
And there needs to be a sensitivity, too, in how we do our outreach and our education to women, specifically, to older women. A lot of times, when you're talking about parts of the body, that is not something that women may feel comfortable just openly discussing, you know, in a forum such as this but we have to think critically and strategically about the best way to reach women in a way that will not be intimidating to them and as much as we can educate them and also try to remove some of the barriers, such as transportation and some women may or may not have insurance and may want a mammogram but be unable to afford it. There are community resources that are available. There are programs, such as Save Our Sisters, which is designed specifically to find women, to go pick them up, bring them to a place to get a mammogram, and take them back home and then also do follow-up.

Holloway:
So many of our viewers across the state can either look at their health department or their Department of Human Services or local community centers for resources.

Jones:
Right and the American Cancer Society as well.

Holloway:
Kathy, let me ask you-I thought as Rondette was talking here about African-American women-I guess women, in general-being concerned about discussing cancer and the parts of the body but one of the things that we ran across in our research is that black women, 52% nationally, are overweight or obese, whereas with white women it's about 33% or something like that, I believe, and that's some real interesting information. Why do you think there's such a disparity between black and white women?

Donnelly:
I'm not quite sure. I know what you're talking about, though. I've seen those statistics. I would tend to think that probably there's some cultural part to that-what historically African-Americans have eaten, especially in the South, in terms of being high fat. Also, I know that they have a higher incidence of sedentary-ism. They're not as physically fit and that tends to increase weight. So, as to why, I'm really not sure. I know, though, it's issue that we're working on and trying to educate people about to get them to change.

Holloway:
If you saw the same study that we read, it also said that even there is a metabolic difference-that you, two, women sitting here ,doing nothing-Rondette is likely to gain more weight just sitting here-less than you. Research has shown that. Did you read that?

Donnelly:
I did and I'd heard a little bit of that before in something else and that article that I read didn't give me the research part to it, so I wonder about that, but even if it-I would say it would vary person to person but also then I wouldn't want people to fall back and say, "Well, just because I'm African-American, my metabolism is lower. It's inherent that I'm going to gain weight," or "Obesity is in my family and I'm going to gain weight." I don't think that's still an excuse to say, "What the heck...I'm heavy. I'm going to be heavy, it's in my family. I'm predisposed to it." I think it means, perhaps, that there's some harder work that needs to be done but you can't just give it all up just because of that.

Holloway:
Rondette, your center is located in a black community and I assume the majority of persons that come in the center are black as well. What have you found from a cultural point of view-we talked about there may be some cultural difference-the eating habits, the exercise, as well, would you say, are some of the obstacles? Would you confirm that?

Jones:
Certainly. We are trying to do more education in the community. Specifically, Strengthening the Black Family, Incorporated is working very hard to get the word out about how we can prepare healthier meals. Actually, working with community-based organizations, working with churches, also. We need to think about the kinds of meals that we're preparing at our churches, our homecomings, and all those other kind of wonderful fun things that we have where we have a lot of different kinds of food. We have to be more sensitive to the health needs of the people that are going to be eating the food. So, if we can think about offering healthier choices, such as including water or making sure that we have fat-free desserts and changing the fried chicken to oven fried chicken-we're trying to really help communities to think creatively about ways that we can eat healthier but still enjoy what we're eating because I think that one complaint that people have made is that the food is just not going to taste the same, it's just not going to taste the same, but it can be very good. You just have to get used to making that difference and there's a lot of different projects and a lot of information that's coming out about creative ways that we can cook that's healthy and nutritious and tastes really good.

Holloway:
Well, we're going to talk about some of those preventive methods later on in just a few minutes but let's also talk about-we want to get all of the (inaudible) illnesses and just establish-a lot of folks know we do have these problems but we want to talk why we have them and then put more time on what we can do about it. But hypertension, heart disease, is also another illness that is more predominant in the black community and why do you think we have that?

Donnelly:
Well, that's another one of those million dollar questions. I'm not sure why. I know that African-Americans do tend to have higher incidence of hypertension-also diabetes. A common factor in my work comes back to being overweight. If you're overweight, you're that much more at risk for hypertension and diabetes and cardiovascular disease. So, it's a big factor in there and then, of course, if you add onto that that black women tend to be heavier than white women-and actually in all of those groups-black women, white women, white males-black women to have the highest incidence of obesity. So, they're already at high risk now for hypertension, diabetes, cardiovascular disease. As specifically, physiologically, why, I'm not quite sure.

Holloway:
Rondette, you want to talk about the stress factor and you related a story earlier as to why you think maybe black women have these because of their focus on others. You want to elaborate on that?

Jones:
I do. I think a lot of times we underestimate the impact that stress can take on an individual's body. I think, particularly, black women find themselves doing things and taking care of everyone-trying to be everything for everyone. They have the responsibility of holding down a job, taking care of kids, being a wife, and then they may be pillars in their community as far as having roles in their churches and then they may have a sick mother that they're also trying to take care of and, yet, they're giving out so much of themselves on a daily basis and really not taking the opportunity to take care of themselves. We find out sometimes that when they reach the age of mid-fifties to sixties that they start coming down with some of the very diseases that they spent most of their adult lives trying to take care of and prevent or care for other people who had those diseases. And I think that we really need to think about what we can do as women to help ourselves and to look more critically at how we're spending our time, trying to make sure that we're not so drained until we are able to give out. But, definitely, stress can lead to increasing your blood pressure, some women will get ulcers, increasing your blood sugar level for women who are diabetics. Stress can cause a heart attack and, in some people, a stroke, so we really need to think about what toll all of these responsibilities are taking.

Holloway:
Before we move to how we can prevent some of these things, let me bring up one other category that we know is bad for us but, yet-in this state, tobacco-and alcohol, as well as drugs, we know aren't good for you but there still is a general consumption. You all want to address-I put them all in one category-the health risks when engaging in those.

Jones:
Well, definitely, smoking is a problem and, certainly, we know that it is an indicator or can cause cancer, as well as heart disease because of the impact that it has on the arteries, and unless we can stop smoking and try to put those cigarettes down, that certainly increases your risks for cancer and health disease.

Donnelly:
Alcohol, also, increases your risk for hypertension and they actually recommend, I think, no more than two drinks in a day, which is for me quite a bit but for most people perhaps not, but it does increase your blood pressure. So, if you're prone to hypertension, then drinking more alcohol is not helpful in that respect.

Jones:
Back to the issue of stress, a lot of times because people are stressed out, they may turn to some type of substance and could become substance abusers. Some people use alcohol or drugs to forget or try to remove themselves from the stress that they're facing but that can only lead them down the road to a large problem of addiction.

Holloway:
Well, let's move now to the positive side because we've got these negative statistics, that we, as African-Americans, are more prone and at risk to a lot of these diseases and illnesses and we've talked about some of them but the good news is we can do something about it. What kinds of things can we do about these illnesses and issues?

Donnelly:
I would tend to go-the way that we eat, first off, and exercise. I think those two are very, very important. You can cut back on alcohol, you can cut back on the cigarettes or cut them out but the way that we eat and our physical activity are very, very important. You've talked about the stress.

Jones:
Right and I would say, too, that we need to think about communicating more as women, talking about what our issues and concerns are. Sometimes, we carry so much inside and the stress can just build up and we may have a nervous breakdown or have some kind of mental illness or something just from being so stressed out.

Holloway:
So, conversation is one thing. What else can you do to cope with stress?

Jones:
Well, I think self-help groups are also important. Support groups. Women taking the time to talk to one another and then also doing the preventive things-the check-ups, the breast self-exams, getting your blood pressure checked. Some people don't know that high blood pressure is called the "Silent Killer" because you could be walking around with it and not know that you have it. So, getting those screenings done that are necessary, getting your annual physical. We didn't talk about some of the reproductive problems that women may experience but- certainly, an annual physical, Pap smears-those kinds of things can be detected.

Holloway:
And on those last two, men should do the same thing.

Jones:
Right.

Donnelly:
Definitely.

Holloway:
Now, wouldn't exercise be a good way to cope with that?

Donnelly:
Oh, definitely, yeah. Actually, the people that I see-probably one of the things that I stress about just talking a walk is take your spouse with you. It's one of the best times I've ever found to carry on a conversation, to find out what's happening in the day. You both come home from work or however you can get the kids settled and if the two of you can go out, it's a marvelous way to take to each other, as well as you're getting some exercise in. I think people sometimes think that exercise means hard-core-got to do a race, got to be 50 or 60 minutes, got to be fast, got to be everyday-I tend not to start out with most people, especially if they've never exercised.

Holloway:
What do you recommend generally?

Donnelly:
Well, the guidelines say "the accumulation of 30 minutes in a day" and that usually means walking-walking is the easiest-and I would describe the pace of walking to be you don't want to stop and chit-chat with the neighbors but you don't want to be out of breath when you're walking. So, it's a nice, fairly fast-paced walk but it's not a race. And then if you need to split that 30 minutes up into six, five minute walking sessions, then I would to get that accumulation of 30 minutes and then three to four to five days a week. It gives you enough leeway that if some days you don't want to walk or it's raining or it's bad or whatever. Now, I know people do say to me that the neighborhood they live in is bad and that they can't get out and walk. Then, I would suggest looking at maybe driving to the malls, even the mall parking lot if it's a mall that's not indoors-some place where there's light and maybe there's other people gathering to be able to walk with.

Holloway:
Let's spend the last few minutes talking about diet and the food because you mentioned your eating, your exercise, and the stress and we talked a little bit about that. What about diet? What kind of foods should we stay away from? What kind of foods should we be eating and how much?

Donnelly:
What I start with, first, is looking at cutting down on the amount of saturated fat that most people eat and that's usually the animal fat-the fat that's on the chicken, the chicken skin, the fat that's around the beef, around the pork-trying to cut that part out. Going from whole milk to two percent to one percent to half percent and trying to cut out those major parts first. Also, it would mean to cut down on the amount of fried foods and the amount of margarine that you would add to things and then probably after that look at cutting down on the amount of sweets they're eating.

Holloway:
You said margarine. You're assuming they've already cut butter, right?

Donnelly:
Right, right.

Holloway:
What else would you add, Rondette?

Jones:
I would add increasing your water. A lot of times, we don't get that eight glasses a day that we're supposed to be getting, so we certainly need to increase how much water we're drinking.

Donnelly:
I'd also make one last play for-I've talked about the things to cut down on but I haven't talked about the things that they do need to eat. In the dietary approaches to stop hypertension, they talk about four to five servings of vegetables in a day and four to five servings of fruit in a day and that's a heck of a lot of fruits and vegetables.

Holloway:
What is a serving?

Donnelly:
A serving would be a small apple, four ounces of juice. A serving of vegetable would be a half a cup of cooked or one cup raw. So, it's not a lot but when combine four or five servings of vegetables in a day, it means you have to eat a couple at lunch and three or four at dinner which is something we don't do. But in some studies that they did, they found by making those changes, by increasing the fruits and vegetables, they could decrease a blood pressure. They were also adding in dry beans and peas.

Holloway:
Now, a lot of people may be saying, all of this that you're saying, "We already know this," but, yet, we still have the problems. Now, knowing you both or singularly may not have the answers but what would you advise to get people to actually start doing these things in greater numbers?

Jones:
Well, I think that it takes a community commitment. I think, certainly, we need more mass media attention to the issue of nutrition, more public service announcements. That would help people change their outlook, to get them to even think about making the change. Also, looking at churches, again, where there are groups of people that can come in and receive health education. Hopefully, informed people will make better choices and different decisions but I think that we really have to focus more on prevention and getting the word out about prevention and that's a systematic community-wide thing that's needed.

Donnelly:
And to add to that, I usually try to get people to understand they can make one small change to begin with. Often, we think we've got to change everything. "I've got to throw everything out of my kitchen. I can never have this again." I try to get them to understand it's one small change and if they can make that small change, then they can move to something else and keep working on that but they often get defeated in the very beginning because they think they have to change everything.

Holloway:
So, take it a step at a time and we can change some of those statistics and even increase your life expectancy. As you start these steps, you're increasing your life expectancy, is that correct?

Jones:
That's true.

Donnelly:
And not only how long we live but how well we live is the quality of life.

Holloway:
Well, that's well said. We're out of time. Thank you all so very much for being with us and sharing some very good information.

Jones:
Thank you.

Donnelly:
Thank you.

Holloway:
Alright. One of the best ways of protecting yourself from chronic disease and other health problems is by making some well informed decisions about your weight, your diet, exercise, and consumption of tobacco, drugs, and alcohol, and how you handle stress, of course, too. Unfortunately, too many of us in the African-American community are not willing to change our habits or become more proactive until after a disease or illness or the health problems but, hopefully, now you're better informed to help yourself and others with whom you have influence. If you have comments or question and would like more information about tonight's topic, give us a call at (919) 549-7167, fax us at 549-7168, send us e-mail at bif@unctv.org or visit us on the World Wide Web at the address on your screen. Thank you again for watching Black Issues Forum. I'm Jay Holloway. You have a blessed evening and we'll see you next Friday night at eleven o'clock. [MUSIC]