Black Women’s Health Study Will Continue

C. Alicia Georges believes her job will get easier.

As a registered nurse and an academic, Georges knows she has seen more African-American women with high blood pressure, diabetes, and some forms of breast cancer than white women with these health issues. The problem is, she has had no way to quantify that hands-on truth or reverse the trend.

Georges is among the legion of health-care practitioners and researchers benefiting from the Black Women’s Health Study, administered by the Slone Epidemiology Center at Boston University’s School of Medicine, which has followed 59,000 black women from across the United States since 1995.

The study is now assured of continuity, thanks to a $9.1 million grant from the National Cancer Institute of the National Institutes of Health for a five-year extension.

“For many years we didn’t have data,” says Georges, an associate professor and chair of the department of nursing at the City University of New York’s Lehman College, who serves on the study’s advisory board. “It was the paucity of that data that affected treatment and prevention programs. This study is one of the best things that could have happened.”

Solving the mystery Georges faces — why African-American women are more likely than white women to develop serious health problems — became the focus of the study’s principal investigators, Lynn Rosenberg and Julie Palmer, both School of Public Health professors of epidemiology at the Slone Epidemiology Center, and Lucile Adams-Campbell, of Georgetown University’s Lombardi Comprehensive Cancer Center.

“Some of the reasons are understood,” says Rosenberg, an associate director of the Slone center, “but mostly not.”

The NIH has supported the team’s research from the beginning, providing more than $30 million so far, Rosenberg says. The next round of funding will pay research team salaries and support a biennial questionnaire sent to study participants.

Each survey tracks how the women’s health and habits have changed over time, gathering data on weight, diet, birth control use, smoking habits, and the development of disease. Topics can also follow medical hunches: Rosenberg says participants were once asked which hair care products they use regularly, on the chance that a correlation to illness might emerge.

Researchers have proven that black women under 45 have a higher incidence of developing breast cancer than white women in the same age group. Yet black women over 45 are less likely than white women to develop the disease, although if they do, their mortality rate is higher. One explanatory theory is that in general, older white women are diagnosed and treated at an earlier stage of the disease.

Another of the study’s findings is that racism, subtle and overt, impacts health. As Rosenberg explains, racism is a source of stress, and while the mechanism is not fully understood, stress can affect organs and the endocrine system, resulting in the release of detrimental hormones as well as raising blood pressure. As a result, Rosenberg says, “women who reported more experiences of racism have a somewhat higher incidence of breast cancer.” Research into that link is still “in its infancy.”

The team has published extensively on diabetes among African-American women. One important finding is the now-proven connection between sugar-sweetened drinks, from soda to fruit juices, and diabetes. Such empty calories are often a large part of young people’s diet and a main cause of weight gain. According to Rosenberg, the risk of diabetes skyrockets as people become obese.

Not all of the study’s findings are dire. Rosenberg and her team have found that women who follow a prudent diet, emphasizing fruit, veggies, whole grains, and fish, have less chance of developing estrogen receptor-negative breast cancer.

Large studies with long track records have become invaluable for understanding the relationships between lifestyles and disease. With new research topics always emerging, Rosenberg sees research continuing as long as funding remains. She points to similar surveys conducted on white female nurses, Nurses’ Health Study and Nurses’ Health Study II, that have been going strong for more than 30 years. The Framingham Heart Study, a long-running National Heart, Lung and Blood Institute research effort begun in 1948 and run by Boston University since 1971, continues to make a profound impact on how doctors understand and treat heart disease.

“There’s this real value in following people for a long time,” she says.

Georges hopes to translate the study’s findings into better ways to prepare future generations of nurses. While the latest funding round is welcome, she says, she hopes that the Black Women’s Health Study continues “for as long as we have black women around.”