Risk Factors for Uterine Fibroids Among Black Women

Sleep is essential for the health and well-being of children, adolescents, and adults. Quality sleep supports emotional well-being, metabolic health, cognitive function, mental health, and cardiovascular and cerebrovascular health. Additionally, getting sufficient, high-quality sleep helps reduce the risk of fatigue-related accidents and injuries, such as motor vehicle accidents and workplace incidents.

Recommended Sleep Duration

The American Academy of Sleep Medicine (AASM) and the Sleep Research Society (SRS) recommend that adults aim for at least 7 hours of sleep each night to promote optimal health. Similarly, the National Sleep Foundation (NSF) advises adults to get 7 to 9 hours of sleep per night, with older adults requiring 7 to 8 hours.

Prevalence of Sleep Disorders and Mental Health Impacts

About one-third of the population experiences insomnia symptoms, such as difficulty falling or staying asleep. Additionally, 4% to 26% of individuals report excessive sleepiness, and 2% to 4% have obstructive sleep apnea. Insomnia is associated with a significantly increased likelihood of mental health issues; individuals with insomnia are 10 times more likely to experience clinically significant depression and 17 times more likely to experience anxiety compared to those without insomnia. Poor sleep is also linked to post-traumatic stress, eating disorders, and psychosis spectrum experiences, such as delusions and hallucinations.

Improving sleep Quality

Improving sleep quality benefits mental health, and research reports that sleep plays a causal role in mental health challenges. Better sleep positively affects future mental health, even those without clinical symptoms.

Strategies for Improving Sleep Quality

• Creating a relaxing sleep environment
• Limiting daytime naps
• Managing stress and worries
• Being mindful of food and drink choices
• Sticking to a consistent sleep schedule
• Incorporating physical activity into daily routines.

According to the Centers for Disease Control and Prevention (2021), Cigarette smoking damages almost every organ in the body, leading to numerous diseases and overall health decline. In the United States, smoking is responsible for over 480,000 deaths each year, nearly one in five deaths. For women, smoking can make it more difficult to conceive and can adversely affect a baby’s health before and after birth. In men, smoking can reduce sperm quality, decreasing fertility and increasing the risk of congenital disabilities and miscarriage. Smoking also harms oral health, potentially leading to tooth loss. Moreover, it increases the risk of cataracts, which cloud the eye’s lens and impair vision. It can cause age-related macular degeneration (AMD), damaging a small spot near the retina’s center needed for central vision. Additionally, smoking is a risk factor for type 2 diabetes mellitus and can complicate its management, with active smokers having a 30-40% higher risk of developing diabetes compared to nonsmokers.

The four major diseases linked to smoking are

• Cardiovascular Diseases
  • Increased mortality rates due to smoking.
  • Elevated risk of ischemic heart diseases.
• Respiratory Conditions
  • Smoking is a primary cause of chronic respiratory deaths.
  • Increased risk of respiratory diseases and tuberculosis.
• Stroke
  • A Study reports a Positive correlation between smoking prevalence and stroke-related deaths.
• Lung Cancer
  • Study reports there is a higher likelihood of lung cancer with increased daily cigarette consumption.

Uterine fibroids (UFs) are the most common benign tumors found in women of reproductive age, with a disproportionate impact on women of color. These disparities are believed to be combined with environmental, genetic, and socio-economic factors.

 Some of the lifestyle changes that can help prevent or reduce the development of uterine fibroids are;

1. Decreasing Alcohol consumption: It’s advised that women decrease their alcohol consumption to reduce the risk of developing uterine fibroids (UFs). Studies have reported an association between alcohol intake and an increased likelihood of UFs. Studies believe that alcohol may alter hormone levels and disrupt hormonal balance, contributing to the formation of UFs. It is advisable to consult with a healthcare professional for personalized advice based on unique health occurrences. By being mindful of alcohol consumption and adhering to recommended limits, proactive steps can be taken to lower the risk of UFs.
2. Engage in at least four hours of vigorous physical activity per week: Research has found a significant association between an increased BMI and the risk of UFs. Obesity is believed to be a contributing factor to UF. Studies believe that women who engage in at least four hours of vigorous physical activity per week are more likely to encounter a decrease in the risk factors of UFs.
3. Consuming more fruits, Vegetables, and dietary fibers:  High intake of processed and refined foods, unhealthy fats, and sugary drinks, and low consumption of fruits, vegetables, and fiber-rich foods may contribute to hormonal imbalances, inflammation and oxidative stress, thereby encouraging the growth of UFs as indicated in the research. Additionally, a lack of fruits, vegetables, and fiber-rich foods has been reported to be associated with an elevated risk of UFs. Fruits, vegetables, and fiber-rich food are excellent sources of antioxidants, vitamins, and minerals that help combat oxidative stress and inflammation. Specifically, Dietary fiber has been indicated to have protective impacts against UFs by supporting hormonal balance and improving regular bowel movements. Hence, adopting a healthy and balanced diet with whole grains, fruits, vegetables, lean proteins, and healthy fats is essential.
4. Managing stress:  Studies have found that chronic psychological stress could increase the risk of uterine fibroids and indicated a significant link between chronic psychological stress and an elevated risk of UFs, predominantly among non-Hispanic Black women. Eating healthy, exercising regularly, getting enough sleep, relaxing, connecting with friends and family, and practicing mindfulness are some ways to manage stress.

As we know, obesity stands as a significant health concern affecting the lives of African Americans. It is imperative to grasp the barriers that contribute to the rising rates of obesity within this population.

Obesity is characterized by excessive body fat accumulation influenced by environmental and genetic factors and poses various health risks, including specific cancers, type 2 diabetes, hypertension, osteoarthritis, hyperlipidemia, and cardiovascular disease. Omondi & Freysteinson (2023) estimated annual medical expenses related to obesity issues in the United States to be around $147 billion. Research reveals that obesity prevalence is notably high among African Americans, with rates around 49.6%, surpassing non-Hispanic Whites at 42.2%. Mainly, obesity rates are higher among African American women, reaching 56.9%, compared to 41.1% among African American men (Lofton et al., 2023).

Access to nutritious foods is limited for African Americans, who often consume less nutritious diets with high levels of added sugars and fried foods. Multiple obstacles hinder healthy eating habits, including limited knowledge, the cost of nutritious foods, time constraints for meal preparation, reliance on transportation to access stores, and communication barriers with healthcare providers regarding dietary habits.

Similarly, opportunities for physical activity are restricted, exacerbating the obesity issue. Reduced physical activity levels and increased sedentary behaviors like gaming or screen time have been associated with higher body mass index (BMI). African Americans facing obesity encounter various challenges in engaging in physical activity, including a lack of awareness regarding effective exercise methods, limited access to affordable exercise programs, inadequate facilities, transportation limitations, and health concerns.

References

Omondi, H., & Freysteinson, W. M. (2023). Understanding Obesity in African American Women Using Leininger’s Theory. Nursing Science Quarterly, 37(1), 71–75. https://doi.org/10.1177/08943184231207383

Lofton, H., Ard, J. D., Hunt, R. R., & Knight, M. G. (2023). Obesity among African American people in the United States: A review. Obesity, 31(2), 306–315. https://doi.org/10.1002/oby.23640

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Postpartum depression (PPD) is characterized by a major depressive episode that begins within four to six weeks following delivery, as per international diagnostic criteria. Recurrence rates for PPD are high, with 40% of affected women experiencing depression again in their lifetime and nearly 50% facing another episode in subsequent pregnancies. Symptoms of PPD encompass fatigue, irritability, anxiety, lack of pleasure, feelings of helplessness, sleep and appetite disturbances, indifference towards life events, low self-esteem, and feelings of incompetence as a parent, among others. PPD is considered a multifactorial condition influenced by both environmental and genetic risk factors for depression.

Risk factors for PPD  include:

• Previous depression.
• Adverse life events.
• Lack of social support.
• Socioeconomic position.
• Personal and family psychiatry history.
• Stressful experiences (such as trauma).
• Specific pregnancy-related factors.
• Intimate partner violence (IPV) occurring close to or during pregnancy also elevates the risk of postpartum depression.

The impacts of PPD are significant and extend beyond the affected individual. They include poor attachment between the mother and newborn, potential stunted growth and low weight in the child, disrupted breastfeeding, and adverse effects on the infant’s cognitive, emotional, and social development. There is also an increased risk for psychiatric disorders in the child during infancy, childhood, adolescence, and adulthood. Women of color and those with lower incomes are more likely to suffer from postpartum depression and may face barriers to accessing treatment (Gopalan et al., 202).

The four-stage process to regain control of Postpartum Depression

Women experiencing PPD often undergo a four-stage process in an attempt to regain control:

1. In the initial stage, mothers grapple with intense worries, persistent obsessive thoughts, and difficulties focusing.
2. In the second stage, women feel a sense of loss of their “regular selves,” describing a robotic feeling while caring for their infants. Withdrawal may occur, and thoughts of self-harm or suicide may surface.
3. The third stage involves women planning strategies to overcome PPD, such as seeking help from healthcare providers, engaging in prayer, or finding comfort in support groups.
4. In the final stage, women regain control of their thoughts and feelings as despair lifts.

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The rising cost of living has become a significant public health concern, particularly for low-income individuals who are struggling daily to survive. Addressing the social determinants of health among this population remains an urgent issue, as many face ongoing challenges accessing essential needs such as food, housing, transportation, and healthcare. During my assessment of some of the low-income individuals, I found that several individuals eat only once a day to save money for rent. Many reported choosing to go hungry rather than risk homelessness. Some have been living in their cars for nearly a year, while others rely on the homes of friends to shower and change clothes. It is heartbreaking to witness the difficult situations people endure every day to stay alive.

The rising cost of living has multiple impacts on health and well-being. According to Grewal et al. (2024), increasing housing costs—one of the key components of living expenses—can have both direct and indirect health consequences. Their study indicates that:

• Financial strain from high housing and living expenses contributes to increased stress, anxiety, and depression, particularly among renters and low-income individuals.
• Food insecurity often results when households must prioritize rent or transportation over nutrition, leading to poor dietary intake and higher risks of chronic diseases.
• Limited access to healthcare arises when individuals cannot afford medical visits, medications, or preventive care due to competing financial demands.
• Housing instability or homelessness can expose individuals to unsafe environments, lack of sanitation, and interrupted social support networks, which worsen both physical and mental health outcomes.

Overall, Grewal et al. (2024) emphasize that the effects of rising housing and living costs are unequally distributed, disproportionately affecting low-income individuals who already face multiple barriers to health. This highlights the need for comprehensive policy approaches that integrate housing affordability, income support, and healthcare access as essential strategies to promote health equity.

Source: https://doi.org/10.1186/s12889-024-18360-w