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Why are we leaving Black women’s health behind?

by Dr. Donna Christensen, Debra Fraser-Howze and Shavon Arline-Bradley
May 24, 2023
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Courtesy of NNPA

Although Black women make up 7.7 percent of the total U.S. population, we have the highest rates of obesity in the country. Sixty percent of Black women live with obesity, which means we have higher risks for heart disease, stroke, and certain cancers related to the condition. 

The urgency for addressing obesity amongst Black women cannot be understated: As the obesity epidemic grows, the health of Black women is increasingly at risk and so is our ability to work, care for ourselves, and participate in society.

It’s not enough to acknowledge obesity for what it is, a silent killer upending Black women’s lives. Acknowledgement must be tied to immediate and impactful action. To truly stem the tide of this crisis, we must dismantle the discriminatory healthcare policies that deny access for millions of Black women to the full range of lifesaving obesity care, including FDA-approved medications.

The science clearly shows that Black women are unavoidably exposed to the societal factors that lead to obesity. Yet as a society, we’re ignoring the evidence. The data say the lived experiences of Black women—disproportionate rates of poverty, gender bias, racism, and lack of access to health care—lead to higher rates of obesity. 

The American Medical Association (AMA) not only recognizes obesity as a complex, chronic disease. They also point out that racial and ethnic disparities are a major factor in the prevalence of obesity.

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If the science is clear, then why has there been no effective solution to slowing the rates of obesity among Black women? The short answer is that national obesity policy is underpinned by outdated and punitive perceptions of the disease, resulting in discriminatory care and insurance coverage schemes that deny millions of Black women from accessing FDA-approved medication and treatment.

For decades, treatment for obesity has largely focused on recommending a regimen of diet and exercise, fueled by the myth that obesity is simply a behavioral issue that can be remedied through lifestyle changes and “self-control.” For years we have left the doctor’s office with vague instructions to lose weight and eat healthy, made to feel weak as we battle this debilitating disease on our own. 

But science has come a long way in the past 20 years, and we now realize there’s a lot more at play that, until now, we have not been able to control. Scientific breakthroughs have even proven that diet and exercise alone can be insufficient for treating obesity. Obesity is a disease, and it must be treated as such.

But access to its treatments are hard to come by. Medicare does not cover anti-obesity medications, nor do most Medicaid and Affordable Care Act plans. These programs are still driven by disproven notions that obesity is a behavioral issue and not a chronic disease. 

As a result, patients reliant on these and other programs—including millions of Black women—are denied access to the full range of care, which includes FDA-approved obesity medications. These policies were created two decades ago when our understanding of obesity was primitive and incomplete.

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The Centers for Disease Control (CDC) recently reported that nearly 42 percent of American adults have obesity. Yet nothing has changed for obesity care coverage since the AMA’s declaration that obesity is a chronic disease a decade ago.

It’s time to modernize our federal, state and private healthcare programs based on science, address this disease seriously with coverage for comprehensive care, and ensure all Black women have access to treatment and care. The time for action is now!

Dr. Donna Christensen is the first female medical doctor to serve in Congress and serves on the Medical Advisory Board of Choose Healthy Life. Debra Fraser-Howze is the founder and president of Choose Healthy Life, a nonprofit organization that addresses health equity through the Black church. Shavon Arline-Bradley is the president and CEO of the National Council of Negro Women.

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