By American Heart Association News February
11, 2020
The image of the strong African American woman – resilient,
driven to succeed, devoted to those around her – is rooted in generations of
history. Many women see it as a proud legacy that helps shield them from the
insults of entrenched discrimination.
But health-wise, that shield might be a double-edged sword.
As part of the African American Women's Heart and Health
Study, which has been examining links between racism and health since 2012,
researchers talked to 208 African American San Francisco Bay Area women, ages
30 to 50, about the racism they've faced and how they cope. They also measured
physical responses to stress, such as blood pressure and certain hormone
levels.
This newest work built off studies that defined what's known
as the "superwoman schema." Its aspects include feeling obligated to
appear strong and suppress emotions; resistance to being vulnerable or
dependent on others; determination to succeed; and feeling obligated to help
others.
For the recent study, published in the Annals
of the New York Academy of Sciences, researchers compared those
physical responses to stress to aspects of being a superwoman.
The results? Some of those aspects – having an intense
motivation to succeed and feeling an obligation to help others – seemed to
worsen the physical harm from racism-induced stress.
The need to appear strong and suppress emotions seemed to
protect women's health in the face of racism – but with an asterisk.
The pressure to be a superwoman starts early, lead author
Amani M. Allen said.
"It's something that black girls and then teenagers and
then women tend to carry with them throughout their life," said Allen,
associate professor of community health sciences and epidemiology at the
University of California-Berkeley School of Public Health. It's more than just
"'I'm black, so I'm dealing with racism,' or 'I'm a woman, and I'm dealing
with sexism.' It's both of those things."
And each amplifies the other.
Some of Allen's earlier work associated the pressures of
being a superwoman with harmful habits: smoking, physical inactivity, using
food to cope with stress, and more.
But when she gives talks about the potential harm from
trying to be a superwoman, she said, "I invariably get someone in the
audience that stands up and says, 'How can you tell me that this is bad for my
health? This is my armor. This is what I put on as a form of protection so that
I can deal with the day-to-day stressors – the darts, the arrows that I know
are going to come my way simply because I'm an African American woman.'"
Karen Patricia Williams, a distinguished professor of
nursing at The Ohio State University in Columbus, said stress from the
"drip, drip, drip" of constant exposure to racism adds up over time.
Her 2019 study in Circulation: Cardiovascular Quality
and Outcomes suggests the stresses of trying to be a superwoman
aren't connected to specific diseases but to several risk factors that could
leave women more susceptible to health problems, including heart disease.
Williams praised Allen's research for getting beneath the surface of how
environment, mental health and physical health overlap.
Those interactions are complex.
For example, some research shows caregiving can boost health
and longevity. But it seemed to hurt the women in Allen's study.
This might be a result of women ignoring their own health,
Allen said. Many of the women described how their concerns about others,
particularly their children and loved ones, can result in them neglecting their
own self-care. "They're so busy taking care and looking after others,
they're not eating right, they're not exercising, they're not doing all the
things that they know would be helpful for themselves," she said.
Similarly, Allen's data showed projecting an image of
strength protected women. But women also said that left them "utterly
exhausted."
And while the data found suppressing emotions was helpful,
most research shows emotional suppression is "really bad for health,"
Allen said. "Kind of like a time bomb waiting to go off."
She thinks women who suppress emotions might see a
short-term benefit from limiting the effects of anger, which she said is both
the most commonly reported emotional response to racism and one that is
particularly damaging to health. But her study didn't measure anger – or
consider long-term health effects. So, more research will be needed, she said.
What should an African American woman who faces these
pressures do?
Everyone is different, Allen said, and they should decide
for themselves if their style of coping is harmful or helpful. She suggested women
be mindful – take the time to stop and think about how they're reacting, and
why. Being around supportive people can be powerful.
"Social support is associated with a hormone called
oxytocin," she said. "And oxytocin has been associated with positive
health outcomes."
Allen and Williams both emphasized the importance of
self-care.
"I think we've been taught not to be
self-indulgent," Williams said. "But I think that we can do a little
bit for ourselves. … Maybe it's just having a day for yourself. Or maybe it's
not a full day. Maybe it's, 'You know, I'm going to let somebody else pick up
the kids today from school, and I'm going to do something by myself.'"
If you have questions or comments about this story, please
email editor@heart.org.
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