Women's Health Week Focuses on Minority Females

Risk Factors for Disease
Unhealthy behaviors alone lead to more than 50% of the premature deaths in this country. The risk behaviors most often leading to premature death and disability are tobacco use, alcohol and drug use, poor diet, and physical inactivity. Many of these risk factors are serious issues for minority women.

Smoking

• American Indian/Alaska Native women ages 18 and over were the most likely to smoke cigarettes (33%) of all women. Among American Indian women living on reservations, 54% have never smoked; smoking prevalence varies by reservation.
• Among minority women, African American women had the second highest percentage of current smokers (21.3%); but more than one-third (38%) of African American women have never tried smoking.
• Among Hispanic women, 13.7% reported current cigarette smoking, in contrast to 23.9% of Caucasian women. Hispanic women smoke less on a daily basis than do Caucasian women. Among Hispanic women, foreign-born women have much lower rates of smoking than U.S.-born Hispanic women.
• Asian American women are the least likely population to smoke (7.4%). In 1995, 73% of these women had never tried smoking. The prevalence of smoking among Asian American female subpopulations, however, ranged from a low of less than 1% among Vietnamese American women to a high of 19% among Japanese American women.

Body Weight: The National Institutes of Health (NIH) defines the term overweight as an excess amount of body weight for height (which includes muscle, bone, fat and water) as determined by weight-for-height tables. Obesity is defined as the excess accumulation of body fat. Women with more than 30% body fat are usually considered obese. In general, most women who are overweight are also obese.

Body mass index measures (BMI), which do not measure body fat, are used to determine if a person is at a desirable body weight. When a woman's BMI exceeds 27.3, she is considered overweight. The degree of obesity associated with a particular BMI ranges from mild obesity at a BMI near 27, moderate obesity at 30, severe obesity at 35, to very severe obesity at 40 or greater. An estimated 41% of the population has a BMI greater than 25. In 1988-94, almost half of all women between 20 and 74 years of age were defined as overweight. Overweight women are at increased risk for hypertension, heart disease, diabetes and some types of cancer.

• More than two-thirds of African American women between the ages of 20 and 74 were classified as overweight in 1988-94 and 37.6% were classified as obese. Almost one-half of Caucasian women were overweight and 23.5% were obese.
• According to the Indian Health Service, 62% of all American Indian women living on reservations and 63% of urban American Indian women are obese.
• Among subpopulations of Hispanic women, Mexican American women have the highest rate of overweight (67.8%) and obesity (34.6%). Hispanic immigrants who have lived in this country for less than 15 years are less likely to be obese (25%) than more acculturated immigrants (35%).
• Asian American women, in general, have the lowest rates of obesity. However, among subpopulations, the percentage of women who are obese ranges from 26% of Filipino American women to 13% of Chinese American women.

Physical Inactivity: Research has shown that physical activity has many benefits for health. It can reduce the risk of certain chronic diseases, appears to relieve symptoms of depression, helps to maintain independent living, and enhances overall quality of life. Conversely, the lack of exercise can negatively affect one's health.

Alcohol Use: Although the consumption of alcoholic beverages is illegal for those under 21 years of age, 10.5 million current drinkers (of the reported 113 million) were between the ages of 12 and 20 in 1998. Of this group, 5.1 million engaged in binge drinking, including 2.3 million who would also be classified as heavy drinkers. The rates of heavy drinking are highest among Hispanic (36%) and Caucasian (32%) female adolescents, in contrast to 13% of young African American females.

Illicit drug use: In 1995, more Caucasian women (32.9%) and African American women (23.2%) reported having used illicit drugs at some point in their lives than did Hispanic women (19.0%). Marijuana is the most popular illicit substance used by women, while others include inhalants, hallucinogens, tranquilizers, sedatives, and pain relievers. Although more Caucasian (9.2%) and Hispanic (4.6%) women have tried cocaine, African American women (4.2%) are more likely to be recent and frequent users of cocaine, especially the more addictive crack cocaine.

HIV/AIDS: Long considered a man's disease, HIV/AIDS is a rapidly growing public health problem among women, particularly minority women. The proportion of newly reported AIDS cases among adolescent and adult women has increased steadily, from 7% in 1985 to 24% in 1998. HIV infection/AIDS is the second leading cause of death among American women aged 25 to 44. Among women with AIDS, African Americans and Hispanics account for 77% of all AIDS cases as of 1999, even though they represent less than one-fourth of the US population. Among children with AIDS, these two population groups represent more than 80% of cases.

Psychiatric Disorders: Several psychiatric disorders disproportionately strike females. Anxiety disorders (which include panic disorder, phobias and obsessive-compulsive disorder) affect 16.4% of Americans. Twice as many females as males suffer from these disorders. Mood disorders such as major depression afflict an estimated 7.1% of Americans. However, women between the ages of 18 and 45 comprise the majority of those with major depression. Among minority women, depression may be worsened by factors such as low education and income levels, lack of employment, acculturation difficulties for immigrants, marital and family problems, racism and single parenthood. Depression:

• Hispanic women have the highest lifetime prevalence of depression (24%) of all women. Nearly twice as many Hispanic women reported being depressed (11%) as African American women (6%) and Caucasian women (5%). A 1993 survey found that Hispanic women were more likely to suffer from severe depression (53%) than Caucasian women (37%).
• African American women are less likely to have this disorder (16%) than are Caucasian women (22%). However, of those suffering from depression, almost half (47%) are afflicted with severe depression.
• Among American Indian/Alaska Native female adolescents, 14% were characterized as extremely sad and hopeless. Six percent displayed signs of serious emotional stress.
• A significant proportion of Asian American women, especially among the refugee population, suffer from psychiatric disorders. A disproportionate number of these older Asian American/Pacific Islander women commit suicide.

Violence Against Women: Violence is not linked specifically to racial or ethnic factors, but it is linked to socioeconomic status. Women with an annual family income of less than $10,000 were more likely to experience violence than those with a family income of $10,000 or more.

• African American women are more likely to be the victims of violent crimes (56 cases per 1,000) than either Caucasian women (42 cases per 1,000) or Hispanic women (52 cases per 1,000). Between 1987 and 1991, they had the highest rate of aggravated assault (8 per 1,000). African American women also have the highest rate of violent victimizations by an acquaintance or friend.
• Among American Indian/Alaska Native women of all ages, the mortality rate from homicide was 5.1 per 100,000 persons in 1997. The rate of violent victimization was 98 per 1,000 females, a rate significantly higher than that found among all other women. Among the different age groups, violent crime rates were the highest (232 per 1,000 persons) for persons aged 18 to 24 in this population group. This violent crime rate was more than twice that found among Caucasians (101 per 1,000) and African Americans (105 per 1,000) of the same age.
• Among all women, Hispanic women are the third most likely group to be victims of violent crimes. Aggravated assault was more common among Hispanic women (7 per 1,000) than among Caucasian women (5 per 1,000). However, Hispanic women had a lower rate of victimizations by acquaintances or friends (10 per 1,000) than African American women (17 per 1,000) or Caucasian women (13 per 1,000).
• Asian American/Pacific Islander women are the least likely group to be victims of violent crime (21 per 1,000) among all women. In addition, persons aged 18 to 24 years old in this population group are the least likely to be victims of violent crime (41 per 1,000) than persons of the same age in other groups.

Heart disease, cancer, stroke, diabetes, and influenza/pneumonia are the leading causes of death among women in the United States. (Heart disease and cancer combined account for approximately half of all deaths in the United States.) Prevention is the key factor in reducing risk for these and other diseases, and women can live longer and healthier lives by incorporating positive health behaviors into their daily routines.

These behaviors include eating better, exercising regularly, being smoke-free, getting regular examinations and screenings, and protecting themselves from disease and injury. During this week, every woman is encouraged to start lifelong habits that focus on staying healthy.