IV. RISK FACTORS FOR DISEASE                                

Besides being at risk for certain diseases by reasons of ethnic diversity, certain health behavior places an individual at risk for disease more than anything.  Some of these behavioral risks are more commonly seen in some ethnic groups more than others.  Risk factors such as smoking, alcohol and drug use, dietary factors, and physical inactivity will cause a person to be more predisposed to certain diseases more so than the common population.  Many of these risk factors are serious issues for minority women. 

Smoking is considered to be the single most important cause of disease in the United States.

1)       Tobacco use. Smoking is the single most preventable cause of death and disease in the United States. As of 1996, roughly 22 million adult women and at least 1.5 million adolescent girls smoked cigarettes. The use of tobacco has been shown to increase the risk of cancer, heart and respiratory diseases, and reproductive disorders.  More than 40 chemicals have been identified in tobacco smoke that causes cancer in humans and animals.  More than 140,000 women die each year from smoking-related diseases.

Female smokers typically begin to smoke during adolescence, usually before high school graduation. The earlier a young woman begins to use tobacco, the more heavily she is likely to use it as an adult.   Among high school seniors in 1990-94, 39.4% of American Indian/Alaska Native females smoked, in contrast to 33.1% of Caucasian females, 19.2% of Hispanic females, 13.8% of Asian American/Pacific Islander females, and 8.6% of African Americans females.

Figure 1

^{Of all minority women, Native American females have a greater likelihood of smoking.  Of these, half of the women living on reservations have never smoked with the numbers varying according to specific reservations.  African American women are found to be second in prevalence among minority women, with more than one-third having never smoked.  Asian American women have the lowest percentage of smokers among all women with Hispanics having the second lowest rate of tobacco use.}

2) Body Weight. The National Institutes of Health (NIH) defines the term overweight as an excess amount of body weight for height—which includes muscle, bone, fat, and water—as determined by weight-for-height tables. Obesity is defined as the excess accumulation of body fat. For practical purposes, most women who are overweight are also obese. Doctors and scientists generally agree that women with more than 30% body fat are obese.

Body-mass index measures (BMI) is a good way to measure whether or not an individual is at a suitable weight. This value is considered one of the best assays of morbid obesity.  (BMI is found by dividing a person's weight in kilograms by height in meters squared.) When a woman's BMI exceed 27.3, that person is considered overweight. The degree of obesity associated with a particular BMI ranges from mild obesity at a BMI near 27, moderate obesity at 30, severe obesity at 35, to very severe obesity at 40 or greater.

Figure 2

More than two-thirds (66.6%) of African American women between the ages of 20 and 74 were classified as overweight in 1988-94 and 37.6% were classified as obese. In contrast, almost one-half (48%) of Caucasian womenwere overweight and 23.5% were obese.

According to the Indian Health Service, 62% of all American Indian women living on reservations and 63% of urban American Indian women are obese.

Among subpopulations of Hispanic women, Mexican American women have the highest rate of overweight (67.8%) and obesity (34.6%).  Hispanic immigrants who have lived in this country for less than 15 years are less likely to be obese (25%) than more acculturated immigrants (35%).

·         Asian American women, in general,have the lowest rates of obesity. However, among subpopulations, the percentage of women who are obese ranges from 26% of Filipino American women to 13% of Chinese American women.

 

Figure 3

3) Alcohol and Illicit Drug Use. Heavy and chronic use of alcohol and other drugs have numerous harmful effects on the body. Alcohol abuse is a serious health concern for women and adolescent females of all races and ethnic backgrounds. Thousands of women die each year from chronic liver disease or cirrhosis, which are the results of sustained alcohol abuse. Heavy alcohol consumption during pregnancy can cause Fetal Alcohol Syndrome (FAS), the leading cause of physical and mental birth defects. FAS is one of the most common known causes of mental retardation. It is the only cause that is entirely preventable.

Death rates from drug-induced causes—including motor vehicle crashes, unintentional injuries, homicides, and suicides—are significant among minority populations. The use of marijuana and other illicit substances is also linked to sexually transmitted diseases such as HIV/AIDS, poor maternal and infant health, and violence, all of which are experienced disproportionately by minority females.