Everybody worries about getting sick. Those who do not are themselves likely to have health issues which they may not be aware of, because it is natural to seek to keep health good and therefore preserve life.
Whether we aim to keep health good or to make it good – more of us are becoming health conscious and willing to do something about it. That is true even if the action is short-lived. (Just attend any gym during January and then March of the same year to see this in action!). In this article, the aim is to overview the broad problem of health in individuals of African origin and follow this later with a more detailed look at individual diseases, how they affect us and what we can do to address how they affect us.
Despite the trend of improved health awareness outlined above, disparities persist when comparing the health outcomes of those of African origin and others in regard to certain health conditions. In particular, and for multiple reasons, the following conditions affect people of African origin disproportionately:
- Cardiovascular disease (which includes hypertension, heart attacks, heart failure).
- Cerebrovascular disease (which includes strokes, transient ischaemic attacks – TIA – or mini-stroke).
- Diabetes (which is closely linked to the above).
- Cancer in general but specifically:
- Lung cancer and
- Prostate cancer.
There are other health issues affecting African Caribbeans, which Trudy Simpson illustrated quite well in a 2011 Voice article and include systematic lupus erythematosus (lupus), sickle cell anaemia, mental health, diabetes, HIV infection, leukaemia and associated bone marrow donation. These will be addressed in later articles.
Along with the above bad news is the good news that the power to improve our health outcomes does, to a degree, lie within the grasp of the African diaspora. The strategies and tactics may simply include simple measures such as self‑education about these conditions and developing an understanding of the options for treatment.
How can I say that? Well, it is becoming clear that some health issues that affect people of the African diaspora are more to do with factors such as level of education and socioeconomics rather than race, per se.
What do I mean? Well, put simplistically, it is well known in medicine that people who are poor tend to have the worst health.
As an example, let us take lung cancer. Poor people are disproportionally affected by this condition. They are more likely to have little education, are more likely to be manual labourers, often have economic stress factors with associated higher levels of stress which often lead to unhealthy pastimes such as cigarette smoking. Despite years of health education in the media warning of cancer risk from smoking, very often smoking continues in this group with inevitable consequences.
People of the African diaspora, for various reasons, and despite economic progress in this group, often fall into this category. So, their health outcomes are not primarily because of their ethnicity but because of their socioeconomic circumstances. If the latter could be change or the effects of their circumstances mitigated, then in theory the health outcomes could change. The challenge is finding a way to do this.
The situation of lung cancer from smoking contrasts with that of a condition such as hypertension – common in those of African origin. Those who have hypertension (specifically the type called essential hypertension), have a genetic makeup that results in higher than average blood pressure.
Current mainstream medical knowledge suggests that definitive treatment can be provided primarily by medications, although there are also viewpoints that advocate alternative medical options. No amount of change in socioeconomic circumstances, however, will alter the genetic makeup of an individual and so affluent or poor, if you have hypertension, the likelihood is that you will need treatment with tablets to keep your blood pressure under control
The point? Communities and individuals of African origin can take action to reduce the negative effects of their health conditions. The task is to identify which conditions we can effectively do something about, what appropriate action can be taken to optimise our health outcomes.
This is why I am proposing health consultancy/advocacy to coordinate tactics and strategies by which individuals disadvantaged by their health/education/socioeconomics can be helped to improve their health outcomes. Progress in improving our health outcomes exists but a more coordinated, sustained effort is needed.
This will include education ‘tailored’ for those of the African diaspora individual, guidance through the maze of options available for management of health to seek the best options, the coordinating of support during health crises through direct and indirect means. Advocacy/consultancy would be provided by individuals who work for or have worked in the NHS and other health systems.
The ‘Cuban solution’ is also a complimentary approach that can be consciously applied in improving health outcomes of the African diaspora in UK. As the Rand Corporation points out, Cuba has done ‘…more with less…’ over the years by the following approach:
‘…Cuba prioritizes primary care and prevention and addresses social determinants of health…’
To partially explain, due to the trade barriers that have existed between Cuba and the United States of America (USA) over the years, US pharmaceutical firms have had less access to the Cuban market than elsewhere. Cuba has had to therefore develop health strategies that focus on ‘prevention’ rather than the current situation in mainland USA where the effective focus is on ‘cure’ – involving medications and other interventions with significant cost and profits to those firms. The Cuban approach has been a successful strategy in keeping down costs to the Cuban government and has broadly improved the health outcomes of people.
While it is not a perfect solution, it can be applied as one part of a multifactorial solution to our health outcomes in the UK but would not be achieved easily. Much work needs to be done but like all worthwhile things ‘…if u waan good u nose ha fi run…’, to borrow a Jamaican saying.
In the next article, I will address the above conditions individually and in more detail and suggest some ways which maybe helpful in dealing with the conditions using my limited experience of medicine and inside knowledge of the way the NHS works.