2007

The occurrence of breast cancer in the BWHS was greater among women who have a mother or sister with breast cancer than among women whose relatives have not been affected by breast cancer. The risk of breast cancer was greatest for women whose relative had the breast cancer at a young age.

We studied several aspects of the diet — gycemic load, glycemic index, and cereal fiber content — in relation to the occurrence of type 2 (adult onset) diabetes in the BWHS.  Glycemic load and index are measures of the type or carbohydrate in the diet.  The analysis was based on 8 years of follow-up of BWHS participants, during which time1,938 participants reported that they had been diagnosed with diabetes. We found that women whose dietary intake had a high glycemic index were at higher risk of diabetes, and women whose diet was high in cereal fiber had a reduced risk.  The importance of the findings is that women can reduce their risk of diabetes by making changes in their diet — that is, by increasing the amount of cereal fiber in their diets.  The way to do this is to substitute unprocessed foods for processed foods—for example, eat whole wheat bread instead of white bread, shredded wheat instead of corn chex, and brown rice instead of white rice. The January 2008 BWHS newsletter gives the cereal fiber content of a number of commonly eaten foods. link to online article

Uterine fibroids (fibroids in the womb) occur 2-3 times more commonly in Black women than in white women and the reasons for the difference are unknown. We studied whether experiences of racism, reported on the 1997 BWHS health survey, were related to the development of uterine fibroids. The analysis was based on 22,000 premenopausal participants followed in the BWHS from 1997 through 2003. During that time period 3,440 women reported having been diagnosed with uterine fibroids. We found that the condition occurred more often in BWHS participants who reported higher levels of racial discrimination than in those who reported lower levels. There was a suggestion in the data that the increased occurrence of fibroids among women who experienced racism might be smaller or absent among those who had skills for coping with stress, such as getting support from friends or family. This is the first study to suggest that racism may contribute to an increased occurrence of uterine fibroids. link to online article

On the 1997 BWHS health survey, participants provided information on how often they experienced racial discrimination in everyday life and on the job, in housing, and by police.  We obtained information on the racial composition of their neighborhoods from the U.S. Census Bureau and then studied how the racial composition of participants’ neighborhoods was related to their experiences of racism.  Women in neighborhoods with the highest percent of Black residents reported the least discrimination, while women in more mixed neighborhoods reported intermediate amounts of racism and women in neighborhoods with the lowest percent of Black residents reported the most discrimination.  While racial integration can have social and economic benefits, these results indicate that there is a price to pay in terms of racial discrimination.

In an assessment of body size in relation to the occurrence of breast cancer, based on 1062 newly diagnosed breast cancers in the BWHS, women who were overweight at age 18 had a lower incidence of breast cancer than women who were thin. The mechanism for such an association is unclear.  On the other hand, the results suggested that postmenopausal women who were currently obese had a higher risk of breast cancer that was estrogen receptor positive than thinner women; this might be because fatty tissue is the major source of estrogenic hormones after the menopause.  The relation of body size to breast cancer risk is complex and requires further study. link to online article

The occurrence of type 2 diabetes (adult onset) has increased in the U.S. as has the proportion of women who are overweight or obese (body mass index ≥ 30). During 8 years of follow-up of BWHS participants, 2,472 new occurrences of type 2 diabetes were reported. The incidence of type 2 diabetes was more than 20 times greater in women in the highest category of body mass index considered (≥ 45) than among lean women. A reduction in weight would lead to a reduction in the risk of developing diabetes. link to online article

Understanding the determinants of adult weight gain may lead to more effective interventions. Our preliminary results suggest that adverse neighborhood characteristics contribute to weight gain over and above personal characteristics.

Lupus (systemic lupus erythematosus) occurs more often in women than men, suggesting that female hormones may be involved. In the BWHS, we found positive associations of lupus with earlier age at starting to menstruate, shorter time between menstrual cycles, and use of postmenopausal female hormone supplements.

Abuse suffered during childhood has been associated with earlier age at starting to menstruate. In the BWHS, women who reported sexual abuse during childhood began to menstruate earlier than those who did not experience abuse during childhood.

Mortality rates from many causes are higher in African-American women than white women. Our preliminary analyses show that mortality is increased in women who smoke and drink heavily, and it is decreased in women who exercise vigorously.

Type 2 (adult onset) diabetes is a serious problem among African American women. Our preliminary analyses show that the incidence of type 2 diabetes is lower among women who exercise vigorously than among women who do not.

Significant racial differences in mortality exist in the U.S. In preliminary analyses, we found that the risk of dying among BWHS participants who lived in disadvantaged neighborhoods was slightly higher than the risk among women who lived in wealthier neighborhoods after taking into account personal factors and habits, such as education and smoking.

More than 26,000 BWHS participants have provided mouthwash samples. The response rate was greater among women who were asked to swish once than among women who were asked to swish twice, but both rates were high.

Experiences of racism may affect various aspects of health. In preliminary analyses, we found that women who reported frequent experiences of racism in 1997 gained more weight in the following 8 years than women who reported fewer experiences.

In preliminary analyses, the incidence of multiple sclerosis (MS) in the BWHS is higher in northern regions than in southern regions, based on 149 new diagnoses of MS reported by BWHS participants from 1995 to 2005. This finding is in agreement with observations made in other racial/ethnic groups.

The Gail model is a formula used to predict a woman’s risk of developing breast cancer, based on her age and several characteristics, such as the age of beginning to menstruate. The model is used to determine whether women are eligible to enter treatment trials for breast cancer. Our analysis of BWHS data shows that the Gail model and a modification derived for African American women have poor accuracy. Better models need to be developed for use among Black women. link to online article

Sarcoidosis is an illness that affects African American women more than other women. The causes are largely unknown. The BWHS has begun to study this illness, and a comparison of medical records with reports of the illness by BWHS participants shows a high level of accuracy of reporting by participants.

Hair relaxers have been used by millions of African American women, often at young ages and for many years. Because these products may contain unknown harmful ingredients, we studied their use in relation to the occurrence of breast cancer. Based on information provided on relaxer use on the 1997 BWHS heath survey and and follow-up through 2003, we found no increases in breast cancer incidence among users, regardless of the length of use, the intensity of use, or the age at starting use. These findings indicate that hair relaxer use does not affect the risk of developing breast cancer. link to online article

The relation of polycystic ovary syndrome (PCOS) to risk of uterine fibroids was examined using data collected through 2003. 275 women reported having been newly diagnosed with PCOS and 3,631 reported a new diagnosis of fibroids. The incidence of fibroids was higher among women with PCOS than among women without that condition. This finding, which has biologic plausibility, is new and requires confirmation. link to online article

The CES-D is a set of 20 questions used to measure symptoms of depression. It has been used in various population studies to determine whether depression is associated with various illnesses. BWHS participants completed the CES-D scale on the 1999 BWHS health survey. Our analyses indicate that the CES-D scale is appropriate for use in African-American women. A previous study has already found, with use of the CES-D, that BWHS participants who exercise have fewer symptoms of depression that participants who are inactive. link to online article

Experiences of racism could affect health adversely. We assessed the relation between experiences of racism reported on the 1997 BWHS health survey to the occurrence of breast cancer in the following 6 years. The incidence of breast cancer was higher among women who reported more everyday and major (in the workplace, in housing, and by police) experiences of racism. The increase in breast cancer incidence among women who reported discrimination in the workplace was statistically significant, and the associations were stronger among women under age 50. This is the first study to find racism to be associated with an increased risk of breast cancer and the results require confirmation. link to online article

High blood pressure affects many African American women. It is well established that personal factors, like lack of exercise and overweight, are associated with increased risk. We studied whether characteristics of the neighborhoods in which women live affect the risk of high blood pressure. link to online article