Heart Disease and Stroke

• 1 in 3 deaths in the United States is due to cardiovascular disease. People of all ages, genders, races, and ethnicities are affected. However, certain groups—including African Americans and older individuals, are at higher risk than others.
• Nearly half of all African American adults have some form of cardiovascular disease that includes heart disease and stroke.
• High blood pressure is the leading cause of heart attack and stroke in the United States. About 2 out of every 5 African American adults have high blood pressure, and less than half of them have it under control. African American adults are much more likely to suffer from high blood pressure (hypertension), heart attacks, and stroke deaths than white adults. Individuals living below the federal poverty level are more likely to have high blood pressure compared with those living at the highest level of income.

Cancer

• Cancer is the second leading cause of death among black people in the United States. Among men, black men get and die from cancer at higher rates than men of other races and ethnicities. Among women, white women have the highest rates of getting cancer, but black women have the highest rates of dying from cancer.
• Breast cancer deaths are going down fastest among white women compared to women of other races and ethnicities. Black women have the highest death rates of all racial and ethnic groups, and are 40% more likely to die of breast cancer than white women. The reasons for this difference result from many factors, including having more aggressive cancers and fewer social and economic resources. To improve this disparity, black women need more timely follow-up and improved access to high-quality treatment.
• Prostate cancer is more common in black men. It tends to start at younger ages and grow faster than in men of other racial or ethnic groups, but medical experts do not know why.

Obesity, Nutrition, and Physical Activity

Obesity is a problem in the African American community and is related to conditions like heart disease, stroke, and cancer. Obesity is common, serious, and costly. The estimated annual medical cost of obesity in the U.S. was $147 billion in 2008.

• African Americans are nearly 1.5 times as likely to have obesity as compared to non-Hispanic Whites.
• From 2011-2014, the prevalence of obesity among African Americans was 48% compared to 35% of non-Hispanic Whites.
• African Americans eat fewer vegetables than other racial/ethnic groups but eat similar amounts of fruit as non-Hispanic Whites.
• More than half (56%) of African American adults 18 years of age and older do not meet the aerobic component of the 2008 Physical Activity Guidelines.

What You Can Do For Your Health

Living a healthy lifestyle can help prevent heart disease, cancer, and stroke. Take these steps:

• Eat a healthy diet with fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products. Choose foods low in saturated fats, cholesterol, salt (sodium), and added sugars.
• Exercise regularly. Adults needs 2 hours and 30 minutes (or 150 minutes total) of exercise each week. You can spread your activity out during the week, and can break it up into smaller chunks of time during the day.
• Be smokefree. If you are ready to quit, call 1-800-QUIT-NOW (1-800-784-8669) or 1-855-DÉJELO-YA (1-855-335-3569 for Spanish speakers) for free resources, including free quit coaching, a free quit plan, free educational materials, and referrals to other resources where you live.
• Limit alcohol use , which can lead to long-term health problems, including heart disease and cancer. If you do choose to drink, do so in moderation, which is no more than one drink a day for women and two for men.
• Know your family history . There may be factors that could increase your risk for heart disease and stroke.
• Manage any medical condition you might have. Learn the ABCS of heart health. Keep them in mind every day and especially when you talk to your health provider:
  • Appropriate aspirin therapy for those who need it
  • Blood pressure control
  • Cholesterol management
  • Smoking cessation

Alzheimer’s disease is a progressive, irreversible brain disorder that affects memory, thinking, and language skills. Over time, people living with Alzheimer’s disease may become unable to carry out daily activities. African American and Hispanic/Latino populations are disproportionately affected.

What is Alzheimer's disease?

Alzheimer’s disease causes brain cells to stop functioning, lose connections with other brain cells, and die over the course of many years. Exactly why this happens is unknown. In advanced stages, a person living with Alzheimer’s disease will experience dementia: a decline in brain function severe enough to interfere with daily life.

Who is affected by Alzheimer's disease?

Age is the best known risk factor for Alzheimer's disease with symptoms usually appearing after age 60. Older African American and Hispanic/Latino adults are more likely to have Alzheimer’s disease than older white adults. You may also be at higher risk of developing Alzheimer’s disease if you:

• Are a woman.
• Have ever had a moderate or severe head injury.
• Have heart disease, stroke, high blood pressure, diabetes, or obesity.
• Have an immediate family member with Alzheimer’s disease.
• Engage in few physical, mental, or social activities.

How is Alzheimer's disease treated?

Although there is no cure, several FDA-approved medications are available to help people maintain mental function and slow or delay the symptoms of Alzheimer’s disease. Your health care provider may also recommend treatments to help manage behavioral symptoms such as anxiety and other health conditions like high blood pressure.

At a Glance

• About half of African American children with poorly controlled asthma benefited more from higher-dose steroids than adding a bronchodilator to treatment. 
• The results contrast with those seen in white children in previous studies. But African American adolescents and adults, like white adults and children, were more likely to benefit from the addition of a bronchodilator.
• These findings highlight the importance of enrolling populations of diverse ages and races in clinical trials.

About 25 million people in the United States live with asthma—and around 7 million of these are children. Asthma disproportionately affects African American children in the U.S. This chronic lung disease inflames and narrows the airways. Symptoms include coughing, wheezing, tightness in the chest, and shortness of breath. Severe asthma attacks can lead to hospitalization and even death.

The first line of treatment for asthma is low-dose inhaled steroids. Steroids reduce inflammation in the lungs. However, these drugs fail to control asthma in some people.

Past studies have shown that adding a type of drug called a bronchodilator to steroid treatment can help with poorly controlled asthma. Bronchodilators help open up the airways. But these trials enrolled few African American participants.

To understand whether results from earlier studies apply to African Americans with asthma, researchers led by Dr. Michael Wechsler from National Jewish Health conducted two clinical trials. One enrolled 284 children from 5 to 11 years old, and the other enrolled 291 adolescents and adults.

The trial in children compared two main treatments: five times the normal dose of a steroid (fluticasone) versus doubling the steroid dose and adding a bronchodilator (salmeterol). The trial in adults tested increases in the steroid dose and different bronchodilator doses.

All participants received all experimental treatments, in sequential 14-week periods, to see which controlled their asthma the best. In addition, all participants underwent a genetic analysis to determine their ancestry. The trials were funded by NIH’s National Heart, Lung, and Blood Institute (NHLBI). Results were published on September 26, 2019, in the New England Journal of Medicine.

In the adolescents and adults, the results mirrored those seen in previous trials that enrolled mostly people of European descent. More adolescents and adults had improved asthma control with the addition of a bronchodilator than with a high dose of steroids. About a quarter of these participants had the same effect on their asthma from both treatments.

The results in children, however, differed. About half had better asthma control after adding a bronchodilator, but the other half did better on a higher dose of steroids alone.

The researchers found no link between the percentage of African ancestry and response to any of the treatments. They also found no other characteristics that were linked to the patients’ responses.

“This study suggests that we cannot look at results from one population and extrapolate the findings to African Americans or any other group,” Wechsler says. “If children do not respond to one treatment, parents and providers could consider another option because there is almost a 50% chance of having a better response.”

Compared to members of other races, Black and African American people have higher rates of getting and dying from many kinds of cancer.

• Black people have the highest death rate for cancer overall.
• Black people have a lower overall 5-year cancer survival rate than White people.
• Black people are more likely than White people to be diagnosed with female breast, lung, and colorectal cancers at a late stage. Cancer is harder to treat after it spreads from the place where it started to other parts of the body.

Many cancers can be prevented. Staying away from tobacco smoke, keeping a healthy weight, drinking little or no alcohol, and getting human papillomavirus (HPV) vaccinations on time can lower the risk of getting cancer. Screening tests can prevent some cancers or find them early, when treatment works best. Some of these risk factors vary by race and ethnicity.

• More Black men than White men say they smoke cigarettes now.
• Non-Hispanic Black Americans are more likely than other groups to be exposed to smoke from other people’s cigarettes, called secondhand smoke.
• Obesity is most prevalent among non-Hispanic Black adults.
• Non-Hispanic White adults are more likely than non-Hispanic Black adults to engage in heavy drinking.
• Overall, non-Hispanic White adults are more likely than non-Hispanic Black adults to be vaccinated against HPV. HPV vaccines help prevent several kinds of cancer.
• Black people are more likely than White people to be up to date on screening tests for colorectal, breast, and cervical cancer.

Note: In the statistics above, some comparisons are only between race categories, while others are between race and ethnicity categories (non-Hispanic or Hispanic).

How to Lower Your Risk

If you are a Black or African American person, you can take steps to lower your risk of getting cancer.
Note: Some comparisons are only between race categories, while others are between race and ethnicity categories (non-Hispanic or Hispanic).

Prostate Cancer

Black men are more likely to get prostate cancer than men who are members of other racial or ethnic groups. They are more than twice as likely to die from prostate cancer than other men. Learn about the possible benefits and harms of prostate cancer screening. Then talk to your doctor about your own risk and decide if screening is right for you.

Breast Cancer

Overall, White women are more likely to get breast cancer than Black women, but Black women are more likely die from the disease. Breast cancer is often diagnosed at later stages and is more aggressive in African American women than in White women. Know how your breasts normally look and feel. Talk to your doctor if you notice changes.

Lung Cancer

Black men have the highest rates of developing and dying from lung cancer. If you smoke, try to quit, and stay away from other people’s cigarette smoke. If you’re 50 to 80 years old and smoke now or quit in the last 15 years, lung cancer screening may be right for you.

Cervical Cancer

Black women are more likely to die from cervical cancer than other women in the United States. If you’re 26 years old or younger, make sure you’re vaccinated against HPV. HPV causes almost all cervical cancers. If you’re 21 to 65 years old, get screened for cervical cancer regularly.

Race and ethnicity are risk markers for other underlying conditions that affect health, including socioeconomic status, access to health care, and exposure to the virus related to occupation, e.g., frontline, essential, and critical infrastructure workers.

Note: Adjusting by age is important because risk of infection, hospitalization, and death is different by age, and age distribution differs by racial and ethnic group. If the effect of age is not accounted for, racial and ethnic disparities can be underestimated or overestimated.

Colorectal cancer is the third most common cancer in the United States. Despite being one of the most preventable types of cancer, over 50,000 deaths from colorectal cancer occur each year. African Americans and American Indians/Alaska Natives are disproportionately affected. Health care providers recommend routine screening starting at age 45, or earlier if you are at higher risk.

What is colorectal cancer?

Colorectal cancer usually develops from polyps or other precancerous growths in the large intestine (comprised of the colon and rectum). The cancer cells may spread from the growth to other parts of the body in advanced stages.

Who is affected by colorectal cancer?

Most cases of colorectal cancer occur in people over the age of 50, but rates are going up for younger adults. African Americans and American Indians/Alaska Natives have the highest rates of colorectal cancer. Factors that increase your risk of colorectal cancer include:

• Family or personal history of colorectal cancer, inflammatory bowel disease, or other intestinal conditions
• Type 2 diabetes
• Lack of exercise
• Overweight or obese
• Tobacco use
• Consumption of three or more alcoholic drinks per day

What are the symptoms of colorectal cancer?

Colorectal polyps and colorectal cancer don’t always cause symptoms, especially at first. If you have symptoms, they may include:

• Changes in bowel movements
  • Constipation or diarrhea
  • Narrow or bloody stools
  • Feeling your bowel is not fully empty
• Vomiting
• Sudden weight loss
• Gas pains or cramps
• Feeling tired or weak

What should I know about screening?

Several non-invasive screening tests are available that can find precancerous changes in stool, tissues, blood, and genes. How often you need to be screened depends on the type of test selected.

If colorectal cancer is found early and treated properly, the survival rate is high for 9 out of 10 people. Health care providers recommend routine screening starting at age 45, or earlier if you are at higher risk.

How is colorectal cancer treated?

Your health care provider will recommend treatment based on the stage of the cancer and your overall health. Several medications act to destroy cancer cells or block them from spreading. Other medications boost the body’s immune system. Cancerous cells can also be surgically removed or destroyed by FDA-approved treatments like freezing, radiation, or chemical injection.

Human immunodeficiency virus (HIV) is a chronic disease that attacks the body’s immune system, which can increase your chances of developing serious infections or cancer. If left untreated, HIV can lead to acquired immunodeficiency syndrome (AIDS), an advanced stage of HIV infection. There is no cure for HIV, but HIV prevention and treatment options are available.

Who is affected by HIV?

In the United States, an estimated 1.1 million people are living with HIV. African Americans and Hispanics/Latinos account for 2 out of 3 new diagnoses. Both men and women can become infected. Men who have sex with men, transgender women who have sex with men, and people who inject drugs have a higher risk of contracting HIV. Higher rates of HIV in certain communities may result from issues such as stigma and lack of awareness of someone’s HIV status.

How can I get tested for HIV?

Routine screening is the best way to reduce the spread of HIV. Screening is recommended for people ages 13 and over and for those with a higher risk of infection. There are three types of tests that may be used for screening and diagnosis:

• Antibody tests look for antibodies (proteins) in your blood or saliva that are made by the body in response to an HIV infection
• Combination (fourth-generation) tests look for both HIV antibodies and antigens, which are foreign substances that cause your immune system to activate
• Nucleic acid tests look for nucleic acids (genetic material) of HIV in the blood

How is HIV treated?

HIV medications, known as antiretroviral therapy (ART), slow the progression of the disease in your body by lowering the amount of HIV in your blood. This keeps the immune system strong enough to fight off other infections. ART involves taking a combination of HIV medications every day regardless of how long someone has had the virus or how healthy they are. 

Benefits of starting treatment early

• Significantly lower your chances of spreading HIV to HIV-negative people through sex, needle sharing, or from mother to child during childbirth and pregnancy
• Lower your chances of getting certain HIV-related cancers and infections
• Increase your chances of living a longer and healthier life

HIV prevention medications

PrEP (pre-exposure prophylaxis) is a method of preventing HIV infection that involves taking HIV medications every day, before possible exposure. Studies show that PrEP lowers the chances of getting HIV from sex by about 99% when taken daily. Among people who inject drugs, PrEP lowers the chances of getting HIV by at least 74% when taken daily.

Health disparities are differences in the incidence, prevalence, and mortality of a disease and the related adverse health conditions that exist among specific population groups. These groups may be characterized by gender, age, race or ethnicity, education, income, social class, disability, geographic location, or sexual orientation. These health disparities are one reason why HIV, viral hepatitis, STDs, and TB take a greater toll in one population group over another. Find information about how these diseases affect African American/Black populations.

HIV

In 2018, African Americans/Blacks accounted for 42% of the 37,968 new HIV diagnoses in the United States and dependent areas. Of the 37,968 new HIV diagnoses in the US and dependent areas in 2018:

• 42% were among adult and adolescent African Americans/Blacks
• 31% were among African American/Black men
• 11% were among African American/Black women

In 2018, in the United States, the death rate for African Americans/Blacks was higher (16.3 per 100,000) compared with any other racial/ethnic group (2.5 Whites). In 2018, African Americans/Blacks represented 43% of all deaths of people diagnosed with HIV. (Note that deaths could be from any cause.) A recent study showed that African Americans/Blacks diagnosed with HIV are less likely than other groups to be linked to care, retained in care, receive antiretroviral treatment, and achieve adequate viral suppression.

In 2018, African American/Black adult and adolescent men accounted for 39% of new HIV diagnoses among men in the United States and dependent areas. Most (79%) new HIV diagnoses among African American/Black men were attributed to male-to-male sexual contact, while 15% were attributed to heterosexual contact.

Among African American/Black adult and adolescent women in the United States and dependent areas, most (92%) new HIV diagnoses were attributed to heterosexual contact in 2018.

Sexually Transmitted Diseases (STD)

Chlamydia

In 2018, the overall rate of reported chlamydia cases among Blacks in the United States was 1,192.5 cases per 100,000 population. The rate of reported chlamydia cases among Black females was five times the rate among White females (1,411.1 and 281.7 cases per 100,000 population, respectively. The rate of reported chlamydia cases among Black males was 6.8 times the rate among White males (952.3 and 140.4 cases per 100,000 population, respectively). Rates of reported cases of chlamydia were highest for Blacks aged 15–19 and 20–24 years in 2018. The rate of reported chlamydia cases among Black females aged 15–19 years (6,817.3 cases per 100,000 population) was 4.5 times the rate among White females in the same age group (1,520.1 cases per 100,000 population). The rate of reported chlamydia cases among Black females aged 20–24 years was 3.7 times the rate among White females in the same age group (7,087.7 and 1,935.8 cases per 100,000 population, respectively). Among females aged 15–24 years, the population targeted for screening, rates were highest among Blacks in all US regions.

Similar racial disparities in reported chlamydia rates exist among males. Among males aged 15–19 years, the rate of reported chlamydia cases among Blacks was 9.1 times the rate among Whites (2,668.6 and 293.0 cases per 100,000 population, respectively. The rate of reported chlamydia cases among Black males aged 20–24 years was 5.3 times the rate among White males of the same age group (3,867.1 and 732.6 cases per 100,000 population, respectively).

Gonorrhea

In 2018, the overall rate of reported gonorrhea cases among Blacks in the United States was 7.7 times the rate among Whites. This disparity was similar for Black males (8.5 times the rate among White males) and Black females (6.9 times the rate among White females). As in previous years, the disparity in gonorrhea rates for Blacks in 2018 was larger in the Midwest and Northeast than in the South and West.

Considering Hispanic ethnicity and all race and age categories, rates of reported gonorrhea cases were highest for Blacks aged 20–24, 15–19, and 25–29 years in 2018. The rate of reported gonorrhea cases among Black females aged 20–24 years (2,040.3 cases per 100,000 population) was 6.9 times the rate among White females in the same age group (297.5 cases per 100,000 population). The rate of reported gonorrhea cases among Black females aged 15–19 years (1,756.4 cases per 100,000 population) was 8.8 times the rate among White females in the same age group (200.1 cases per 100,000 population). Among Black males aged 20–24 years, the rate of reported gonorrhea cases (2,212.1 cases per 100,000 population) was 9.4 times the rate among White males in the same age group (236.3 cases per 100,000 population). The rate of reported gonorrhea cases among Black males aged 25–29 years (1,860.7 cases per 100,000 population) was 7.0 times the rate among White males in the same age group (265.5 cases per 100,000 population).

Primary and Secondary Syphilis

In 2018, 34.7% of reported P&S syphilis cases with known race/Hispanic ethnicity information occurred among Blacks. The rate of reported P&S syphilis cases among Blacks was 4.7 times the rate among Whites (28.1 versus 6.0 cases per 100,000 population, respectively). This disparity was similar for Black females and males. Similar disparities were seen in all regions of the United States.

Congenital Syphilis

From 2014 to 2018, the rate of reported congenital syphilis increased 126.7% among Blacks (38.2 to 86.6 cases per 100,000 live births). In 2018, the rate of reported cases of congenital syphilis among Blacks was 6.4 times the rate among Whites (86.6 versus 13.5 per 100,000 live births, respectively).

Viral Hepatitis

In 2018, there were 1,649 death certificates among US residents that listed hepatitis B as the underlying or a contributing cause of death. Of these, 304 (18.4%) were among African Americans resulting in a hepatitis B death rate of 0.7 deaths per 100,000 population.

In 2018, there were 15,713 death certificates among US residents that listed hepatitis C as the underlying or a contributing cause of death. Of these 15,713 hepatitis C related deaths, 2,978 (18.9%) were among African Americans. Thus, the 2018 hepatitis C related death rate for African Americans was 6.31 deaths per 100,000 population.

Tuberculosis (TB)

In 2018, 87% of all reported TB cases occurred in racial and ethnic minorities. TB disease was reported in 1,799 non-Hispanic African Americans/Blacks in the United States, accounting for 20% of all people reported with TB disease nationally; this proportion is high considering non-Hispanic African Americans/Blacks make up approximately 13% of the U.S. population. While the rates of TB disease in non-Hispanic African Americans/Blacks have been cut in half (from 8.8 cases per 100,000 persons in 2008 compared to 4.4 in 2018) over the past decade, the rate of TB disease in non-Hispanic African Americans/Blacks is over eight times higher than the rate of TB disease in non-Hispanic whites (0.5 cases per 100,000 population). Overall, 9,025 TB cases were reported to CDC from the 50 states and the District of Columbia in 2018.

Heart disease refers to several conditions that affect the heart. In the United States, it affects more than 1 in 10 adults (30 million) and is the leading cause of death for people of most racial and ethnic groups (responsible for about 1 in 4 deaths).

Heart disease may not be diagnosed until a person experiences signs or symptoms of a heart attack, heart failure, or an arrhythmia. These symptoms may include:

• Heart attack: Chest pain or discomfort, upper back or neck pain, indigestion, heartburn, nausea or vomiting, extreme fatigue, upper body discomfort, dizziness, and shortness of breath
• Heart failure: Shortness of breath, fatigue, or swelling of the feet, ankles, legs, abdomen, or neck veins
• Arrhythmia: Fluttering feelings in the chest (palpitations)

Who is at risk?

High blood pressure, high cholesterol, and smoking are key risk factors for heart disease. About half of all adults in the United States have at least one of these risk factors. Other medical conditions and health behaviors that put you at higher risk are:

• Diabetes
• Alcohol use
• Unhealthy diet
• Physical inactivity
• Overweight and obesity

Your risk for heart disease increases as you age and if you have a history of heart disease in your family.

How is heart disease treated?

Your health care provider may prescribe one or more FDA-approved medications to treat your heart disease or its risk factors. Some types of heart disease are also treated with medical devices such as pacemakers (implanted in the body to regulate the heart rate) or stents (metal tubes that are inserted in an artery to improve blood flow). Your health care provider will work with you to determine which treatment is the best option for your condition.

Participating in a cardiac rehabilitation (rehab) program after having a heart attack, heart failure, or some type of heart surgery is important for recovery. Supervised by a team of health care professionals, this program may include:

• Physical activity
• Counseling to find ways to relieve stress and improve your mental health
• Education about healthy living (such as healthy eating), taking medication as prescribed, and ways to help you quit smoking

Hepatitis B is a viral infection that causes inflammation of the liver. Hepatitis B can be an acute, short-term infection or a chronic, long-lasting infection. Asian Americans and Pacific Islanders make up over half of the people in the United States living with chronic hepatitis B. African Americans have the second-highest rate of chronic hepatitis B. If you are living with chronic hepatitis B, talk to your health care provider about starting a treatment regimen.

What is hepatitis B?

Hepatitis B virus (HBV) causes inflammation of the liver. It is spread by:

• Having unprotected sex with an infected person
• Sharing contaminated razors, toothbrushes, or needles
• Coming in contact with infected blood like from an open wound or transfusion
• Mother to baby during vaginal or cesarean birth

Hepatitis B infection may be acute (short term) or chronic (long term).

Acute HBV symptoms can last from a few weeks to up to six months and may include:

• Fatigue
• Fever
• Joint Pain
• Loss of appetite
• Abdominal pain
• Yellow eyes and skin (jaundice)
• Clay-colored bowel movements
• Dark urine
• Nausea and/or vomiting

Chronic HBV infection occurs when the virus remains in a person’s body. People living with chronic HBV can spread the virus to others, even if they do not feel or look sick themselves. Over time, chronic HBV can cause scarring of the liver, liver failure, liver cancer, or even death.

Know Your Status

If you think you’ve been exposed to HBV, ask your health care provider to get tested. Blood tests can determine whether a person was infected in the past, is currently infected, or has never been infected.

Hepatitis B treatments

People living with chronic hepatitis B should be monitored regularly by their health care provider for signs of liver disease and evaluated for possible treatment. There are three types of treatment options for chronic HBV.

• Antiviral medications: Medications taken by mouth to help your body fight the virus and reduce the risk of liver damage.
• Interferon injections: Injections consisting of interferons, which are substances produced by cells in the body to help fight the infection.
• Liver transplant: If chronic hepatitis B leads to liver failure or liver cancer, you may need a liver transplant as a last resort. A transplant is a surgical procedure that removes your unhealthy liver and replaces it with a healthy liver from a donor.

Hypertension (high blood pressure) happens when blood flows through your arteries at higher-than-normal pressures over time. This makes the heart and blood vessels work harder and less efficiently. Nearly half of all adults have hypertension, and it is more common among African American and Hispanic/Latino adults than other groups.

What is hypertension?

Hypertension (high blood pressure) develops when blood flows through your arteries at higher-than-normal pressures over time. Arteries that have narrowed because of a buildup of cholesterol make the heart and blood vessels work harder, increasing blood pressure.

Your blood pressure measurement is made up of two numbers: systolic and diastolic. Normal blood pressure is less than 120 (systolic)/80 (diastolic) mm Hg. High blood pressure is diagnosed when you have consistent systolic readings of 140 mm Hg or higher or diastolic readings of 90 mm Hg or higher.

Hypertension is known as the silent killer because most people do not have symptoms of hypertension, so it's important to have your blood pressure checked regularly. If not controlled, high blood pressure can lead to heart disease, stroke, heart attack, heart failure, and chronic kidney disease.

Who is affected by hypertension?

Nearly half of all adults in the United States have hypertension. High blood pressure is more common in African American and Hispanic/Latino adults than in other groups. Only 1 in 4 adults living with hypertension have their condition under control.

How is hypertension treated?

You may be prescribed FDA-approved medications to control or lower your blood pressure. Types of hypertension medications include:

• Angiotensin-converting enzyme (ACE) inhibitors: Keep blood vessels from narrowing.
• Angiotensin II receptor blockers (ARBs): Keep blood vessels from narrowing.
• Calcium channel blockers: Allow blood vessels to relax.
• Diuretics: Remove extra water and sodium (salt) from your body, reducing the amount of fluid in your blood.
• Beta blockers: Help your heart beat slower and with less force so that it pumps less blood through your blood vessels.

Your health care provider may also recommend that you adopt a heart-healthy lifestyle by:

• Choosing foods that are lower in sodium (salt) and those that are rich in potassium
• Avoiding or limiting alcohol
• Being physically active
• Aiming for a healthy weight
• Quitting smoking

African Americans, Hispanics, and American Indians are at high risk for developing kidney failure. This risk is due in part to high rates of diabetes and high blood pressure in these communities. Below is more information about kidney failure for each of these groups.

African Americans

African Americans are almost four times as likely as Whites to develop kidney failure.

While African Americans make up about 13 percent of the population, they account for 35 percent of the people with kidney failure in the United States. Diabetes and high blood pressure are the leading causes of kidney failure among African Americans.

Hispanics

A growing number of Hispanics are diagnosed with kidney disease each year. Since 2000, the number of Hispanics with kidney failure has increased by more than 70 percent.

Compared to non-Hispanics, Hispanics are almost 1.3 times more likely to be diagnosed with kidney failure.

American Indians and Alaska Natives

American Indians also are disproportionately affected by kidney failure. Compared to Whites, American Indians are about 1.2 times more likely to be diagnosed with kidney failure. Diabetes is the leading cause of kidney failure among American Indians. However, better diabetes care is reducing the risk for kidney failure in American Indians with diabetes.

Protect Your Family and Yourself!

African-American men have the highest rates of lung cancer in the U.S.

Lung cancers are mostly caused by smoking.

When you smoke around your family, everyone smokes! The smoke from your cigarettes, called secondhand smoke, can cause lung cancer and other health problems in people who have never smoked, even kids.

There’s no safe way to smoke. Menthol cigarettes are just as dangerous as non-menthol cigarettes.

It’s never too late to quit. Your risk for lung cancer goes down when you quit, no matter how old you are or how long you have smoked.

Quitting can be hard, and you may need help. For free help quitting, visit smokefree.gov, call 1-(800)-QUIT-NOW, or text the word QUIT to 47848 from your mobile phone.

Lupus is an autoimmune disease that can cause pain and inflammation in the body. Symptoms can flare up at any time and are different for every person. Lupus disproportionately affects racial and ethnic minority women. Although lupus cannot be cured, medications can prevent flares, treat symptoms, and reduce organ damage and other problems.

What is lupus?

Lupus is a chronic (long-term) autoimmune disease that can damage many parts of the body. Autoimmune diseases occur when a body’s immune system mistakenly attacks and destroys healthy cells, tissues, and organs. These attacks cause inflammation that leads to tissue damage, which may be permanent in some cases.

What are the symptoms of lupus?

Lupus is a disease where symptoms sometimes are worse (flares) and other times are better (remission). Symptoms may differ from person to person and may change over time. They include:

• Muscle and joint pain
• Prolonged or extreme fatigue
• Rash
• Chest pain
• Hair loss
• Sun or light sensitivity
• Fever
• Mouth sores
• Anemia
• Memory problems
• Blood clotting
• Eye disease
• Kidney problems (lupus nephritis)

Who is affected by lupus?

About 9 out of 10 people diagnosed with lupus are women aged 15 to 44, but men are affected as well. Notably, it's more common in African American, Asian, Hispanic/Latino, and American Indian/Alaska Native women. African American women are three times more likely to get lupus, and they may develop the disease at a younger age and have more serious and life-threatening complications than non-Hispanic white women.

How is lupus treated?

BLyS-specific inhibitors are medications that limit the amount of abnormal B cells (cells in the immune system that create antibodies) found in people with lupus. Belimumab, a type of BLyS-specific inhibitor, is the first and only medication specifically developed for and approved to treat lupus.

Treatment options to manage lupus symptoms

• Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs may help reduce mild pain and swelling in joints and muscles
• Corticosteroids: may help reduce swelling, tenderness, and pain
• Antimalarials: prevent or treat malaria and also treat joint pain, skin rashes, fatigue, and lung inflammation
• Immunosuppressive drugs/chemotherapy: may be used in severe cases, when lupus affects major organs or other treatments do not work

Mental health matters! Mental health includes our emotional, psychological, and social well-being. It affects how we think, feel, act, handle stress, relate to others, and make choices. Mental health is just as important as physical health at all stages of life. Mental health issues are common – about 1 in 5 American adults experiences a mental illness each year. Mental health issues are treatable and often preventable. However, people in some racial and ethnic minority groups face obstacles to maintaining positive mental health.

Obstacles to Mental Health for Racial and Ethnic Minority Groups

The mental health of some racial and ethnic minority groups has worsened since the start of the COVID-19 pandemic relative to that of non-Hispanic white people.

The COVID-19 pandemic has been a challenge for everyone, and racial and ethnic minority groups have been placed at higher risk for COVID-19 infection, COVID-19 severe illness or death, and pandemic-related stressors. These stressors, such as unemployment, loss of a loved one, and COVID-19 stigma, can cause emotional distress and may lead to new or worsening mental health issues. Mental health issues may increase when people face additional stressors, on top of those related to COVID-19, and lack access to the resources and support needed to navigate these challenges.

Mental health care is important for mental wellbeing, yet many people from racial and ethnic minority groups face obstacles in accessing needed care. These obstacles may include lack of or insufficient health insurance, lack of racial and ethnic diversity among mental healthcare providers, lack of culturally competent providers, financial strain, and stigma.

Racism negatively impacts mental health. Racism contributes to unequal access to resources and services, including mental health care. First-hand experiences of racial discrimination, as well as witnessing or hearing about discrimination from others or in the media, can cause or intensify stress and racial trauma.

Working Together for Mental Health Equity

All of society benefits when people from racial and ethnic minority groups have access to mental health care, supportive social conditions, freedom from stressors that can compromise mental health, and access to other resources needed for health. We all have a role to play in promoting health equity.

Individuals can

• Learn about healthy ways to cope with stress and respond to loss. When possible, engage in these practices.
• Get help for mental health issues through free and confidential resources.
• Learn about mental health and take the mental health quiz.
• Share information on mental health, healthy coping skills, and resources with family, friends, neighbors, and other members of your community.
• Encourage open conversations about mental health and use non-stigmatizing language when talking about mental health issues.
• Learn about implicit bias, microaggressions, and other forms of discrimination and make efforts to avoid perpetuating them.

Mental health equity is the state in which everyone has a fair and just opportunity to reach their highest level of mental health and emotional well-being.

Public health organizations can

• Ensure mental health programming incorporates perspectives, ideas, and decision-making from appropriately representative people of racial and ethnic minority groups at all stages of programming – from planning to implementation to evaluation.
• Consider the data on mental health when developing organizational priorities and programs.
• Prioritize action on and/or meaningfully account for the potential influence of social determinants of health when designing mental health programs.
• Measure the impact of racism on mental health and develop best practices for reducing racism and its consequences.
• Ensure mental health educational materials are culturally and linguistically appropriate and follow health equity principles for communication such as using plain language.
• Take intentional steps to increase the reach of mental health information to racial and ethnic minority groups through culturally responsive communication outlets.
• Establish and foster partnerships with other organizations to fill gaps in reach and/or expertise.
• Verify and promote available free and low-cost mental health resources.
• Explore referrals to mental health services to ensure those served can be efficiently connected with needed resources.

Healthcare systems can

• Screen patients for depression and other mental health conditions and refer patients to accessible mental health care services.
• Make mental health educational materials available to all patients during their appointments, via patient portals, and in waiting rooms.
• Make efforts to recruit mental healthcare providers that reflect the race and ethnicity of the populations they serve.
• Provide cultural humility training to mental healthcare providers.
• Ensure mental healthcare services are culturally and linguistically appropriate.

States and communities can

• Expand community-based mental health care that provides culturally responsive mental health services at low or no cost for youth and adults.
• Evaluate policies for their differential impact on social determinants of health, and, when needed, modify these policies or create new policies that ensure equitable access to resources for people from all race and ethnicity groups.
• Evaluate policies for their potential to reinforce mental health stigma and revise or remove stigmatizing policies.
• Encourage community and faith-based leaders to have positive dialogues and discussions around mental health issues to help reduce stigma.
• Make efforts to ensure decision-makers reflect the races and ethnicities of the populations they serve.

CDC is collaborating with partners to improve mental health among racial and ethnic minority groups by

• Developing and sharing culturally responsive resources to promote and strengthen the emotional well-being of populations through How Right Now | Finding What Helps, also available in Spanish
• Gathering data on mental health, access to care, demographics, and more through the Household Pulse Survey, in collaboration with the US Census Bureau
• Analyzing data to better understand mental health disparities during COVID-19
• Recognizing the harm racism has on mental health and overall health, declaring racism a serious threat to the public’s health, and taking actions to address racism
• Implementing the CORE strategy, an agency-wide strategy that aims to integrate health equity into all work at CDC
• Ensuring equity principles guide planning around mental health programming
• Raising awareness of health workers’ mental health issues through the Health Worker Mental Health Initiative
• Identifying policies and practices that connect more children and families to mental health care and seeking to understand the impact of social determinants of health on mental health care – Improving Access to Children’s Mental Health Care
• Developing data systems and tools that appropriately identify, respond to, culturally tailor, and reach historically marginalized and/or racialized populations during crises through Project REFOCUS, in partnership with Howard University, Department of Communication, Culture and Media Studies UCLA Center for the Study of Racism Social Justice and Health Funding, and CDC Foundation

Although African American women tend to have higher bone mineral density (BMD) than white women throughout life, they can still be at significant risk of developing osteoporosis. The misperception that osteoporosis is only a concern for white women can delay prevention and treatment in African American women who do not believe they are at risk for the disease.

What is osteoporosis?

Osteoporosis is a metabolic bone disease characterized by low bone mass, which makes bones fragile and susceptible to fracture (broken bone). Osteoporosis is known as a silent disease because symptoms and pain do not appear until a fracture occurs. Without prevention or treatment, osteoporosis can progress painlessly until a bone breaks, typically in the hip, spine, or wrist. A hip fracture can limit mobility and lead to a loss of independence, and vertebral fractures can result in a loss of height, stooped posture, and chronic pain.

What are the risk factors for osteoporosis?

Risk factors for developing osteoporosis include:

• A thin, small-boned frame.
• Previous fracture or family history of osteoporotic fracture.
• Estrogen deficiency resulting from early menopause (before age 45), either naturally, from surgical removal of the ovaries, or as a result of prolonged amenorrhea (abnormal absence of menstruation) in younger women.
• Advanced age.
• A diet low in calcium.
• Cigarette smoking.
• Excessive use of alcohol.
• Prolonged use of certain medications, such as those used to treat lupus, asthma, thyroid deficiencies, and seizures.

Are there special issues for African American women regarding bone health?

Studies highlight the risk that African American women may face with regard to developing osteoporosis and fracture.

• Many African American women may be at increased risk for osteoporosis because some may consume less calcium than the Recommended Dietary Allowance.
• African Americans are more prone are to lactose intolerance than are other groups. Lactose intolerance can hinder optimal calcium intake. People with lactose intolerance often may avoid milk and other dairy products that are excellent sources of calcium because they have trouble digesting lactose, the primary sugar in milk.
• African American women are less likely than white women to participate in health screenings for osteoporosis or to receive an osteoporosis therapy when they are diagnosed with the disease.

How can osteoporosis be prevented?

Osteoporosis prevention begins in childhood. The recommendations listed below should be followed throughout life to lower your risk of osteoporosis.

• Eat a well-balanced diet adequate in calcium and vitamin D.
• Exercise regularly, with an emphasis on weight-bearing and resistance activities. Examples of weight-bearing exercises include walking, jogging, and dancing. Resistance exercises – such as lifting weights – can also make bones stronger.
• Live a healthy lifestyle. Avoid smoking and, if you drink alcohol, do so in moderation.

Talk to your doctor if you have a family history of osteoporosis or other risk factors that may put you at increased risk for the disease. Your doctor may suggest that you have your bone density measured to determine your risk for fracture and to measure your response to osteoporosis treatment. The most widely recognized bone mineral density test is called a dual-energy x-ray absorptiometry, or DXA test. It is safe and painless, a bit like having an x-ray, but with much less exposure to radiation. This test can measure bone density at your hip and spine.

What treatments are available?

Although there is no cure for osteoporosis, several medications are available for the prevention and/or treatment of the disease, including: bisphosphonates; calcitonin; estrogen (hormone) therapy; estrogen agonists/antagonists (also called selective estrogen receptor modulators or SERMs); parathyroid hormone (PTH) analog; parathyroid hormone-related protein (PTHrp) analog; RANK ligand (RANKL) inhibitor; and tissue-selective estrogen complex (TSEC).

One in every 20 Americans over the age of 50 has P.A.D., a condition that raises the risk for heart attack and stroke.

Peripheral arterial disease, or P.A.D., develops when your arteries become clogged with plaque—fatty deposits that limit blood flow to your limbs, especially your legs. Just like clogged arteries in the heart, clogged arteries in the legs mean you are at risk for having a heart attack or stroke.

P.A.D. is more common in African Americans than any other racial or ethnic group. This may be in part because some of the conditions that raise the risk for developing P.A.D., such as diabetes and high blood pressure, are more common among African Americans.

Plaque buildup in the legs does not always cause symptoms, so many people can have P.A.D. and not know it. People who do experience symptoms, such as pain or cramping in the legs, often do not report them, believing they are a natural part of aging or due to another cause. In all, P.A.D. affects 8 to 12 million people in the United States, especially those over 50.

You can lower your risk for P.A.D. Timely detection and treatment of P.A.D. can improve the quality of your life; help you keep your independence and mobility; and reduce your risk of heart attack, stroke, leg amputation, and even death. Taking steps to learn about P.A.D., including asking your health care provider to check your risk, can help you stay in circulation longer to enjoy your life.

Most Pregnancy-Related Deaths are Preventable

Each year in the United States, about 700 women die during pregnancy or in the year after. Every pregnancy-related death is tragic, especially because most are preventable. Conditions such as weakened heart muscle, thrombotic pulmonary embolism, and high blood pressure contributed to a significantly higher proportion of pregnancy-related deaths among African American women than among white women.

Working Together to Reduce Disparities

To reduce disparities, multiple sectors need to work to address the factors contributing to these deaths.

Healthcare providers can:

• Help patients manage chronic conditions like diabetes, heart disease, high blood pressure and obesity.
• Communicate with patients about warning signs.
• Use tools to flag warning signs early so women can receive timely treatment.

Hospitals and healthcare systems can:

• Identify and address unconscious bias in healthcare.
• Standardize coordination of care and response to emergencies.
• Improve delivery of quality prenatal and postpartum care.
• Train non-obstetric providers to consider recent pregnancy history.

States and communities can:

• Assess and coordinate delivery hospitals for risk-appropriate care.
• Support review of the causes behind every maternal death.

Women and their families:

• Know and communicate about symptoms of complications.
• Note pregnancy history any time medical care is received in the year after delivery.

Prostate cancer is the most common cancer among men in the U.S. and the second most common cause of cancer-related deaths. And African-American men are more likely to get prostate cancer and twice as likely to die from the disease than men of other races.

The prostate is part of the male reproductive system that makes semen. The walnut-sized gland is beneath the bladder and surrounds the upper part of the urethra, the tube that carries urine from the bladder.

The U.S. Food and Drug Administration regulates certain tests and treatments for prostate cancer to ensure their safety and effectiveness.

Signs and Symptoms of Prostate Cancer

Prostate cancer is frequently a very slow-growing disease, often causing no symptoms until it is in an advanced stage. At that point, symptoms may include difficulty starting urination, weak or interrupted flow of urine, and frequent urination, especially at night. Other symptoms of advanced prostate cancer may include back or other bone pain, weakness, and unintended weight loss.

But these symptoms can have many other causes than prostate cancer, such as a harmless (benign) enlarged prostate. If you have any concerns about any of these symptoms, contact your health care professional.

Most patients with prostate cancer die of other causes, and many never know they have the disease. But once prostate cancer begins to grow quickly or spreads outside the prostate, it is dangerous.

Tests to Detect Prostate Cancer

A blood test that measures prostate-specific antigen (PSA) can be used to help with the detection of prostate cancer, although it is not recommended for screening in all cases. PSA is a protein produced by cells of the prostate gland.

Other factors that may help to put the PSA into context to better understand the risk of prostate cancer include age, race, family history, prostate size, urinary tract infection or irritation, medications and rate of PSA rise.

Because of the widespread use of PSA testing in the U.S., prostate cancer is often detected early. In some cases, the prostate cancer found can be very slow-growing, and this can lead to overtreatment.

“In most of these cases, the prostate cancer may not require treatment, and the use of PSA testing to screen for prostate cancer is controversial,” says Daniel Suzman, M.D., a medical oncologist at the FDA.

The U.S. Preventive Services Task Force – an independent, volunteer panel of national experts in prevention and evidence-based medicine – recommends against PSA-based screening for prostate cancer in men age 70 and older because of:

• The lack of data that screening increases survival rates.
• The risk of overtreatment, leading to side effects in men who otherwise would never have experienced any symptoms.

For men ages 55 to 69, the task force recommends an individualized discussion of the risk and benefits of screening.

Imaging of the prostate, such as magnetic resonance imaging (MRI), may help with detecting prostate cancer. If the risk of prostate cancer is high, a health care professional performs a biopsy to remove a sample of prostate tissue for examination to determine if cancer is present and, if so, how aggressive the cancer appears.

The appearance of aggressiveness under the microscope is described by a Gleason score, which is assigned by the pathologist (a doctor who examines bodies and body tissues). Depending on the overall risk for prostate cancer that has spread outside the prostate, additional imaging may be needed to recommend a treatment plan.

How Prostate Cancer Is Treated

Localized Prostate Cancer: Radiation and/or surgery are the preferred treatments for localized prostate cancer that is at risk for spread. Radiation may be given after surgery to certain patients if they are at high risk for any prostate cancer remaining. Side effects from treatment of prostate cancer with surgery or radiation therapy can include effects on urination, erectile dysfunction, and bowel problems.

Hormone Therapy: Radiation therapy is sometimes combined with hormone therapy (also called androgen deprivation therapy, or ADT). Androgens, such as testosterone, are hormones that can cause prostate cancer cells to grow. ADT stops testosterone from being produced or directly blocks it from acting on prostate cancer cells. Hormone therapy may be given to patients with prostate cancer that has recurred after radiation or surgery and is the standard of care for patients with cancer that has spread outside the prostate to other areas of the body (metastatic disease). Side effects from ADT are largely due to the loss of testosterone and can include hot flashes, weight gain, loss of bone density, erectile dysfunction, and fatigue.

Non-Metastatic Castration-Resistant Prostate Cancer: Some men who are treated with hormone therapy before they experience metastatic disease may develop a form of prostate cancer that is resistant to standard hormone therapy (known as non-metastatic castration-resistant prostate cancer). The FDA has approved three drugs for non-metastatic castration-resistant prostate cancer: apalutamide, enzalutamide and darolutamide. These drugs block the effect of testosterone and similar hormones on the prostate cancer cells. Patients who received these drugs in clinical trials went longer without developing metastatic disease than patients who received placebo; they also lived longer.

Metastatic Castration-Resistant Prostate Cancer: In 2004, the FDA approved docetaxel. This is the first approved chemotherapy drug for metastatic castration-resistant prostate cancer (i.e. resistant to hormone therapy alone) that showed a survival benefit, after years of research failed to find a treatment that would prolong the lives of metastatic prostate cancer patients.

“When prostate cancer metastasizes to another location in the body, it is in most cases incurable, and the goal of treatment is to improve a patient’s symptoms or function, or to extend the length of the patient’s life,” Suzman says.

Since the approval of docetaxel, the number of therapies for metastatic prostate cancer has continued to grow. The FDA has approved six additional therapies for metastatic castration-resistant prostate cancer, all of which have shown improvements in survival and are not directed to specific mutations in the cancer. These include hormonal therapy, chemotherapy, a cancer vaccine, and radioactive drugs.

Additionally, the FDA has approved four therapies for patients with metastatic castration-resistant tumors that require testing for specific mutations in the prostate cancer to determine if the patient may be a candidate for treatment. Some of these therapies are approved in combination with a hormonal therapy, such as abiraterone or enzalutamide.

Metastatic Castration-Sensitive Prostate Cancer: For patients with previously untreated metastatic prostate cancer, several major trials showed that adding additional therapy, including hormonal therapies (abiraterone acetate, enzalutamide or apalutamide), docetaxel, or darolutamide with docetaxel, improved their survival. According to Suzman, this approach has become a standard of care for patients with previously untreated metastatic prostate cancer.

To receive docetaxel, patients must be fit for chemotherapy. Abiraterone acetate tablets are also approved, in combination with prednisone, for patients with metastatic high-risk, castration-sensitive prostate cancer, while enzalutamide and apalutamide are each approved for all patients with metastatic castration-sensitive prostate cancer.

Emerging Research in Prostate Cancer

One promising area of prostate cancer research is related to preventing overtreatment of patients with prostate cancer that is still localized to the prostate and who have a low risk of becoming symptomatic or dying from the condition. There is increasing evidence that close surveillance and repeated biopsies may safely allow these patients to delay definitive therapy (surgery or radiation).

“There is a need to reduce the burden to patients of overtreatment if the prostate cancer is slow-growing,” Suzman says.

Sickle cell disease is an inherited blood disorder that can cause anemia, severe pain, infections, organ damage, and stroke. It is a lifelong condition that primarily affects Black/African American and Hispanic/Latino populations.

What is sickle cell disease?

Healthy red blood cells are flexible and travel through your blood vessels to carry oxygen to your tissues. Sickle cell disease (SCD) is caused by a genetic mutation that changes the shape of red blood cells from round to C-shaped like a farm tool called a sickle. Sickled red blood cells are stiff and sticky and can get stuck in blood vessels and clog the blood flow, preventing oxygen from getting to parts of the body. This blockage can cause pain.

Who is affected by sickle cell disease?

Sickle cell disease is the most commonly inherited blood disorder in the United States. About 1 out of every 400 Black or African Americans and about 1 out of every 16,000 Hispanic/Latino Americans are born with SCD.

What are the symptoms of sickle cell disease?

The symptoms and complications of SCD vary in severity from person to person and may change over time. Early symptoms usually develop around 5 months of age and may include:

• Painful swelling of the hands and feet (dactylitis)
• Fatigue or fussiness from a shortage of oxygen in the blood (anemia)
• Yellowish color of the skin (jaundice) or in the white parts of the eye (icterus)

Adults and children living with SCD often experience pain crises, which are the most common cause of hospitalization. Sickle cell disease raises the risk of acute chest syndrome, infections, heart and kidney damage, and stroke.

How is sickle cell disease diagnosed?

Since 2006, all U.S. states require newborn screening for SCD using a blood test. Adults can get screened to identify sickle cell trait (SCT), which is when a person carries the gene for SCD. Your health care provider can estimate your chances of passing the gene to your children.

How is sickle cell disease treated?

Patients may use pain medications to manage pain crises. Blood transfusions (receiving healthy blood from a donor) can help prevent complications or treat severe anemia. Four FDA-approved medications may help prevent the common complications of SCD in children and adults:

• Hydroxyurea
• L-glutamine oral powder
• Voxelotor
• Crizanlizumab-tmca

Consult with your health care provider to find out if any of these medications are right for you or your child.

The only cure for SCD is a bone marrow or stem cell transplant. Younger patients with severe SCD can consider transplants, but they are expensive, require a matching donor, and have serious risks.

Is it true that only people with light skin get skin cancer?

No. Anyone can get skin cancer. It's more common among people with a light (fair) skin tone, but skin cancer can affect anyone. Skin cancer can affect both men and women. Even teenagers and, rarely, younger children can develop skin cancer.

How can people with dark skin get skin cancer?

Although dark skin does not burn in the sun as easily as fair skin, everyone is at risk for skin cancer. Even people who don't burn are at risk for skin cancer. It doesn't matter whether you consider your skin light, dark, or somewhere in between. You are at risk for skin cancer. Being in the sun can damage your skin. Sunlight causes damage through ultraviolet, or UV rays, (they make up just one part of sunlight). Two parts of UV, UVA and UVB, can both cause damage to skin. Also, the sun isn't the only cause of skin cancer. There are other causes. That's why skin cancer may be found in places on the body never exposed to the sun.

How can I find skin cancer early?

• Talk with your doctor if you see any changes on your skin that do not go away within one month.
• Check the skin on all surfaces of your body, even in your mouth.
• Watch for a new mole or other new growth on your skin.
• Check for changes in the appearance of an old growth on the skin or scar (especially a burn scar).
• Watch for a patch of skin that is a different color and becomes darker or changes color.
• Watch for a sore that does not heal – it may bleed or form a crust.
• Check your nails for a dark band. Check with your doctor if you see changes, such as if the dark band begins to spread.

When skin cancer is found early, it can be treated more easily.

What does skin cancer look like?

There are many different types of skin cancer (such as melanoma and basal cell skin cancer). Each type looks different. Also, skin cancer in people with dark skin often looks different from skin cancer in people with fair skin. A change on the skin is the most common sign of skin cancer. This may be any new growth on the skin, a sore that doesn't heal, or a change in an old growth.

If you notice a change on your skin, see your doctor. Don't wait until the change looks like the more advanced skin cancers in these photos.

How can I protect myself from skin cancer?

Have your doctor check your skin if you are concerned about a change.
Your doctor may take a sample of your skin to check for cancer cells.

Ask your doctor about your risk of skin cancer:

• Some skin conditions and certain medicines (such as some antibiotics or hormones) may make your skin more sensitive to damage from the sun.
• Medicines or medical conditions (such as HIV) that suppress the immune system may make you more likely to develop skin cancer.
• Having scars or skin ulcers increases your risk.
• Exposure to a high level of arsenic (a poison that is sometimes found in well water or pesticides) increases your risk.

Stay out of the sun as much as you can. Whenever possible, avoid exposure to the sun from
10 a.m. to 4 p.m. If you work or play outside, then…

• Try to wear long sleeves, long pants, and a hat that shades your face, ears, and neck with a brim all around.
• Use sunscreen with a label that says it is broad spectrum or is at least SPF 15 and can filter both UVA and UVB rays.
• Wear sunglasses that filter UV to protect your eyes and the skin around your eyes.
• If you are concerned about having a low level of vitamin D from not being in the sun, talk with your doctor about supplements.

Don't use tanning beds, tanning booths, or sunlamps.

Getting restful sleep is often hard. Sleep apnea can make it even harder.

New NIH-supported research finds that African Americans with more severe forms of sleep apnea are at greater risk of high blood pressure. An estimated one in four African Americans in the U.S. have a moderate or severe case of sleep apnea.

Sleep apnea happens when there is airflow reduction during sleep. Common signs are snoring or gasping.

The study researchers say that screening groups at high risk for sleep apnea can help reduce their risk of high blood pressure and heart disease.

Untreated sleep apnea can lead to heart attack, diabetes, cancer, or glaucoma.

If you have a heart condition, snore loudly, or feel that excessive daytime sleepiness gets in the way of your daily activities, discuss your symptoms with a doctor. They can help you determine how these problems might be managed.

Each year in the United States, there are more than 795,000 strokes. Stroke is the fifth leading cause of death in the country. And stroke causes more serious long-term disabilities than any other disease. Nearly three-quarters of all strokes occur in people over the age of 65 and the risk of having a stroke more than doubles each decade after the age of 55.

For African Americans, stroke is more common and more deadly - even in young and middle-aged adults - than for any ethnic or other racial group in the United States.

Learning about stroke can help you act in time to save a co-worker, friend, or relative. And making changes in your lifestyle can help you prevent stroke.

New treatments are available that greatly reduce the damage caused by a stroke. But you need to arrive at the hospital within 60 minutes after symptoms start to prevent disability. Knowing stroke symptoms, calling 911 immediately, and getting to a hospital are critical.

What is a stroke?

A stroke is serious - just like a heart attack. A stroke is sometimes called a "brain attack." Most often, stroke occurs when blood flow to the brain stops because it is blocked by a clot. The brain cells in the immediate area begin to die because they stop getting the oxygen and nutrients they need to function.

What causes a stroke?

There are two kinds of stroke. The most common kind of stroke, called ischemic stroke, is caused by a blood clot that blocks or plugs a blood vessel in the brain. The other kind of stroke, called hemorrhagic stroke, is caused by a blood vessel that breaks and bleeds into the brain.

What disabilities can result from a stroke?

Stroke damage in the brain can affect the entire body - resulting in mild to severe disabilities. These include paralysis, problems with thinking, problems with speaking, and emotional problems.

Stroke Symptoms

• Sudden numbness or weakness of the face, arm, or leg (especially on one side of the body)
• Sudden confusion, trouble speaking or understanding speech
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden severe headache with no known cause

What should you do?

Because stroke injures the brain, you may not realize that you are having a stroke. The people around you might not know it either. Your family, friends, or neighbors may think you are confused. You may not be able to call 911 on your own. That's why everyone should know the signs of stroke - and know how to act fast.

Don't wait for the symptoms to improve or worsen. If you believe you are having a stroke - or someone you know is having a stroke - call 911 immediately. Making the decision to call for medical help can make the difference in avoiding a lifelong disability.

Call 911

If you believe you are having a stroke - or someone you know is having a stroke - call 911 immediately.

When I walked into the locker room at work, I realized something was wrong. I couldn't speak. I tried to pick up my lock, but my right hand couldn't grab it. One of my co-workers noticed something was wrong and asked if I could write. With my left hand, I scribbled 911 on a piece of paper. Luckily, my friend knew the signs of stroke and got help. She called an ambulance, and I was rushed to the emergency room. The doctors ran some tests and put a drug into my IV. Within 10 minutes I could speak again. I didn't know a thing about stroke before I had one. Now, I make sure that all my family knows the signs of stroke so they can get help if they need it.

Ruth Junious
Stroke Survivor

Know Stroke Prevention

Conditions that can cause stroke are very common among African Americans. The best treatment for stroke is prevention. You can reduce your risk of having a stroke by taking action to improve your health.

What can you do to prevent a stroke?

While family history of stroke plays a role in your risk, there are many risk factors you can control.

• If you have high blood pressure, work with your doctor to get it under control. Many people do not realize they have high blood pressure, which usually produces no symptoms but is a major risk factor for heart disease and stroke. Managing your high blood pressure is the most important thing you can do to avoid stroke.
• If you smoke, quit.
• If you have diabetes, learn how to manage it. As with high blood pressure, diabetes usually causes no symptoms but it increases the chance of stroke.
• If you are overweight, start maintaining a healthy diet and exercising regularly.

Every minute counts. The longer blood flow is cut off to the brain, the greater the damage. The most common kind of stroke, ischemic stroke, can be treated with a drug that dissolves clots blocking the blood flow. The window of opportunity to start treating stroke patients is three hours. But a person needs to be at the hospital within 60 minutes of having a stroke to be evaluated and receive treatment.

Where Can You Learn More About Stroke?

Talk to your doctor about your personal risk factors for having a stroke. For more information about stroke prevention and treatment, call the National Institute of Neurological Disorders and Stroke at 1-800-352-9424.

STROKE PREVENTION

• Manage your diabetes
• Eat right
• Control your high blood pressure
• Exercise
• Don't smoke

I had a stroke when I was 49 years old. I am 67 now and have gone almost 20 years without another stroke. Until I had my stroke, I didn't do anything good for my health. I had high blood pressure, I was overweight, and I smoked. When bad things happen to people, they tend to think "why me?" But, when I think about my stroke, I think "why not me?" I had all the risk factors and wasn't taking care of myself like I am now. I've learned a lot of important lessons from my stroke, which have caused me to change my eating habits, quit smoking, and really control my high blood pressure for the first time in my life. I hope people realize they can prevent stroke. It doesn't have to happen to them.

Ted Turner
Stroke Survivor