By Dr. Reba Peoples
Reba Peoples, MD, Psychiatrist
We’ve all heard the old adage that black people have to work twice as hard to be seen as half as good. The sad truth is that, thanks to a host of structural and systemic factors that make us more vulnerable to chronic disease, black people also have to work twice as hard to stay half as healthy. Although basic science would suggest that a virus cannot discriminate, when it comes to COVID-19, the facts state otherwise.
From a health perspective, the past few months have dealt a devastating and disproportionate blow to Black Americans. As of May 3, 2020, black people accounted for 33% of all COVID-19 deaths in Wisconsin in spite of black people making up just 6% of the population. In looking at rates of infection, black people account for 22% of all infections in spite of making up just 6% of the population. As many states rush to reopen, we cannot ignore the underlying structural and systemic factors that make us more vulnerable to exposure and more vulnerable to severe infection and even death after being exposed. We also cannot ignore the crucial role that our own preparedness will play in helping us weather this storm.
Matthew 7:24 makes reference to the wise man who built his house upon a rock. When the winds blew and the rains fell, his house stood firm because it was built on a solid foundation. When we make a commitment to self-care and care of our communities, we are making a commitment to building on a solid physical and emotional foundation that will allow us to weather any storm. This storm is no exception.
In terms of exposure risks, many in the black community simply do not have the luxury of being able to work from home. Those of us employed in public facing positions in essential services like grocery stores, public transit, the postal service, restaurants, etc. are at higher risk of exposure simply due to the nature of our professions. Individuals living in apartments or multi-generational homes may not be able to physically distance from vulnerable loved ones due to lack of space.
In order to limit our exposure, we must continue to take precautions including hand hygiene, social distancing of six feet between yourself and other people outside of your household, masking when in public and masking when in contact with members of our households who may be vulnerable to infection.
Although the CDC recommends using cotton material or bandanas as face coverings, the best filtration coverage will be from nonwoven material like polypropylene. This is the same material that is used in surgical masks and also the type of material that is present in many N95 masks. This material is often layered in a special material called SMS fabric. SMS stands for ‘spunbond, meltblown, spunbond’ and is the type of material used in surgical draping. Because medical equipment is in such short supply, it may be difficult to obtain surgical draping however an alternative to surgical draping is automobile car covers made from SMS materials or layering the polypropylene material from reusable grocery bags. There are many tutorials regarding how to construct a homemade facemask using SMS or polypropylene material. These masks can sometimes come very close to matching the filtration capacity of an N95 mask. A few links to homemade mask instructions can be found here:
https://www.ksat.com/news/local/2020/04/16/local-nurse-designs-mask-with-995-filtration-efficiency/
https://anest.ufl.edu/clinical-divisions/mask-alternative/#prototype1
In terms of infection risks, those with chronic diseases like asthma, heart disease, obesity and diabetes have a much higher likelihood of having a much more severe course of illness and even death than those without underlying health conditions. Black Americans are unfortunately much more likely than the general population to be impacted by these conditions. Unlike what many health commentators would have you believe these disproportionate numbers are not merely due to unhealthy lifestyle choices.
Did you know that according to a 2017 study in the Lancet medical journal, air pollution is considered the biggest cause of preventable death worldwide? This is because the oxidative stress and inflammation caused by exposure to these toxins sets the body up for a host of metabolic reactions that lead to a higher likelihood of developing diseases like asthma, heart disease and diabetes. Black Americans face twice the health risk of air pollution in comparison to their white counterparts thanks to unequal distribution of toxins from a variety of sources from aging industrial plants to traffic fumes from the interstate highways that have cut through many black communities.
We also know that the presence of food deserts in low income neighborhoods makes it difficult to obtain high quality, nutrient dense whole foods. For those of us who have access to high quality foods, deceptive marketing practices that label highly processed foods that are filled with sugar and other chemical additives as ‘health’ foods makes it difficult and confusing to know how to make the right choices. Racism itself can also lead to health disparities because of the increased allostatic load that the stress of encountering everyday acts of racism and racial bias can place on our bodies.
So, what can we do about it? From an individual standpoint, we must commit to doing all that we can to care for our bodies and nurture our spirits. From a communal standpoint, we must continue to shine a light on the systems and structures that are placing us at risk. We must continue to demand accountability through civic engagement and civic action. We must continue to educate ourselves and each other and we must continue to demand change through our votes, through our voices and through our wallets.
What are the fundamentals of proper self-care?
1. Get Enough Sleep – Your body and your brain cannot function without adequate sleep. Being sleep deprived can actually impact the areas of the brain that are responsible for making decisions, solving problems, controlling emotions and coping with change. Without adequate sleep, the more limbic or primitive part of your brain is more likely to be the part of your brain that is in control. When this happens, you are more likely to respond to challenges from a place of anger rather than from a place of rational, righteous indignation. Adequate restorative sleep is also crucial in helping maintain a healthy immune system. How much sleep is the right amount? It varies from person to person but you always want to aim for a minimum of 6-8 hours of solid sleep nightly.
2. Move Your Body – Physical exercise is so important in helping maintain emotional balance and in keeping your immune system healthy. Studies have shown that just 20 minutes of exercise four times weekly is actually as effective as an antidepressant in mild to moderate cases of depression. We also know that mindful moment like yoga, tai chi, dance and even martial arts can strengthen the connections in the area of the brain that allows you to have a finite sense of time. People who struggle with overcoming trauma often live in a constant state of heightened fear and anxiety because their brains have not been able to properly deliver the message to their bodies that the danger has passed. Their brains and bodies are essentially ‘stuck’ in the past.
3. Choose Your Thoughts Wisely – Did you know that the average American is estimated to have an average of 50,000 thoughts in a single day? For most of us, about 65% of those thoughts are negative. The nature of trauma is that it robs you of your ability to imagine the possibility of a better future or different outcome. When we allow ourselves to become stuck in externalizing blame rather than mobilizing resources, we rob ourselves of our ability to actively manifest change. Yes, there is blatant injustice in the world. Yes, people of color have historically been systematically brutalized, beaten, murdered and oppressed. Yes, it is important to name these things however it is also important to recognize the true work only BEGINS with the label – it doesn’t end there. Labeling injustice not only allows us to acknowledge the fact that it exists, but more importantly allows us to imagine the possibility of dismantling those structures that allow it to exist in the first place. All action begins with a thought. We need to choose our thoughts wisely.
4. Eat Real Food – I cannot stress this enough. One of the best protections that you have against the ravaging effects of daily exposure to toxic stress is fueling your body a variety of colorful, nutritious, whole foods. A general rule of thumb is that if something comes in a bag, a box or a can, it probably should not go into your body. When we eat foods that are high in sugar content or foods that trigger inflammation in the body (wheat and dairy are the primary offenders for a good number of people) our brains release chemical messengers called pro-inflammatory cytokines. People with high levels of these chemicals in their brains are more likely to struggle with depression, more likely to have symptoms of anxiety and are more likely to have physical symptoms like sluggishness and fatigue. Make an effort to commit to avoiding processed foods and refined sugars. Your brain and body will thank you.
5. Know Your Limits and Know When to Get Help – This is a big one – especially for those of us who may work in environments where we are one of a few or perhaps even the only person of color. Please know that you are not alone and there are plenty of people out there who understand and are able to offer support. Don’t be afraid to reach out to your support network to talk things out when needed. It’s also important to recognize that there is no shame in reaching out to a mental health professional for extra support when needed.
This is by no means meant to be an exhaustive or all-inclusive list but merely a starting point to get you on the path toward feeling your best and daring to thrive in the face of adversity.
Be well and God bless.
Reba Peoples, MD is a Board-Certified Psychiatrist who practices in Minnesota and Georgia. She is also an expert in culturally specific wellness training. For more information go to her website: https://www.imarahealthandwellness.com.