WASHINGTONThe high rates of cancer in minority communities, some
researchers have suggested, may derive from lifestyle factors detrimental to
health. But a traditional public health approach emphasizing individual risk
factors, poverty, lack of insurance, and limited access to medical services
does not suffice to explain ethnic disparities in health behavior and health
outcomes, said Kathy Sanders-Phillips, PhD, Distinguished Scientist in Drug
Abuse and director of the research program in epidemiology, Howard University.
Rather, she said at the American Psychological Association Conference on
Enhancing Outcomes in Women’s Health, deeper and more significant disparities
in the social conditions of various groups contribute importantly to
differences in their health.
For people living in inner-city minority communities, she said, exposure to
violence adversely affects health promotion behaviors. On the simplest level, a
dangerous neighborhood discourages residents from getting exercise through such
means as taking regular walks.
But Dr. Sanders-Phillips sees the detrimental health effects of violence as
far more subtle and pervasive, undermining people’s will and desire to take
care of their health.
She reported on a study conducted in South Central Los Angeles to examine
women’s health habits as well as their experience of violence. The results
showed a striking relationship between these two apparently unrelated
characteristics. The subjects, 55% black, 43% Hispanic, and all low income,
were asked whether they had such healthful habits as sleeping 7 to 8 hours a
night, eating breakfast, exercising three times a week, abstaining from alcohol
and tobacco, and choosing a low-fat, high-fiber diet.
The women were also questioned about their willingness to improve their
health practices in an effort to prevent breast cancer. In addition, the women
were asked about their experience with violence in their community.
In this study, the women most likely to engage in healthy behavior were
immigrant Hispanics, Dr. Sanders-Phillips said, and those least likely were
black women who had experienced the murder of a family member. Intention to
change unhealthy behaviors was also weakest in those from the most violent
families and with lower incomes.