The Strong Black Woman: Dr. Yvette Cozier
The Black History Month 2022 theme focuses on the importance of Black Health and Wellness. This theme acknowledges the legacy of not only Black scholars and medical practitioners in Western medicine, but also other ways of knowing (e.g., birth workers, doulas, midwives, naturopaths, herbalists, etc.) throughout the African Diaspora. The 2022 theme considers activities, rituals, and initiatives that Black communities have done to be well.
The Strong Black Woman
The phrase “strong Black woman” evokes both myth and reality. The myth is of a proud, no-nonsense woman who faces hardship with wisdom, but in the end, she must accept her fate. The reality is a proud woman who has no other choice but to persevere, survive. It can often be difficult to distinguish between the two. In honor of Black History Month, I share my perspective.
Defining the Challenges
In the US, Black women have higher morbidity and mortality rates than White women for almost every major health condition. These words begin most of my research papers and were some of the first words I learned when I began my career as an epidemiologist thirty years ago. Taken alone, these words convey little of the complexities that make up Black women’s lived experiences. For example, compared to their White counterparts, Black women are more likely to be the primary household breadwinner; reside in lower socioeconomic status communities regardless of their own education or income; hold frontline jobs with limited flexibility, or opportunity to telecommute; serve as caregivers within multi-generational households; and experience discrimination and racial bias at every level of society. The research that my colleagues and I have conducted in the Black Women’s Health Study (BWHS) since 1995, explores the health effects resulting from chronic discrimination and bias.
About the Black Women’s Health Study
Until the 1990’s, most of the studies of women’s health included only small numbers of Black women or none at all. Improving the health of Black women required more knowledge of the causes of these health problems and more knowledge about how women stay healthy. More knowledge meant more research. The BWHS was begun in 1995 to play a key role in carrying out this research.
Compared to women who reported no or infrequent experiences of perceived racism or discrimination, those reporting frequent experiences were found to have a three-fold increased risk of preterm birth1, a nearly two-fold increased risk of clinical insomnia2, and a greater than 2.5 increased risk of poor cognitive function as they aged3. While many succumb under this terrible weight, many others continue to show up for their family, friends, and co-workers. Every. Single. Day.
Resilience and the Power of Community
What contributes to this incredible resilience? Data from the BWHS also provides some insight. We queried participants regarding their religious/spiritual and coping practices. Frequent religious service attendance was associated with lower mortality4 and using one’s religion/spirituality to cope with stress was associated with decreased risk of hypertension5. Also, coping in the form of talking to others about racist or discriminatory experiences, or acting against such experiences, seemed to attenuate or lessen the health impact of these events6,7. These activities emphasize the importance of community, – spiritual or secular —, in our lives, and how mindfulness, prayer, and activism can provide strength and comfort in a turbulent world.
Taking Care & Taking Action
In summary, we need to care for ourselves and each other. In 2021, we saw Naomi Osaka and Simone Biles each boldly engage in self-care by stepping away from competition when their mental health was at risk. In doing so, they opened the door for others to do the same without judgment. Self-care can look different for each of us. For me, it involves reading a book by my favorite author (versus reading the latest scientific paper in my discipline) or completing the daily Sudoku; activities which bring me peace and joy. The recent loss of Chelsie Kryst reminds us that not only do we need to give ourselves permission to practice self-care, but it is important that we reach out to others for support, as well.
I am reminded of a small group of Black and Latina women who met at dawn during the pandemic to walk the trails of Franklin Park, engaging collectively in a health-promoting activity that they each could not do alone. During their daily walks, they exercised, encouraged, and celebrated each other before departing to their respective jobs. They cared for themselves and for each other. Activism can also take different forms. In recent weeks I have thought often of the elderly Black women who checked-off my name in the precinct books when I went to cast my vote. They remind me of my grandmother who volunteered for the same job during her retirement years. She taught me that your ‘vote is your voice’ and that it should never be taken lightly. This was her form of activism born of a time when her right to vote was not guaranteed. Perhaps it will be my turn to volunteer and make sure that democracy remains standing for the next generation. These and many other activities, big and small, honor the legacies of strong Black women during Black History Month and every month.
- BWHS Health-related Resources
- 2020 marked the 25th anniversary of the BWHS. Due to Covid-19, the celebration was postponed to 2021 and consisted of a series of webinars on research and health concerns. View this list of webinars and more.
- Books, Websites, and Guides on Black Health & Wellness
- Association for the Study of African American Life and History
- Black Women and Public Health: Strategies To Name, Locate, & Change Systems Of Power. Evans SY et al. (Eds). SUNY Press – Available March 2022
- Diva Docs Boston. A network of Black women physicians in Greater Boston
- Community Conversations: Sister to Sister (Cambridge, MA). An ongoing (monthly) open forum to explore health issues of particular relevance to Black women.
About the author: Yvette Cozier, DSc (she/her/hers) is an Associate Professor of Epidemiology and the Associate Dean for Diversity, Equity, Inclusion and Justice at Boston University School of Public Health. She is also a Senior Epidemiologist at the Slone Epidemiology Center at Boston University School of Medicine where she co-leads the Black Women’s Health Study. Her research interests include the influence of genetics and social factors (e.g., neighborhood socioeconomic status, experiences of racism and discrimination) on cardiometabolic diseases and sarcoidosis.
1. Rosenberg L, Palmer JR, Wise LA, Horton NJ, Corwin MJ. Perceptions of racial discrimination and the risk of preterm birth. Epidemiology. 2002 Nov;13(6):646-52.
2. Bethea TN, Zhou ES, Schernhammer ES, Castro-Webb N, Cozier YC, Rosenberg L. Perceived racial discrimination and risk of insomnia among middle-aged and elderly Black women. Sleep. 2020 Jan 13;43(1):zsz208.
3. Coogan P, Schon K, Li S, Cozier Y, Bethea T, Rosenberg L. Experiences of racism and subjective cognitive function in African American women. Alzheimers Dement (Amst). 2020 Jul 21;12(1):e12067.
4. VanderWeele TJ, Yu J, Cozier YC, Wise L, Argentieri MA, Rosenberg L, Palmer JR, Shields AE. Attendance at Religious Services, Prayer, Religious Coping, and Religious/Spiritual Identity as Predictors of All-Cause Mortality in the Black Women’s Health Study. Am J Epidemiol. 2017 Apr 1;185(7):515-522.
5. Cozier YC, Yu J, Wise LA, VanderWeele TJ, Balboni TA, Argentieri MA, Rosenberg L, Palmer JR, Shields AE. Religious and Spiritual Coping and Risk of Incident Hypertension in the Black Women’s Health Study. Ann Behav Med. 2018 Nov 12;52(12):989-998.
6. Cozier YC, Wise LA, Palmer JR, Rosenberg L. Perceived racism in relation to weight change in the Black Women’s Health Study. Ann Epidemiol. 2009;19(6):379-387.
7. Lu D, Palmer JR, Rosenberg L, et al. Perceived racism in relation to telomere length among African American women in the Black Women’s Health Study. Ann Epidemiol. 2019;36:33-39.