Now Viewing: Women and girls

GirlTrek: Black Women Walking for Body, Mind and Soul

Jul 3, 2014, 10:21 AM, Posted by Keecha Harris

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I first met my friend Leah in September 2013, when she started walking with GirlTrek in Birmingham, Ala. GirlTrek is a movement of thousands of Black women across the country mobilized in response to the problem of staggering rates of obesity and its co-morbidities. Leah read a local NPR article about Black women walking for wellness under the banner of GirlTrek, and she decided to check it out.

As a GirlTrek volunteer, it is always a pleasure to connect with women new to our local organizing efforts. Leah joined us on a Full Moon Trek. Under celestial brilliance, Leah and I walked into the woods of the Hillsboro Trail as strangers. By the end of the trek, I had a new and humorous sister who fearlessly faced the possibility of running into snakes and other wildlife.

And when there is the promise of a storm, if you want change in your life, walk into it.
If you get on the other side, you will be different.
And if you want change in your life and you’re avoiding the trouble, you can forget it.
—Bernice Johnson Reagon

Friends were exactly what Leah needed. She and her husband had moved to Birmingham in 2007 to escape Michigan winters, and to establish a vibrant community of people with common interests. The winters are warmer here, true—but friends aren’t always easy to come by when you’re a stranger in a new city.

And that was the beginning of Leah’s relationship with a warm, welcoming organization of women passionate about improving their health—and fostering change. In short: she found the new friends she had been seeking. But these friendships gave her much more than she anticipated. Her doctor had delivered the grim news the month before that she was pre-diabetic. So walking with others was very timely.

Leah found herself in good company. GirlTrek has a goal of engaging 1 million Black women and girls in its walking-related programming by 2015. The program is sparking a health revolution, and it does so by building upon the rich cultural legacy and assets of the African American community.

Take, for example, Harriet Tubman. She’s a patron saint to GirlTrek supporters. Tubman was known to walk as many as 15 miles per day in uncut forests, through mossy swamps and across the Appalachian Ridge. Within the course of a decade, Tubman walked north toward freedom with hundreds escaping slavery. If Harriet Tubman could walk her way into new realities, the thinking goes, then so can we.

Leah was intrigued by the Full Moon Trek—and why would she not want to be part of a group of Black women who trekked to the light of the moon?  We connected through Facebook, excited to learn more about each other during a night walk in nature.

Walking to bring about change was a familiar theme for Leah. In fact, she was born to trek.

“Thinking back, walking has always held importance in my life—even before I took my first steps or took my first breath of air. My mother was weeks past her due date. Upon her third trip to the hospital, she was put in a hospital gown and instructed to walk up and down the halls.”

Thereafter, Leah and her mother racked up quite a few miles on foot. On weekends and evenings, her mom walked to relish joy or to ease pains, with little Leah in tow: “She’d walk, and walk, and walk, and walk. My little legs would go as fast as they could to keep up. When we returned home, I’d nearly collapse. But of course the next time she put on her shoes, I’d be ready to go again!“

That began to change in October. Leah has stepped up to lead other walkers to wellness. For the past eight months, she has led daily treks at the University of Alabama at Birmingham. These “smokeless breaks” are about 30 minutes each, with two to six women walking together.  Sometimes they walk to Railroad Park. During inclement weather, they trek inside along the long corridors connecting area hospitals.  

All of that walking has paid off for Leah—in a way that the everyone should applaud her for. In 2003, Leah did her first half-marathon. Over the last eight months, she has lost 30 pounds ... and shaved 17 minutes off her half-marathon time. She is no longer taking Metformin to treat her pre-diabetes. She feels more confident and peaceful. Moreover, Leah has found the warm, vibrant community of friends that she desired when she moved here.

For Leah, there is now no challenge too great. In May, Leah and other GirlTrekkers committed to walk at least 52.4 miles to honor their mothers. She walked at work and on weekends with her 5-year-old daughter, Neah Imani, in tow. Neah’s name means "moving faith."

Movement has been transformational for these three generations of trekkers. Leah’s mom continues to inspire her walking journey. In fact, Leah’s mom lost over 40 pounds in 2013, by walking the hallways at the University during her breaks.  

These days, though, mom can’t keep up with Leah any longer. She says Leah walks too fast. But even though they can’t walk together, they’re still walking in common cause: to heal their bodies, soothe their souls and form community with other black women.

About the Author
Keecha Harris, DrPH, RD is a walking enthusiast who has trekked every day since October 2012.  Her consulting company has provided support to the Robert Wood Johnson Foundation Childhood Obesity Team and the Research, Evaluation and Learning unit.   

Be Heart Smart: Addressing the High Burden of Cardiovascular Disease Among African-American Women

Feb 5, 2014, 8:28 AM, Posted by Nadia Winston

Nadia Winston, MSPH, is a graduate student at the University of Illinois at Chicago, School of Nursing, pursuing dual nurse practitioner studies in family practice and occupational health. She has a master of science in public health degree from Meharry Medical College and is a former scholar with the Robert Wood Johnson Foundation Center for Health Policy at Meharry Medical College. This post is part of the “Health Care in 2014” series.

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Cardiovascular disease is the number one killer of African American women. It has become imperative for the nation to take back the reins of its health status and educate the public about this threat. The statistics are alarming. Black women are twice as likely to suffer from cardiovascular disease as women of other ethnicities. And according to the American Heart Association, cardiovascular disease kills nearly 50,000 African-American women annually. The reason for this disparity can be attributed to a lack of health knowledge, being overweight or obese, and lack of physical activity. Early intervention and action has been identified as the key to reducing this population’s risk of mortality from cardiovascular disease and related diagnoses.

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Addressing and raising awareness of the health risks associated with cardiovascular diseases for African American women has been quite challenging. Recognizing this issue, Vanessa Jones Briscoe, PhD, MSN, then a Health Policy Associate at the Center for Health Policy at Meharry Medical College, developed and implemented a culturally appropriate health education program to educate minority populations about unhealthy lifestyles. It is called the “Be Heart Smart” program.

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Focus on Health to End Poverty

Jan 23, 2014, 12:00 PM

Janice Johnson Dias, PhD, is a Robert Wood Johnson Foundation New Connections alumnus (2008) and president of the GrassROOTS Community Foundation, a health advocacy that develops and scales community health initiatives for women and girls. She is a graduate of Brandeis and Temple universities and a newly tenured faculty member in the sociology department at City University of New York/John Jay College of Criminal Justice.

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Policy action and discussion this month have focused on poverty, sparked by the 50th anniversary of Lyndon Johnson’s War on Poverty and Dr. King’s birthday. Though LBJ and King disagreed about the Vietnam War, they shared a commitment to ending poverty. Half a century ago, President Johnson introduced initiatives to improve the education, health, skills, jobs, and access to economic resources for the poor. Meanwhile, Dr. King tackled poverty through the “economic bill of rights” and the Poor People's Campaign. Both their efforts focused largely on employment.

Where is health in these and other anti-poverty efforts?

The answer seems simple: nowhere and everywhere. Health continues to play only a supportive role in the anti-poverty show. That's a mistake in our efforts to end poverty. It was an error in 1964 and 1968, and it remains an error today.

Let us consider the role of health in education and employment, the two clear stars of anti-poverty demonstrations. Research shows that having health challenges prevents the poor from gaining full access to education and employment. Sick children perform more poorly in schools. Parents with ill children work fewer hours, and therefore earn less. Health care costs can sink families deeper into debt.

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Health Care Providers Shouldn’t Hit the Snooze Button When It Comes to Asking Their Patients About Sleep

Jul 12, 2013, 9:00 AM, Posted by Aric Prather

Aric A. Prather, PhD, is an assistant professor of psychiatry at the University of California, San Francisco and an alumnus of the Robert Wood Johnson Foundation Health & Society Scholars program.

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Heart disease accounts for one in every four deaths in the United States—600,000 deaths per year.  Prevention and treatment regimens for heart disease include important changes in lifestyle, centering primarily on alterations to diet and physical activity.  Interestingly, sleep is rarely part of this discussion.

This is alarming given the growing evidence from large-scale population studies and laboratory-based experiments that demonstrate that sleep plays a larger role in heart health than originally appreciated by the medical community.  For example, in a 2003 study, women with established coronary heart disease who reported poor sleep quality were more than 2.5 times more likely to go on to experience a cardiac event than good quality sleepers. Nevertheless, when it comes to asking patients about their sleep, health care providers routinely hit the snooze button.

In an effort to raise the profile of sleep as a risk factor for cardiovascular disease (CVD), my work has focused on investigating the links between sleep and the biological pathways implicated in CVD development and progression.  Said another way, much of my research focuses on how sleep disturbance gets under the skin. 

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U.S. Women: Many Missing From the Picture of Health

Jun 4, 2013, 4:21 PM, Posted by Susan Dentzer

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The missing women. The concept was first put forward by Nobel Prize-winning economist Amartya Sen in the 1980s. He pointed to demographic evidence that hundreds of millions of women were simply missing from the planet—most likely never having been born, or died, due to discrimination or neglect.

Biologically, females are stronger than males; as a result, in much of the world women outnumber men in population sex ratios. But Sen found the ratio was flipped in India, Pakistan, and Bangladesh. Subsequent investigations show a similar pattern in other parts of the world where women are at substantial economic and social disadvantage to men—including other countries in Asia, the Middle East, North Africa, and central and Eastern Europe.

Now, research sponsored in part by the Robert Wood Johnson Foundation raises the question: Is there a growing corps of “missing women” in the United States as well?

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A Doctor Delivers Multiple Acts of Human Kindness to Homeless Women

Aug 3, 2012, 11:55 AM, Posted by Roseanna Means

Roseanna H. Means, MD, is the founder of Women of Means, which provides free medical care to homeless women in the Boston area, a clinical associate professor at Harvard Medical School, and an internist on the attending staff at Brigham and Women’s Hospital in Boston.  She is a 2010 Robert Wood Johnson Foundation Community Health Leader.

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The prolonged recession of the last four years has hit many people hard.  My work is taking care of homeless women, which I have done for the past 20 years.  I lead a team of volunteer physicians and part-time paid nurses who provide free walk-in care to women and children in Boston’s shelters.  We fill in the gaps left by larger, more bureaucratically rigid systems that put unrealistic and unattainable expectations on those who are disabled by extreme poverty, mental illness, trauma, and cognitive dysfunction.

I designed a program of “gap” care that brings health care to them. We act as the communication and advocacy bridge between the shelter/street world and the hospitals and health centers.  Gap care is part of a continuum that I feel has an important role to play in health care access for vulnerable populations.

Here is a glimpse of our work.

Walking into one of the women’s shelters on a recent morning, I see a woman standing glumly in line for coffee, her hands chapped and shaky, her face pale and dry, a blanket heaped around her shoulder, pouring hot liquid into her body before staking out a cot where she can sleep for a few hours, let her guard down, away from the doorway where she was prey to drunk men who jumped her, raped her and stole her stuff.

She is hungover.  She drank to escape the horror of having been attacked.  She has been on and off the wagon so many times we have all lost count.  She’s also been raped and stabbed more times than any of us can remember.  She doesn’t go to the police any more.  She’s just one more homeless woman who has been raped, a “nobody”; just more paperwork.  I give her a hug and remind her that I love her no matter what.  I know that she has a library of negative and self-loathing messages in her head.  Mine is the one that can break through that chatter and give her a shred of self-respect.

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How a Personal Experience Led to a Program of Research Focused on Eliminating Intimate Partner Violence Disparities Among Hispanic Women

May 18, 2012, 1:00 PM, Posted by Rosa Gonzalez-Guarda

The U.S. Department of Health and Human Services, Office on Women’s Health has designated May 13 to May 19 as National Women’s Health Week. It is designed to bring together communities, businesses, government, health organizations and others to promote women’s health. The goal in 2012 is to empower women to make their health a top priority. The Robert Wood Johnson Foundation (RWJF) Human Capital Blog is launching an occasional series on women’s health in conjunction with the week. This post is by Rosa M. Gonzalez-Guarda, PhD, MPH, RN, Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholar and Assistant Professor, University of Miami, School of Nursing & Health Studies.

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As a young Cuban-American and Miami native who grew up in an Hispanic enclave, I was naturally drawn to Hispanic men—short, dark and handsome. Who would have expected that I would have found him during my last year of college at Georgetown University in Washington, DC? I fell in love with this other Cuban-American Miami native quickly. He was fun, smart, charming, had strong family values and, to top it all off, he could dance salsa and merengue.

It was not too long before I realized that my college sweetheart was jealous and controlling. However, this did not seem all that unusual since these are characteristics that are endorsed by many in the culture where I come from. In fact, when I questioned that he was “allowed” to go out with his friends to bars, but I was not, some family and friends agreed with him. Although I did not realize it at the time, the “allowed” language and his controlling behavior were a good indicator of what lay ahead in our relationship—a nightmare.

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Moments of romance and bliss turned into moments of anger, aggression and torment. Times of peace grew shorter and shorter, as he grew increasingly emotionally abusive. He did some “man handling” too.

When I decided to go off to graduate school at Johns Hopkins University School of Nursing and the Bloomberg School of Public Health, things got worse. I was in another city and the co-chair of a social and cultural student committee. This made him feel like he was completely out of control and very jealous. He grew more aggressive and emotionally abusive. My family and friends became increasingly worried about me, as they saw my cheery personality slowly dwindle. My parents put a lot of pressure on me to break things off. I knew they were right, but for some reason I couldn’t bring myself to do it. I just needed time.

I thought that I could appease my family by getting help. I went to the school psychologist and when a faculty member at the School of Nursing looked for volunteers for a research study on teen dating violence, I quickly signed up. At that time, I had no idea that the Principal Investigator of the study was a world renowned violence researcher: who else but our very own Jacquelyn Campbell, PhD, RN, FAAN, who directs the RWJF Nurse Faculty Scholars program. Working on this study made me realize that I also wanted to conduct research on health disparities affecting my own community of Hispanic women at home. As I fell in love with the prospects of health disparities and violence research, I fell out of love with an abusive partner.

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A Nurse-Midwife and a PhD Candidate

May 15, 2012, 3:00 PM, Posted by Elisa Patterson

The U.S. Department of Health and Human Services, Office on Women’s Health has designated May 13 to May 19 as National Women’s Health Week. It is designed to bring together communities, businesses, government, health organizations and others to promote women’s health. The goal in 2012 is to empower women to make their health a top priority. The Robert Wood Johnson Foundation (RWJF) Human Capital Blog is launching an occasional series on women’s health in conjunction with the week. This post is by Elisa L. Patterson, MS, CNM, a fellow with the Robert Wood Johnson Foundation (RWJF) Nursing and Health Policy Collaborative at the University of New Mexico.

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I have been a certified nurse-midwife for almost 19 years. It is an ingrained part of who I am. I have served women of many different ethnic, socioeconomic, and cultural backgrounds. Being a nurse-midwife embraces my duality of being a nurse and a midwife. I am very proud of these credentials.

As I add to my education in a PhD program – through the RWJF Nursing and Health Policy Collaborative at the University of New Mexico College of Nursing – I have found it a challenge to express in my “elevator speech” how these two credentials enhance my abilities to do policy work. I tried starting with what I am doing as a PhD student at the University of New Mexico. But when I say, “I’m also a nurse–midwife,” listeners seem to tag onto that singular piece of information and forget the rest of the conversation. Then, they might share their personal birth story or one that is a fond memory from a close friend. Or, they might ask me if I deliver babies at home.

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I have not been able to figure out how to combine the important and, to me, impressive fact that while, yes, I am a nurse-midwife, I am also very capable of conversing about, researching and representing many other issues.

The American College of Nurse-Midwives (ACNM) has a way to help me and other nurse-midwives who face this dilemma. Next month at their annual gathering, a public relations campaign will be presented to the membership. It will include a vision, mission statement, and core values. The ultimate goal is to describe the value of nurse-midwives and, in general, support the provision of high-quality maternity care and women’s health services by Certified Nurse-Midwives.

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Healthier Moms, Stronger Babies

May 14, 2012, 10:57 AM, Posted by Rebekah Gee

The U.S. Department of Health and Human Services, Office on Women’s Health has designated May 13 to May 19 as National Women’s Health Week. It is designed to bring together communities, businesses, government, health organizations and others to promote women’s health. The goal in 2012 is to empower women to make their health a top priority. The Robert Wood Johnson Foundation (RWJF) Human Capital Blog is launching an occasional series on women’s health in conjunction with the week. This post is by Rebekah Gee, MD, MPH, RWJF Clinical Scholars alumna and an assistant professor of public health and obstetrics and gynecology at Louisiana State University (LSU). She is director of the Louisiana Birth Outcomes Initiative.

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Louisiana is a fantastic place to live. It’s one of the most culturally rich and enchanting places in the United States. The state, however, also faces some of the greatest challenges in our nation.

Louisiana has a long history of poverty, poor education, and social problems that affect the health of too many of its citizens. And for women—particularly African American women—the challenges are even greater. We are 49th in the nation in terms of overall birth outcomes, like infant prematurity and mortality, and we get failing grades on report cards that measure those indicators of health.

In 2010, Bruce Greenstein, Secretary of the Louisiana Department of Health and Hospitals (DHH), recognized the importance of poor birth outcomes as a crucial public health issue—and named it his top priority. We were the first state in the nation to offer birth outcomes this kind of backing from our government officials. In November, 2010, we launched the Birth Outcomes Initiative, which I direct. It engages partners across the state—physicians, hospitals, clinics, nurses—and provides them with the best evidence and guiding principles to achieve change. We have made significant progress already.

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We are working with the state’s hospitals on maternity care quality improvements, including ending all medically unnecessary deliveries before 39 weeks gestation. We have partnered with 15 of the largest maternity hospitals to provide them with the support and resources to make this a reality. Now, every maternity hospital in the state (there are 58) has signed on to the 39-Week Initiative.

Soon, we will be publishing perinatal quality scores—available to the public—so hospitals and physicians are held accountable for outcomes. In our pioneer facilities, we have seen the rates of elective deliveries drop by half. Many facilities have had as much as a 30-percent drop in the number of babies who needed to go to the NICU. The efforts of the Birth Outcomes Initiative are improving lives day after day.

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Let's Toast the Beginning of Health Care Equity

Jan 4, 2012, 6:00 PM, Posted by Nalo Hamilton

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As we head into 2012, the Human Capital Blog asked Robert Wood Johnson Foundation (RWJF) staff, program directors, scholars and grantees to share their New Year’s resolutions for our health care system, and what they think should be the priorities for action in the New Year. This post is by Nalo M. Hamilton, PhD, MSN, WHNP/ANP-BC, Assistant Professor at the University of California Los Angeles School of Nursing and an RWJF Nurse Faculty Scholar.

As 2012 approaches, I hope that the United States remains resolute in providing access to equitable health care for all, especially women.

We live in a time where women have made significant contributions in academic, social and political areas but their contributions to women’s health care are eroded with every passing year. Currently, as the working poor, a record number of women are living in poverty and are unable to access affordable health care.

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Thus, their diaspora of medical conditions go without primary care management resulting in acute conditions that are stabilized in the emergency department. However, once the condition is stabilized, a woman is sent home without the ability to follow-up with her primary care provider, thus continuing the cycle of acute onset, ER admission and discharge.

In my current practice I primarily manage: hypertension, tobacco dependence, obesity, anxiety, depression, dyslipidemia, breast disorders, diabetes, hypothyroidism, infections, dysfunctional uterine bleeding and family planning. For me this list represents the many organs that exist between a woman’s eyeballs and toes. Additionally, these conditions highlight how critical it is for women to have access to health care, not only for chronic conditions but for preventative screening as well.

The Affordable Care Act is a critical first step but much remains to be done at local and national levels.

A new year brings with it new opportunities and hope, so raise your glass with me in a toast to 2012—the beginning of health care equity.

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.