The saying goes “Black don’t crack!” Is this really true? I believe this saying not because I am black but because I have enough proof to support it. One of my high school classmates whose name I would not reveal just turned 50 years; the last time I saw him about 2 years ago he could have passed for a 30 year old. When it comes to the ladies, the least said the better. In that group though I will always exercise the greatest caution on account of the popularity of Botox. I am not saying the men are not into Botox. The truth though is most of these family men are too broke to even consider Botox.
Are We Cracking on The Inside?
This post looks at how systemic racism leads to early death among many African Americans. I recently attended a seminar on racial disparities in health outcomes. This seminar opened my eyes to a paradox that has plagued me for a very long time. Many of us work very hard to overcome many odds to do well in this country. The speaker suggested that resilience which allows many of us to attain success against many odds may have a price. The price of success despite racial discrimination may be more than we bargained for. Unfortunately, for many of us that price is more rapid progression of heart disease and earlier development of hypertension. Though they may look good on the outside many of our Black brothers and sisters are cracking on the inside.
Study on How Racism & Discrimination Can Lead to Heart Disease & Strokes in Black Women
A recent study by Cedillo YE et al compared 31 African American women ages 21 – 45 to European Americans. As expected reported racism was higher among the African Americans. Many studies have shown that perceived racism leads to high levels of cortisol (stress hormones) in the blood. On the long term this can be measured in the hair. The study recruited the women from August 2014 to April 2016. They excluded any person taking medications that can affect our bodies responses to stress. Those with hypertension were not included in this study for that reason.
The study required the women to come into clinic 2 times to collect information on stress, blood, saliva and hair samples. Hair samples were cut as close to the scalp as possible to ensure a good reflection of longterm stress experience. A survey instrument that had been previously tested in other studies and found useful was used to measure lifetime discrimination. This tool defined experiences within 12 months as recent and anything else as lifetime experiences.
Short Summary of Results of The Women’s Study
The study showed that Black women had higher levels of perceived racism. Both groups showed similar stress responses to unfair treatment. Likely a reflection of the higher levels of perceived stress, African American women had overall higher levels of stress hormones. Inflammatory markers which also tend to predict risk of hypertension and death by heart attacks and strokes were higher in African American women. Women who reported recent experience of discrimination have higher levels of inflammatory signs in the blood, higher pulse. Those who reported more lifetime discrimination had higher levels of hsCRP (inflammatory protein), serum cortisol (stress hormone), higher cholesterol levels and higher blood pressure. All these high levels tend to increase a person’s risk of heart attacks, strokes and even kidney disease.
Is There A Known Scientific Basis For The “Black Don’t Crack” Theory?
Science, fortunately, has a way of figuring our answers to many questions. So is there any science supporting “Black don’t crack”? As we all grow older we develop skin wrinkles. These wrinkles tend to start around the lower eye lid > upper eye lid > cheeks > forehead > lips > nasolabial fold > glabella. Most of the wrinkling is believed to be related to sun damage. Hillebrand et al did a study among 3460 individuals in 5 cities in USA, UK, Italy and Japan.
Facial wrinkling by age group in ethnic groups living in Los Angeles
The study did find that, skin wrinkling occurred more in the following ethnic groups in this order Whites Americans > Hispanics > African Americans > East Asians. These studies suggest that black skin, or just skin with more melanin-producing cells may age more slowly. The table below shows the skin characteristics associated with differences in aging across ethnic groups.
African American Skin Characteristics & Dermatologic Implications
|Skin Characteristic||Impact on skin aging and looks|
|Increased melanin content||More sun protection, less sun related wrinkling and discoloration|
|Thick skin dermis||More reserved elasticity, less sun related wrinkling|
|More and larger fiber producing cells||Preserved skin elasticity, and less pronounced sun damage|
|Slower melanin degradation||Black spots and other changes in skin color|
So Are We Cracking Or Not?
From this short research review I can safely say that there is enough evidence supporting the fact that African Americans tend to look good into their 5th to 6th decades. This is however only true for those that live to that age. Without accounting for violent deaths and homicides, racism may be taking its toll on our lives. One thing racism has not been able to affect is our tendency for slower skin aging. African American’s may therefore age more gracefully on the outside but are more likely to die young. The social and economic implications of this differences in life outcomes goes very far and wide.
We must therefore do well to take good care of ourselves, both mentally and physically. Most of the negative outcomes of discrimination mediated stress is worse with internalized racism. I call this denialism, so we need to live conscious lives and develop ways and means of addressing racism either by addressing the perpetrators or discussing it with another person. Nobody benefits by internalizing racism; the perpetrator does not learn, neither do we improve on how we handle it. When we internalize racism we perpetuate it.
By Dr. Leonard Sowah an Internal Medicine Physician in Baltimore, Maryland
Feature photo: #orangetheworld – Brazil – Black Women’s March against Racism and Violence” by UN Women Gallery is licensed under CC BY-NC-ND 2.0