You've probably heard the expression "black don't crack," a reference to black women's ageless beauty. But though their skin may be smooth and wrinkle-free on the outside, black women are aging faster than white women on the inside, health experts say.
Dr. Michelle Gourdine, a former deputy secretary of health and chief public health physician for Maryland, explains that extreme stress causes wear and tear on our internal organs, contributing to heart disease, high blood pressure and stroke in black women – all diseases of aging.
"The cells that make up your heart, your blood vessels, whatever else, begin to age prematurely because of all the stress, and that predisposes you to disease," says Gourdine, author of "Reclaiming Our Health: A Guide to African American Wellness."
She points to a 2010 National Institutes of Health study titled "Do US Black Women Experience Stress-Related Accelerated Biological Aging?" The study's authors analyzed data from the Study of Women's Health Across the Nation and found that black women between the ages of 49 and 55 are 7.5 years biologically "older" than white women.
"US blacks are more likely to experience stressful situations, such as material hardship, interpersonal discrimination, structural discrimination in housing and employment, and multiple caregiving roles than whites," the authors wrote.
According to the study, this cumulative impact of overexposure to stress hormones takes a toll on the body and contributes to the development or progression of such ailments as "cardiovascular disease, obesity, diabetes, susceptibility to infection, carcinogenesis, and accelerated aging."
"What the article seems to imply is that we just have a heavier load to carry, bottom line," says Gourdine, currently a clinical assistant professor in the departments of pediatrics and of epidemiology and public health at the University of Maryland School of Medicine, and a senior associate at Johns Hopkins Bloomberg School of Public Health.
"When you think about black women and how we're all raised to be strong and that's what we expect each other to be as African-American women, what comes with that is a set of added responsibilities."
Gourdine points to how black women are often the primary breadwinners in their families and have to juggle multiple roles – sometimes navigating a culturally insensitive workplace while also acting as caregivers for children, grandchildren and ailing parents. And for black women in high-powered positions, there's an even greater risk, she says.
"In meetings where you're the only woman or only African American, you feel like all eyes are on you," Gourdine says. "You feel that pressure to perform, of proving that you're good enough and that you do work hard. There is stress from always having to be 'on.'"
Those expectations are compounded by our cultural expectations of "strong black women," she continues. "We are expected to be independent and not ask for help, keep our needs inside and not admit that we need help," she says.
Dr. Gayle Porter, a clinical psychologist and co-director of the Gaston & Porter Health Improvement Center, says she is amazed at how reluctant black women are to acknowledge that they're stressed. "Strength means being able to acknowledge that you need help and support. That's part of being strong," she says.
Instead, black women tend to deal with stress through destructive behaviors such as overspending, which can cause financial stress, or overeating, which can lead to obesity and diabetes.
"These are some of our brightest, hardworking, most intelligent, most loving women," notes Porter. "We are dying at rates that are greater than any other group of women from heart disease, cancer, diabetes and stroke, so whatever it is that we're doing is not working."
Indeed. black women develop high blood pressure – which could lead to strokes or heart attacks—at an earlier age than white women and have higher rates than their white counterparts. Although heart disease is the No. 1 killer of women in general, black women are more likely to die from the disease than women of other races. Breast cancer and diabetes also affect black women at higher rates.
Porter is a co-founder, along with Dr. Marilyn Gaston, of the Prime Time Sister Circles, a 12-week program that helps black women between the ages of 40 and 75 improve their health and deal with stress. The major stressors that women in the group have identified are health, financial stress and caregiving responsibilities, says Porter.
"We give sisters a safe space where they can learn how to identify stress, how to appropriately cope with it, how to reduce it if they can't eliminate it, and learn how to function in an assertive way that will teach them how to take care of themselves and take care of other people," she says.
The group teaches participants stress-management techniques such as deep breathing and encourages daily exercise. The women also have to keep a daily log of stressors.
"As black women, we have to look at the relationships between how we are dealing with stress and the fact that we are dying," says Porter. "Our folks don't want to acknowledge how stressed they are, but it's evident, and it impacts our entire community."
(Lottie L. Joiner is a Washington, D.C.-based freelance writer and senior editor of The Crisis magazine. Follow her on Twitter.)