Triple threat to health for older African American women

Older African American women who have experienced high levels of family violence throughout their lives are more likely to suffer worse physical and mental health than their counterparts, found a Temple researcher in the February issue of the Journal of Women's Health.

"In general, there is a higher incidence of mental health issues such as depression and anxiety, and more chronic pain syndromes," said lead author Anuradha Paranjape, M.D., M.P.H., an associate professor of medicine at Temple University School of Medicine and Hospital.

"I think this is an issue for all older women. I have focused on African American women because of my experiences as a busy clinician in downtown Atlanta and now at Temple, where most of my patients are African American. This is an underserved community that experiences health disparities," Paranjape said.

National data shows older African American women are at risk for experiencing poorer health status by virtue of their age, race, and gender. Given this triple threat to their overall health, examining the effect of family violence in this particular demographic group is particularly important, she noted.

These older women have unique service needs since their history of abuse can span across the spectrum of intimate partner violence to other types of abuse later on in life.

"Clinicians caring for older African American women need to be cognizant of the role both current and prior violence exposure may play in their patients' current health status," Paranjape said.

Paranjape advises primary care physicians "to empathize and validate the patient's experiences, and refer them to social support organizations if needed." More importantly, physicians need to know that there may be non-medical reasons why a patient doesn't feel well. If a patient is over the age of 60, it's mandatory for the heath care provider to report the abuse, in Pennsylvania.

For the study, 158 African American women, age 50 or older, were interviewed in ambulatory clinics of a large public hospital. Study participants were asked about the presence and severity of family violence relating to physical violence, emotional, financial, and sexual abuse, neglect, and coercion. Lifetime family violence exposure as well as an adult physical and mental health status were then measured and analyzed by the researchers.

The results found significant differences in scores reflecting poorer health for women who had reported high levels of family violence compared to those who reported low levels or no history of abuse. Unemployment was also found to be strongly associated with worse health status, Paranjape said.

"The next step is to look at what differentiates the women who do better from those who do worse. It is possible that women who do better have better coping skills. In that case, programs that are designed to help survivors of abuse cope in a healthy way need to be funded, implemented and assessed for efficacy," she said.