39. Improving Black Women's Health

Contagious Conversations  /  Episode 39. Improving Black Women's Health





Judy Monroe: Hello and welcome to Contagious Conversations. I'm Dr. Judy Monroe, President and CEO of the CDC Foundation and host of today's conversation. Every episode we hear from inspiring leaders and innovators who make the world healthier and safer for all of us. Contagious Conversations is brought to you by the CDC Foundation, an independent nonprofit that builds partnerships to help the Centers for Disease Control and Prevention save and improve more lives.

Joining me today is Dr. Melody McCloud, an obstetrician gynecologist who became the first Black female to establish an OB-GYN practice in DeKalb County, Georgia. Dr. McCloud is the founder and Medical Director of Atlanta Women's Healthcare PC, and lectures nationwide on women's health, sex and social issues. Her recent book entitled Black Women's Wellness: Your "I've Got This" Guide to Health, Sex and Phenomenal Living was released in January.

In this episode, we discuss the health threats faced by minority women, the vital role of equity and public health. And what steps women can take to live healthier lives. Welcome, Dr. McCloud.

Melody McCloud: Thank you so much for having me, Dr. Monroe. It's just wonderful to be here with you and all of your listeners. Thank you.

Judy Monroe: Well, thank you. Wonderful to have you. And Dr. McCloud, we'll start with the first question I have for you. So, you've had a long career in obstetrics and gynecology, and you were the first Black female to establish an OB-GYN practice in DeKalb County, Georgia in 1985. Tell us a bit about your life journey and what drew you to this field of medicine.

Melody McCloud: Well, thank you. My initial input or energy and interest in medicine began when I was a little girl. I grew up poor. I never knew any of my grandparents. I had an absentee father. I lived with a single mother who was extremely stressed out with various things, lived in a sixth floor walk-up building on the fifth floor. But I was fortunate enough to have a Black female pediatrician when I was a little girl. Her name was Dr. Doris Wethers, W-E-T-H-E-R-S. And I used to love to go to her office and smell the rubbing alcohol in the air, for some reason. And also, I remember hearing how she would help people feel better, and I think that in some ways just touched me as a person, who I am. And so she was my first vision of a physician. And seeing her as a Black woman ... at that time, maybe I didn't put a racial thing on what I saw, but to just see that vision, gave me the energy and desire to do what she did. So I'm grateful for her. Dr. Doris Wethers.

Judy Monroe: Well, thanks for sharing that story. I think it's a really powerful story of how important role models are. And how young children, when they can see themselves in adults that are doing things that are inspiring to them.

Melody McCloud: Yeah. If you can see it, you can kind of grasp it, maybe you can be it.

Judy Monroe: Exactly. Exactly. Well, and I think it speaks to all of us. We never know who's watching, right? So, it behooves us to remember that we may be role models for others.

Melody McCloud: Exactly.

Judy Monroe: This month is National Minority Health Month, and so much of your career has been spent providing care for minority populations, particularly minority women. What are some of the most significant physical health threats faced by minority women? And what effects does societal stress have on Black women's physical health?

Melody McCloud: I found that the most significant physical threats to women in general, and particularly minority women, are what I call medicine's top five affecting our lives: Heart disease, obesity/diabetes, cancers, maternal mortality and HIV AIDS. So that's really the top five, really pretty much for everybody. When it comes to black women in particular, there's a statistic that not many people realize is happening, and that is, the CDC reports as do NIH and others, that the sixth leading cause of death for Blacks is homicide. And that's a little known statistic. So ironically, for Blacks, homicide is listed as number six when it's not listed at all for any other demographic. So that's the first part. With regard to other issues, I find that as an OB-GYN and taking care of women from all walks of life– Black, White, Hispanic, other–we're all normal. We all start out the same. But for some reason, the data changes for Black women, and that concerns me. And there's some issues or reasons why that may be, which we maybe can get to later on.

Judy Monroe: Certainly the top five you listed, but number six, homicide. I mean, that really strikes me. That's alarming and quite concerning.

Melody McCloud: Yeah, I had gone to some Georgia emergency management meetings, Homeland Security meetings. I've written about crime. I think people need to realize that homicide is not only public safety, but it's public health. We are losing Black lives to senseless crime. And we need to address that, I think in a very meaningful, tangible way. And I think some people don't want to hear some things. The community's being affected, lives are being taken. A lot of young people's lives are being taken by young people. And we need to draw attention to that. I've got suggestions I addressed in the media, in the paper, public speaking. And it needs to be looked at not only from, like I said, from a safety standpoint, but from a public health crisis.

Judy Monroe: Well, it certainly is a public health crisis. No question. So, let's talk about your book a moment. You've recently published a book that's focused on Black women. And in fact, the book has been described as a head-to-toe health resource for Black women. Tell us a bit about the journey of writing the book? And what inspired you to put pen to paper?

Melody McCloud: Well, for one, I love medicine. I love taking care of people. I love educating people. I love writing. And so all of that comes together in the form of a book. I wrote this book amidst the whole Covid lockdown. So, it was a little bit of a challenge, because we all were going through a mental languishing period. Also with Covid, data was changing all the time. So, look, I've written this book about twice, quite honestly. But a lot of other books rarely give voice to Black women's health in particular. I've noticed that we might get a sentence, we rarely get a paragraph. Certainly we don't get a chapter. And given with Covid bringing to the fore ethnic health disparities, it kind of became a good time to say, ‘Okay, people are paying more attention to their health, and let's show them ways that you can improve your health.’ And I felt a resource, a reference book to have on hand would be good to have. And I really salute the publishers, Sounds True, because they recognized the need for that at this particular time.

Fortunately, a chief medical correspondent on a national news program jumped on board, gave me an endorsement. Denzel Washington's wife gave me an endorsement, as did some psychologists. So it was just good. And we need to get the word out. People need to just have a word of knowledge. Knowledge is power.

Judy Monroe: Yes, it certainly is. Well, thank you. Thank you for putting your effort and time during Covid to writing this book. So ,one of the health issues that impacts minority women so much and more significantly than non-minorities is maternal mortality. The CDC Foundation has supported several projects to improve health outcomes for pregnant women, and we're passionate about women's health. What changes have you seen in maternal health outcomes?

Melody McCloud: Well, as an OB-GYN, it really hurts my heart to see the numbers regarding maternal mortality right now. The numbers have gone up exponentially across the board in recent years. And we're losing mothers with maternal mortality, perinatal mortality, infant mortality. And especially for Black women, this is extremely concerning. Black women have almost three times the number of deaths related to maternal mortality and infant mortality. The main reason for that is, Blacks may not start prenatal care as early as they need to. Early prenatal care is crucial, and it's critical. And also, I encourage people to make sure you go for a pre-pregnancy consultation with your doctor, okay? If you're thinking about getting pregnant, go talk to your doctor about what health risks you come into the pregnancy with. Also, a lot of women are having, or getting pregnant later in life because maybe they've gone through school longer, or they didn't find a husband or a partner they wanted to have a baby with.

So they're delaying childbirth. And by that time, by the time you get a little bit older, you may have some medical conditions. You may have gotten hypertension, you may be a bit more obese, you may have diabetes. If you don't know that going into the pregnancy, that can cause a problem for you during the pregnancy. So pre-pregnancy consultations are important. Beginning prenatal care early is important, because that way, we as physicians can pick up on these medical conditions. And also, we can take steps to help prevent you having medical complications. And also, having loss of your infant, your fetus, and/or your baby later on in life. Very important.

Judy Monroe: We'll be right back with Dr. Melody McCloud.

The CDC Foundation believes we have more impact working together and is committed to supporting and working with communities to eliminate health inequities. By joining with public health, private sector, philanthropic and community partners, we aim to improve health for all, and realize our vision of vibrant and resilient communities where everyone can thrive and live their healthiest lives. Learn more at cdcfoundation.org/healthequity.

And now back to our conversation with Dr. Melody McCloud.

From your perspective as an OB-GYN doctor, what are the most important steps women, and particularly minority women, can take to improve their own health and wellbeing?

Melody McCloud: Well, the main thing I feel is everyone should start with just knowing your family history, okay? Know where you come from. Know what risks you face. Who had diabetes in the family? Who had heart trouble? Who had a stroke at an early age? That's really to me, number one. Know your family history. Also, I really want people to know how important it is to get that checkup. The numbers have changed of how often you need to have one. I still like people to have an annual checkup. You never know how often your sugar's going out of whack, or your heart, or whatever. So, I still encourage annual exams.

Sometimes we hear that people may not have money for this, that and the other. Okay, I feel that may be true, but we have money to do some things that we want to do. Okay. We have money for hair, we have money for makeup. We have money for that designer bag. And so, I tell people, ‘Don't tell me you don't have one money for one exam once a year to go get your checkup done, that can save your life.’

Also, too–and this is a factor that contributes to ethnic health disparities–and that is the fact that we often hear that people, Blacks in particular, may not have access to medical care. Or they may not have medical insurance. And yes, that is true in many, many instances. But the issue with Blacks and other minorities is, even for those with access to care and with medical insurance, the numbers still lag far behind when it comes to successful healthcare outcomes. So, I think that plays another role. And that's when I also talk about how societal stress affects Black women's health.

Judy Monroe: Yeah, thanks for that. You know, you make it real. So thank you.

Melody McCloud: Yeah, you got to keep it real. Like I said, just once a year. And also to make use of free medical services that may come your way. You may not have money for this, that and the other, but we have free health clinics to go to. We have community health programs and health fairs. There are mobile mammogram units that come to your neighborhood. Make use of that. And even for Blacks who, you know, we may be in church every week, few days a week. At least before Covid, we were. Every week. But we don't go to the doctor once a year to get our checkups done. So, I encourage women to use that same energy and discipline you have for your spiritual health, apply that to your physical health.

Judy Monroe: That's fantastic advice. Much of this is around health equity and how essential a foundation of equity is to quality public health. You've developed a really intimate perspective on health equity through your career. So why is it important that we focus on health equity and where do you hope that focus leads us in public health?

Melody McCloud: Well, this is really a hot topic right now. And I think one thing that's really, really important is we need more Blacks and other healthcare professionals and Black physicians in the healthcare work, physician workforce. That's really important. Not that any one of a minority has to go to a doctor like them, but we do find that some data shows that people are more receptive of medical information when it's given to them by someone of their own ethnicity. For Blacks, there's been a lot of hesitation regarding and interacting with the medical profession because of past histories. But seeing someone who looks like you may help encourage you to get that care. Again, make use of services that are available. I encourage people, minorities, to participate in clinical trials because we now know that some data is not the same as it is for other people. So that's really important.

And also in this day and time, medicine's not as it used to be from years ago. So I encourage people to be their own best advocate when going to the doctor's office. Take someone with you, if you need to, who has a medical background, because they may be able to hear something you don't hear. Or they may ask a question that you don't even know to ask. So I think that's important. And also too, we have more Blacks going into biomedical research. I'm so proud of even Dr. Kizzmekia Corbett, who worked with the Covid vaccines; young, black female. So I'm excited about that. To get more people into the healthcare professions and to see more people participating in the beauty of science and how all of us are here. And longevity and life expectancy has grown because of interest in research and medical care.

Judy Monroe: As you said, being able to go to a physician or a caregiver that looks like you, that trust may be there, that might not be elsewhere. But also the role modeling, I'm going to go back to your childhood pediatrician. We need our physicians and medical providers to be a diverse group and be strong role models.

Melody McCloud: Someone you feel you can relate to. And also hopefully that you can be heard, because there is this thing of implicit bias, unfortunately. Implicit racial bias.

Judy Monroe: Right.

Melody McCloud: And I think doctors and healthcare institutions are becoming more aware. And even having in-hospital training sessions to try to make sure that that is abated to some degree. To just realize there may be some implicit biases. Sometimes people aren't being heard. I mean, patients may complain of this, that or the other, and they're really not being heard. Or their symptoms are being minimized simply because unfortunately, because of clinicians' implicit bias. And ‘Oh, that person's just asking for pain medicine.’

Judy Monroe: Yeah.

Melody McCloud: So those are issues. And one other thing too, I find, getting back to the whole disparity piece, is the societal stress that Black women in particular experience. Again, access to care insurance, we have that, but for those that have it, it still happens. And I think one factor is important. It needs to be pointed out that societal stress, these psychosocial stressors that affect our spirit, increases our cortisol. It puts more stress on us, is the rejection. I saw an image one time where the brain lit up in the same way to physical pain as it does to social pain. So if a Black woman is feeling rejected, negative media imaging is affecting our spirits, that increases our cortisol. Which can increase our stress, our heart, our eating. And all those things tie in together to affect our health, to lead to adverse physical outcomes.

Judy Monroe: Yeah. They seriously do. So, I'd like to kind of end on a high note here, and as we look at Black and minority women still facing many unique challenges in achieving and maintaining health. But let's look forward, and if I can ask you to project a bit, what bright spots do you see in public health, particularly as they relate to women?

Melody McCloud: I see that we do have more women going into medicine themselves, and a lot of women only want to go to a woman doctor. I don't personally have an issue with that, but some women only want to see a woman doctor. Because a woman may understand a woman's special needs more than a man might. So ,to see more women going into being clinicians as physicians and surgeons, heart surgery, I've seen, and all aspects of clinical care. Again, more going into biomedical research was important, and biomedical engineering. I just think that's just fascinating. I'm becoming more fascinated by engineering. I really …

Judy Monroe: I'm right there with you. Engineering is fascinating.

Melody McCloud: Isn't it amazing? I mean, engineering, it's just so fascinating. And biomedical engineering, even mechanical engineering, I'm just really ... for some reason, I don't know where I'm at in my head right now, but I'm just finding that fascinating. And to know that they're out there, and I think we just need to see them more. We see the singers and the hip hop stars and those athletes, but we need to see and bring more attention to those who are going to the medical sciences, the biomedical sciences. And congratulate them and support them and see more of them so we can have even more to affect the healthcare outcomes of our future generations. Judy Monroe: Well, this has really been an insightful conversation. Been a lot of fun for me to speak with you and to get your insights. It's a really relevant discussion given that we're right at the start of the National Minority Health Month. Thank you so much, and congratulations on your book. Really, really outstanding work.

Melody McCloud: Well, thank you so much for having me. And again, knowledge is power. We have issues, but I know we've got this. We can do this with a word of power, a word of education. To everyone, thank you for having me.

Judy Monroe: All right. We've got this! I love it.

Melody McCloud: That's right.

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