FARAI CHIDEYA, host:
From NPR News, this is NEWS & NOTES. I'm Farai Chideya.
'Tis the season to make promises to yourself. If you're like a lot of us, you're thinking about what you want out of the New Year. Maybe that's a home, a better job or a relationship. But what about improving your health?
Taking care of our health is something that a lot of people put on a back burner. And that could mean illnesses that are best caught early, like prostate cancer and diabetes. They go untreated, especially in communities of color. One glaring example is AIDS, which can be treated but not cured.
It's reported that the rate of HIV diagnoses for black adults and adolescents is 10 times the rate for whites. This year, a number of public service announcements, like this one from the 2006 Rap-It-Up Campaign, have addressed the issue.
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Unidentified Woman: My idea of HIV was a IV drug user or a gay man. I never thought that a straight heterosexual woman, you know, who was not promiscuous could get it. Every day, people are still getting infected. And every day, people are still dying.
CHIDEYA: Now AIDS is just one of several illnesses we've taken a look at that effect African Americans more than other communities. Dr. Ivan Walks, a former chief health officer of the District of Columbia, recapped some of these issues with NPR's Tony Cox.
TONY COX: HIV and AIDS. New studies this year show that young black adults are much more likely to be infected with an STD, including HIV/AIDS, than young white adults. Why is there still a spike in AIDS cases among blacks in this country?
Dr. IVAN WALKS (Former Chief Health Officer, District of Columbia): Well, we have several issues. And I think one of them - and I want to make sure we highlight this - is that even though the incidence is higher among young blacks, it's higher still among young black women.
And so we have to do a lot of education. We have to get past a lot of those cultural issues about not wanting to use protection, wanting things to be, quote, unquote, "natural" - a lot of the cultural things as well as a lack of real educational programs that are focused on reaching young African-Americans.
We tend to speak differently, we tend to listen differently, and need to be communicated with differently. So I think that when we're looking at health disparity issues, how is that message about what should be done getting to the communities that need it the most?
COX: Another silent killer in the black community is prostate cancer. And not long ago, we took a look at a new study that suggested that older men diagnosed with prostate cancer will live longer the earlier that they receive treatment.
And this sort of flies in the face of the conventional wait-and-watch approach taken by many doctors. What should we keep in perspective here, do you think?
Dr. WALKS: With almost any problem, early diagnosis and early intervention is the way to go, whether it's prostate or whether it's the plumbing in your home. If you are watchful and you're looking for things that could go wrong - and with prostate cancer, you want to make sure everyone age 50 over gets that prostate exam, gets in to see the doctor, and make it part of a routine physical.
African-American men, in particular, have a problem with the prostate exam. And we need to make sure that people understand how important it is. And so whatever personal issue, whatever cultural issues there may be, they have to come second to the importance of maintaining good health.
COX: We talked about cancer and we talked about black men. Let's talk about a disease that affects black women in high numbers, and that's breast cancer. An ongoing study from the University of Chicago that we highlighted this year suggests that women who do not have strong social support could be more prone to breast cancer. Talk to us about how social support plays a role in combating this disease.
Dr. WALKS: Well, I think that social support in many ways helps folks to feel like they are more valued, that they are more important when they're interacting with other people. You sort of have a responsibility to hold up your end. You don't want to let others down. You don't want to be a burden on others.
And so having social supports - one, you can have peer pressure, you can have groups that support each other, so that we know what, have you had your exam yet? Yeah, I've had my exam. Do you know how to do your exam? Let's talk about it. All of the kinds of things that positive peer pressure can do can actually be optimized with strong social supports.
COX: Here's another. I've heard about this from my grandmother and mother, and others in my family. And I know that in black families around the country this is certainly a very common thing - high blood pressure and hypertension. One of the most talked about issues in health this year was the ongoing controversy around BiDil - the first drug approved by the FDA for use in a single racial group.
What are your thoughts about this issue, doctor?
Dr. WALKS: In looking at that whole controversy, my thoughts were we have to do what works. And I think that on one side you don't want to walk in and have -for example, you go to the mechanic and they go, oh, it's a Chevy, it must be the transmission. So we automatically know what's wrong with you because you walk in and you're black.
That's not where we want to go, but what we want to do is to recognize that people respond differently to medication and we've known that for years. And especially in the area of hypertension, African-American men tend to work and respond better with multiple medications, with different kinds of medications.
And so this is just another tool in the toolbox so that we have options now. We don't have to say, well, we don't know if anything is going to help. Is it going to be a waste of time to go to the doctor? They don't have medications. They don't understand that being black makes it different.
We do understand all of those things. We have medications that are more likely to be effective in this particular group. So let's get to the doctor, get the blood pressure checked, and get the right medication.
COX: Here's another one, Doctor - diabetes. You hear that a great deal. Some people called it sugar in the old days. What should we be doing with regard to protecting ourselves from this?
Dr. WALKS: When we talk about diabetes, we really should not talk about it without talking about obesity and talking about general positive approaches to maintaining good health. Diabetes is something that, for the most part, occurs because of a certain lifestyle, because of a certain kind of food intake, because of a certain kind of approach to exercise or the lack thereof.
Diabetes is such a huge killer in the African-American community in particular, and disproportionately. And it destroys everything. It destroys our nervous system. It takes our eyesight. It just kills us slowly and it kills us horribly. And I don't want to talk about it in any nicer term than that because it is so preventable.
If we are really focused on this illness and we understand how dangerous it is to let ourselves and our children be overweight and stay overweight, to let our children play videogames all day and not go outside and play and get that exercise that's needed - if we continue to do those things, diabetes is not a nice disease.
COX: Dr. Walks, in the summer we took a closer look at how many veterans suffer from post-traumatic stress disorder and drug addiction. We also know that according to health advocates, many warning signs that lead to suicide have a tendency to go unnoticed among young men of color.
With regard to mental illness, are we making advances, enough advances?
Dr. WALKS: We are making some advances. Are we making enough? Absolutely not. We have huge disparities across cultures with respect to mental illness and the approach to treating mental illness. And it's an area that is such a taboo, particularly within the African-American community.
For example, with all the money we're spending on preparedness and on terrorism, and what have you, after a disaster, the longest need stretching out many, many years after Oklahoma City, September 11th, Hurricane Andrew, Hurricane Katrina - all of those issues are going to be mental health concerns.
And we have to understand that it's OK to ask for help, and it's OK for your loved one to need to get help. This stigma against the seeking of help for mental illness, mental disease - and then the self-medicating with substances, with drugs and alcohol, that can also lead to domestic violence - increases all of the kinds of problems that result from untreated mental health problems, are huge in our community and we really need to talk about this more and get people the help they need. But the problem is a lot of resources are not available in our communities. So we need to let people know that they should get help, but we also need to ensure that help is available.
COX: Dr. Walks, two more areas I'd like to address with you. The first is this. We hear a lot about baby boomers, the generation going now into the sixties and beyond. But black baby boomers, are we more susceptible to disease than others as we age?
Dr. WALKS: We have a higher disease burden as we age because of all of the things that we routinely talk about. The higher incidence of diabetes, different kinds of cancer - breast cancer, prostate cancer - the higher incidence of HIV, all of those things are impacting our community differently. So as a large part of our population ages, we are going to see more and more of those issues come up.
COX: On the flipside of that, talk about pediatrics, if you can, and whether or not our children are getting the kind of healthcare that they should be getting.
Dr. WALKS: One of the most underused opportunities in healthcare in America is something called Early Periodic Screening Diagnosis and Treatment. It's a federal program that dollars often go unspent. We don't check our children when they're young. The immunizations are often not kept up to date. Those that live in parts of the Northeast where the housing stock is old and there's pre-1978 paint on the walls that's chipping - lead indigestion and lead poisoning, huge thing in young children. Asthma is a huge problem within the African-American community. We have a lot of diseases, environmental toxins like lead, impacting our children. Cigarette smoking and the second-hand smoke the children get.
But if I had to pick one challenge that I would ask us to take on as a community with respect to our children, it's the obesity. Childhood obesity is going through the roof. Childhood diabetes is going through the roof. And the obesity impacts everything in a negative way. It impacts our health and it impacts the health of a child over their entire life. It's not - well, it's baby fat, and they'll be okay, they'll grow out of it. That's not the case. We know that the fat deposits can go into those arteries and begin to damage the long-term health at a very early age. The early and appropriate care that's needed is critical.
One of the things that I want to make sure I made clear. In the United States of America, if you are deathly ill, you can get healthcare. You can go to an emergency room and you cannot legally be turned away. The challenge we have is how do we get people covered with health insurance and how do we get people early in preventive healthcare, because maintaining a healthy community is much less expensive in a number of ways, not just dollars, but socially in everything else, than trying to treat people when they don't have coverage and they need to be deathly ill before they can see a doctor.
COX: Dr. Walks, this is some very important information. Thank you very much.
Dr. WALKS: Happy New Year to you. It's always a pleasure to talk with you.
COX: Same to you, Dr. Walks. Thanks again.
Dr. COX: Take care.
CHIDEYA: That was NPR's Tony Cox and Dr. Ivan Walks. Dr. Walks is chief executive officer of Ivan Walks and Associates, and the former chief health officer of the District of Colombia.
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CHIDEYA: Just ahead, President Gerald Ford and his record on civil rights. Plus, highlights from our coverage of New Orleans this year.
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