By Michael Washington
Photos by Samantha Hernandez
When Dr. Cassandra Ford began her scientific inquiry into hypertension and rural, African-American women’s perceptions of it, she found her participants had strong opinions about their health—and about her as a researcher.
A native of Starkville, Miss., Ford was familiar with the factors contributing to the disproportionately high rate of mortality from cardiovascular disease in the rural South. An assistant professor in UA’s Capstone College of Nursing, Ford was even more familiar with the even higher rates of mortality among African-American women.
“After learning that African-American women in Alabama had the highest death rate from heart disease even though they account for less than a third of the female population in the state, I was compelled to study the ‘why’ and ‘how’ of this disparity,” says Ford.
Her study investigates the perceptions of Southern, rural, African-American women regarding personal and environmental factors that affect their hypertension. Ford worked with a sample of 25 African-American women, aged 40–74 years, who lived in rural Alabama. The participants gathered in seven talking circles for 60 minutes.
The majority of participants believed that hypertension and cardiovascular disease were common occurrences in the African-American community, and they associated them directly with stroke and heart attacks. However, most were unaware of the impact of diabetes and cholesterol as predictors of hypertension.
“They overwhelmingly faced the barriers common with health disparities in rural areas, such as low income, health care costs and lack of insurance,” says Ford. “But they also dealt with medication cost, side effects, forgetting to take their medication, fatigue, inadequate access to facilities for exercise and care, and lack of support from family and friends.”
Ford found that a range of personal and environmental factors play a significant role in hypertensive status. As a researcher and nurse, she inquired of ways to help the participants address the barriers they faced.
The process, Ford says, was eye opening.
“Some women were aware they may be sacrificing their health by eating the same food they prepared for their families. So, they challenged me on it. ‘Would you be able to make these changes in your life?’ they asked me.”
That was a hard question for Ford, an African-American woman herself, who understood well the challenges of changing the traditions of large, highly-seasoned meals at the Southern table.
“I realized that it was easy for me to make suggestions, but the most effective ways to see a change arise from my work was to live it,” she recalls. “So, I continued to build relationships with the participants.”
Ford also provided educational materials, including information about healthy eating, to the women upon completion of the circles.
She found the best way for researchers to document their participants’ behavior was to be conscious of her own. Ford said she believes that allowed her to be more effective in subsequent talking groups.
“I listened to what they said to me,” she says. “They were very concerned that I’d tell them what to do, without addressing how one of their biggest battles was actually implementing and maintaining the healthy changes.”