Disparities between race and disease continue to exist in many areas of the health field, including with HPV and cervical cancer.
Black women are found to be significantly more at risk for contracting HPV and having more persistent infections that can lead to cervical cancer, compared to white women.
It is estimated that:
- Black women are 1.5 times more likely to test positive for high-risk HPV infections and 1.7 times more likely to have an abnormal Pap test.
- 56% of black women were still infected 2 years after infection compared to just 24% of white women.
- Black women are 40% more likely to get cervical cancer and are two times more likely to die from the disease compared to white women.
These numbers are staggering and can be linked back to the underlying factors that allow HPV infections to persist and develop into serious complications.
Diet
A key factor in warding off persistent HPV infections and cervical dysplasia is a varied and healthy diet. Missing key nutrients like folate, vitamin C, vitamin E, and selenium, have all been associated with higher rates of persistent HPV infections.
The demographics and socioeconomic classes that struggle to make a healthy diet their reality based on both financial pressures and access to health information, end up suffering the most.
Black Americans are disproportionally more likely to live in low-income neighborhoods and to have reduced access to healthy food. According to The FoodTrust, access to healthy food and full-service grocery stores is challenging for many Americans, particularly in low-income neighborhoods and in communities of color. Furthermore, the study finds that having better access to healthy food corresponds with healthier eating and a lower risk for obesity and other illnesses.
Access to health information and the recent rise of the ‘wellness industry’ is also disproportionality white-washed, making it more difficult for women of color to model and implement healthy behaviors. More effort is needed to make both healthy food and information more accessible to these groups.
Stress
We all experience a variety of stressors in our lives. However, black women are much more likely to suffer from stress than white women. This is largely due to socioeconomic determinants, as well as experiences of racism and discrimination that combined, contribute to greater mental health issues.
We know that stress can play a negative role in impacting our immune system and increasing our risk of developing a number of diseases, including cervical dysplasia.
Risk Behaviors
A number of lifestyle behaviors that are associated with greater rates of HPV infection and persistence, such as cigarette smoking and number of sexual partners, have been found to be more common amongst low-income black women, than other low-income racial and ethnic groups.
A study evaluating HPV positivity across races found that black women had the highest HPV positivity and reported more HPV risk behaviors than white or Hispanic groups.
Access to Health Care
Another reason black women may be more likely to die from cervical cancer is due to cervical abnormalities being caught at a later stage of diagnosis. Many low-income women of color still do not have access to basic quality screenings, either because the services are not readily offered or are too expensive with their insurance.
One study found that black women had 50 percent lower odds of receiving surgery and 50 percent higher odds of receiving radiation compared with white women.
Considering cervical dysplasia that is caught early is highly treatable with the right lifestyle approaches and interventions, there is significant room for improvement needed in providing health care services to this population.
Are black women being left out of medical research?
Research also suggests that black women are less likely to benefit from the HPV vaccine, leading to higher rates of high-risk infections.
The HPV vaccines currently cover two high-risk strains, HPV 16 and HPV 18, which are responsible for about 70% of cervical cancers. Research looking at the specific strains of HPV found in white women and African-Americans has found women were infected with different subtypes.
The most frequent HPV subtype found in white women with early cervical dysplasia were strains 16, 18, 56, 39, 66. Whereas the most frequent subtypes in black were strains 33, 35, 58, 66, and 68. Because current vaccines do not cover the three HPV strains blacks are getting the most, 35, 66, and 68, they are having higher rates of infection.
The researchers concluded, “Since African-American women don’t seem to be getting the same subtypes of HPV with the same frequency, the vaccines aren’t helping all women equally.”
What You Can Do to Help
The disparity in HPV amongst women of color is multi-faceted and requires systemic changes to allow for greater access to screening, services, products and the education needed to address reproductive health and general wellbeing of this population.
The good news is a lot of these factors are within our collective capacity to change. We all have the ability to educate ourselves and advocate for the changes that are needed, now:
- Educate yourself: Being an advocate for change requires us to be well-informed on the topic and where we can be of service to help. Read books, watch movies, and engage in conversation on these topics with a diverse number of people to get a better understanding of the issues and what can be done to help.
- Engage in dialogue: Part of the issue with HPV and cervical cancer rates being higher in black women is due to a lack of information on the topic. Do what you can within your social circles and on social media to inform others about the importance of Pap tests and to direct those who have been recently diagnosed to resource and information providers, like Papillex, that provide accurate and actionable information on HPV.
- Amplify black voices: follow, share, and engage more with the black community to expand your perspective on the health struggles that are experienced by black women and to help make wellness an accessible part of their lives.
- Vote: action is needed at the government level to allow greater access to health care, proper screening, healthy food, and support services. Stay informed on local elections and encourage political action on issues that black people are disproportionately experiencing.
2020 is bringing to light an opportunity for us to all rise together. For this opportunity to lead to the reforms that are needed, we need to do our part as individuals, businesses and communities to level the playing field when it comes to health and well-being.
