You’ve probably heard the saying, “an ounce of prevention is worth a pound of cure.” It simply means that preventing a problem may be easier than dealing with one later. This is true when dealing with health conditions.
More than half of US adults will be diagnosed with at least one chronic health condition in their lifetime.1 Women tend to have more chronic conditions than men,2 and due to structural racism and discrimination, Black women are more greatly affected by chronic disease than most other groups.
Keeping up with your preventive care will help you learn how to prevent disease where possible, but also help you identify certain diseases early on so that you can get the treatment you need. Below are several suggestions for the types of health care women should prioritize according to their age group.
Preventative Care Measures Important for All Ages
Some preventive care measures are important no matter how old you are. Three examples include:
- Staying current on your vaccines – Together, you and your doctor or pharmacist can make sure you stay on track with your vaccine schedule so that you’re protected from many infectious diseases. Getting annual vaccines — like a flu vaccine — will also be important.
- Getting tested regularly for sexually transmitted infections (STIs), including HIV – Rates of STIs, though high overall in the US, are generally higher amongst Black communities. Yearly STI testing is recommended for women under 25 years old who are sexually active, and all women 25 and up. People between the ages of 13 and 64 should get tested for HIV at least once, but more frequent testing may be recommended for people with a higher risk of getting HIV.6
- Getting your annual checkups – Having a yearly visit with your primary care doctor and gynecologist can help you ensure you’re staying up-to-date on vaccines, STI testing, cancer screenings, and important lab work.
Preventive Care Measures to Prioritize at Various Ages
Age range: Adolescent years
Sex education
Sex education is important across your entire lifespan, but it’s especially important for young people during their formative years. Sex education doesn’t only focus on how to prevent pregnancy and STIs. It also helps young people understand consent, healthy communication, how to set boundaries and respect others’ boundaries, safer sex, and more — all in age-appropriate ways. Access to honest sex education helps young people grow into adults who are well-prepared to navigate all types of interpersonal relationships.
HPV Vaccination
Human papillomavirus (HPV) is the most common STI. Some types of HPV can cause cervical cancer or genital warts. Cervical cancer happens most often in Hispanic communities, but Black women are most likely to die from cervical cancer.
More than 90% of all cervical cancer cases are completely preventable. Using condoms is one way to lower the risk of getting HPV. Also, getting the HPV vaccine is one of the best ways to prevent cervical cancer. It’s recommended to start the 3-dose HPV vaccine series at age 11 or 12, before a person is likely to be exposed to HPV so that they have protection if and when they are exposed. But anyone who hasn’t received the vaccine before age 26 is eligible.8
Contraception (Birth Control)
Contraception is important for many reasons. While some people use it to prevent pregnancy, birth control can also treat some medical conditions like acne, endometriosis, or polycystic ovary syndrome (PCOS), which can cause painful periods, infertility, and weight gain. These conditions can be caused by hormonal imbalances, so hormonal birth control methods can help to change your hormone levels, which can treat the root causes or the symptoms of some of these conditions.
Condoms are the only type of contraception that protects against STIs, but there are several other options that work for birth control. Available contraceptives include:9
- External condoms, which can be put onto a penis
- Internal condoms, which are used inside the vagina
- Pills
- Implants
- Shots
- Patches
- Intrauterine devices (IUDs)
- Vaginal ring
Age range: 20s to 30s
Cancer screenings
Cancer screenings are a necessary part of preventive care. After all, early detection of cancer can lead to early treatment, which can be lifesaving. Pap smears and HPV tests can help detect cervical cancer, and breast exams like mammograms or breast ultrasounds can help can detect breast cancer.10
Cervical cancer screening should begin at age 21 for women whose cervixes show no signs of cervical cancer and who are at average risk of cervical cancer. Depending on the type of test used for screening, continued screening may be recommended every 3 years, or every 5 years, through age 65.
Usually, women at average risk of breast cancer do not start getting mammograms until their 40s; however, your health care provider may recommend getting your first mammogram at an earlier age if you have a higher personal risk of breast cancer. While the American Cancer Society no longer recommends monthly breast self-exams for all women, it may still be a good idea to perform a self-exam several times per year if you’re at higher risk for breast cancer. Factors that increase your risk include having:
- A personal or strong family history of breast cancer
- A genetic mutation (such as a mutation in a BRCA gene)
- Chest radiation therapy before the age of 30
Learn how to perform a breast self-exam.
Heart health
Having your blood pressure, diabetes, cholesterol, and weight checked routinely can help you proactively lower your risk for chronic conditions like heart disease. If you are diagnosed with a chronic disease, getting the disease under control through lifestyle changes and medication (if needed) can lower your risk of complications. Prevention and management of chronic disease may lower your risk of heart disease and stroke.
Heart health and lowering your risk of complications is also important during pregnancy.11-13 People — especially in Black communities — are dying at alarming rates from pregnancy-related complications. According to the CDC, 4 out of every 5 maternal deaths are preventable, with most related to heart disease or stroke.
Prenatal care
Social factors like access to transportation and financial factors like insurance status influence a person’s ability to have consistent prenatal care. And pregnant people who have less prenatal care visits tend to have worse pregnancy outcomes. Black women are deeply affected by these barriers to care due to generations of systemic and structural racism.
Early and routine prenatal care can help pregnant people ensure they and the fetus or baby are receiving appropriate care during the pregnancy. Routine prenatal care is also critical for detecting potential complications — for example, preeclampsia (dangerously high blood pressure during pregnancy) or other heart conditions — early on.
Fibroid management
During an annual wellness exam, your gynecologist should screen for fibroids — a noncancerous tumor in or on the uterus — during a pelvic exam. Strong family histories of fibroids and lifestyle increase your risk of having fibroids. Black women are also at higher risk for fibroids. If your doctor detects fibroids, they may discuss with you lifestyle-related solutions like weight management or making manageable improvements to your eating habits. Birth control may also be an option for managing your symptoms. And in some cases, surgery may be recommended. Knowing your fibroid status early can also help prevent or explain challenges with infertility or pregnancy loss.15-16
Age range: 30s to 40s
Breast and colorectal cancer screenings
Cancer screenings continue to be important in your 30s and 40s, as more women enter the age ranges where screening is recommended. Breast cancer is still the second leading cause of death for women in the US and for Black women the risk of dying from breast cancer is higher compared to white women.17 For women at average risk of breast cancer, it’s recommended to have a first mammogram at age 40. However, for women with a higher risk of breast cancer, starting mammograms before age 40 can increase chances of survival.18 Speak with your healthcare provider to see if early screening is recommended.
Of the cancers that are diagnosed in people of all genders, colorectal cancer is the 3rd most common. Like other cancers, the risk for colorectal cancer is higher in Black communities, and while screening rates have improved, they are still too low. Unfortunately, people are being diagnosed at much younger ages, but the reason for this isn’t clear. The American Cancer Society recommends starting colorectal cancer screening at age 45. But you may need screening earlier if you have health conditions like inflammatory bowel disease (IBD) or a family history of colorectal cancer.19
Prenatal care
As with younger women, prenatal care is still vital for those in their 30s and 40s since women are choosing to have children later in life for various reasons.21 After age 35, studies show some women’s risk of pregnancy-related complications increases.12,22 Prenatal care appointments are linked to better health outcomes for women who attend all visits and make recommended changes.
Fertility assessment
Understanding your fertility status is an important step in family planning. Over the years, more and more women have spoken out about their issues with fertility, including celebrities like Michelle Obama and Gabrielle Union. Although Black women are more likely to have fertility issues, they’re also less likely to seek or take longer to receive fertility treatment. Unfortunately, the stigma and financial stress around fertility treatments continue to be barriers to care.23
The American College of Obstetricians and Gynecologists suggests having your fertility checked if you haven’t become pregnant after 1 year of regular intercourse without birth control. The time range shortens to after 6 months if you are over the age of 35.
Age range: Late 30s to 50s
Preparing for perimenopause and menopause
As women enter their late 30s to 50s, they may notice a change in energy, mood, and menstruation — signs that menopause is on the horizon.24 This transitional period is known as perimenopause, meaning “around menopause.” By definition, you are in menopause after 12 months without a period. Black women often reach menopause sooner and experience more severe symptoms like hot flashes, night sweats, sleep disturbances, and depression. Preparing for this transition can improve the symptoms they experience.
For some women, lifestyle changes are enough to manage menopause symptoms.25 In addition, completing annual wellness visits for a breast exam, Pap smear, and labs (cholesterol, thyroid, or other hormone and blood sugar levels) can help you decide where to focus your health goals.
For example, high cholesterol or blood sugar levels could point to a need for a calcium-rich, plant-based diet or increased physical activity. Menopause symptoms improve when you get at least 150 minutes per week of moderate exercise and two days of strength training.26 If your thyroid or other hormone levels are low, hormone replacement therapy is an option as well as non-hormone based treatments.
Stress management, like meditation and yoga, is often forgotten but is proven effective for managing menopause. Some changes, like quitting smoking and limiting alcohol consumption not only help menopause but other chronic conditions as well.
Vaccines
It’s been established that staying on top of your vaccines is important throughout the lifespan. During your late 30s to 50s in particular, certain vaccines you may not have needed before become more important. In order to stay up-to-date, the CDC recommends US adults receive the following vaccines27:
- Tetanus, diphtheria, and pertussis (Tdap or Td)
- Pneumococcal or pneumonia vaccine (PCV15 then PPSV23 or PCV20)
- Zoster or shingles vaccine (Shingrix)
The Tdap or Td vaccine is usually given once and then repeated every ten years. If you’ve never had this vaccine, are pregnant, or expect to be around babies who’ve not received their vaccines, Tdap is preferred first.
Pneumonia vaccines are generally recommended in those 65 and older, but you should receive them sooner if you have underlying health conditions or other risk factors such as:
- Alcoholism
- Chronic heart/kidney/liver/lung diseases
- Cigarette smoking
- Cochlear implant
- Diabetes mellitus
- HIV or other immunodeficiencies
- Solid organ transplants
- Sickle cell disease
If you’ve had chickenpox, the shingles virus is lying dormant in your body and can be activated at any time. When you turn 50, the shingles vaccine is recommended to prevent a painful rash from forming when active. It’s a 2-dose series, with the second dose being given 2-6 months after the first.
Age range: 60s and beyond
Heart disease
Heart disease is the leading cause of death for US adults, including Black women. Uncontrolled blood pressure, cholesterol, and even diabetes can lead to premature death from heart attacks and strokes. If you are 60 and beyond, it’s not too late to focus on your health.
Learn more about how to live a heart-healthy lifestyle to lower your risk.
Cancer screenings
You may need fewer cancer screenings as you get older. For women, cervical cancer screenings are no longer required after 65 or if your cervix has been removed. Breast and colorectal cancer screenings often stop around age 75. Every person is different, so your doctor can help you figure out whether you should continue certain screenings and how often.
Urinary tract infection (UTI) prevention
Problems with urination often affect older adults due to changes in the body. Low estrogen levels in postmenopausal women put them at a higher risk of UTIs. Small changes to your routine can help prevent UTIs28.
- Drinking plenty of water or other liquids to stay hydrated
- Taking a shower instead of a bath
- Avoiding the use of douches, sprays, or powders in your genital area
- Urinating directly after any sexual activity
- Wiping from the front to the back
- Keeping blood sugars under control, for people with diabetes
Bone health
Changes to bone health are common over time. Your body’s ability to absorb bone-strengthening minerals like vitamin D and calcium begins to decline, causing bones to become brittle and break easily. Postmenopausal women also lose the protective effect of estrogen on bones.29
At age 65, your doctor may recommend having a bone scan (DEXA scan) .30 This test measures your bone’s thickness and your risk of osteoporosis — a condition that weakens your bones. Repeat testing and treatment depends on your results. Taking 1,200 mg of calcium and 800 international units (IU) of vitamin D supplements daily can support your bone health. It’s best to speak with your healthcare provider before starting additional supplements as you may get enough through your diet.
Conclusion
Many of the chronic health conditions people – especially Black women – experience are preventable or manageable early on. With Black women more likely to experience — or have worse outcomes from — conditions like heart disease, certain cancers, infertility, or pregnancy-related complications, prevention becomes essential. Leading a healthy lifestyle along with taking advantage of preventative care measures are shown to improve health outcomes. If you haven’t already, get started by finding healthcare providers you trust and sharing your concerns. It’s important to understand your risk to make the best decisions for your life and health.
Conversation Starters
- Which preventative care measure were you most surprised about?
- Do you have any hesitations about completing any of the recommended measures?
- What other preventive care actions would you add to this list?
References
- Chronic Diseases in America | CDC. www.cdc.gov/chronicdisease/resources/infographic/chronic-diseases.htm.
- Boersma, Peter, et al. “Prevalence of Multiple Chronic Conditions Among US Adults, 2018.” Preventing Chronic Disease, vol. 17, Centers for Disease Control and Prevention, Sept. 2020, https://doi.org/10.5888/pcd17.200130.
- Chinn, Juanita J et al. “Health Equity Among Black Women in the United States.” Journal of women’s health (2002) vol. 30,2 (2021): 212-219. doi:10.1089/jwh.2020.8868
- “Preliminary Flu Burden Estimates, 2021-22 Season.” Centers for Disease Control and Prevention, 4 Oct. 2022, www.cdc.gov/flu/about/burden/2021-2022.htm.
- “HIV And Women: HIV Diagnoses.” Centers for Disease Control and Prevention, 18 Aug. 2022, www.cdc.gov/hiv/group/gender/women/diagnoses.html.
- “Which STD Tests Should I Get?” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 14 Dec. 2021, https://www.cdc.gov/std/prevention/screeningreccs.htm.
- “Comprehensive Sexuality Education.” ACOG, www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2016/11/comprehensive-sexuality-education.
- “Human Papillomavirus (HPV) Vaccines.” National Cancer Institute, 25 May 2021, www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-vaccine-fact-sheet.
- “How Effective Is Contraception at Preventing Pregnancy? -Your Contraception Guide Secondary Navigation Getting Started Methods of Contraception W.” NHS Choices, NHS, 17 Apr. 2020, https://www.nhs.uk/conditions/contraception/how-effective-contraception/.
- “New ACS Cervical Cancer Screening Guideline.” National Cancer Institute, 18 Sept. 2020, www.cancer.gov/news-events/cancer-currents-blog/2020/cervical-cancer-screening-hpv-test-guideline.
- “Maternal Mortality Rates in the United States, 2021.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 16 Mar. 2023, https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2021/maternal-mortality-rates-2021.htm.
- Lister, Rolanda et al. “Black Box Warning: Cardiovascular Complications Make Motherhood Unsafe for African American Women.” World journal of gynecology & womens health vol. 4,1 (2020): .000578. doi:10.33552/wjgwh.2020.04.000578
- Gad, Mohamed M., et al. “Disparities in Cardiovascular Disease Outcomes Among Pregnant and Post‐Partum Women.” Journal of the American Heart Association, vol. 10, no. 1, Wiley, Jan. 2021, https://doi.org/10.1161/jaha.120.017832.
- “Maternal Health in the United States.” Maternal Health Task Force, 10 July 2020, www.mhtf.org/topics/maternal-health-in-the-united-states.
- “Uterine Fibroids – Symptoms and Causes – Mayo Clinic.” Mayo Clinic, 21 Sept. 2022, www.mayoclinic.org/diseases-conditions/uterine-fibroids/symptoms-causes/syc-20354288.
- Riggan, Kirsten A et al. “Patient Recommendations for Shared Decision-Making in Uterine Fibroid Treatment Decisions.” Journal of patient experience vol. 8 23743735211049655. 20 Oct. 2021, doi:10.1177/23743735211049655
- Yedjou, Clement G et al. “Health and Racial Disparity in Breast Cancer.” Advances in experimental medicine and biology vol. 1152 (2019): 31-49. doi:10.1007/978-3-030-20301-6_3
- “Breast Cancer Facts & Figures.” American Cancer Society, 2022, https://www.cancer.org/research/cancer-facts-statistics/breast-cancer-facts-figures.html.
- “Colorectal Cancer Guideline: How Often to Have Screening Tests.” Colorectal Cancer Guideline | How Often to Have Screening Tests, 17 Nov. 2020, https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/acs-recommendations.html.
- “Colorectal Cancer Screening Tests.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 23 Feb. 2023, https://www.cdc.gov/cancer/colorectal/basic_info/screening/tests.htm.
- Associated Press. “Motherhood Deferred: US Median Age for Giving Birth Hits 30.” US News & World Report, 6 May 2022, www.usnews.com/news/us/articles/2022-05-06/motherhood-deferred-us-median-age-for-giving-birth-hits-30.
- Correa-de-Araujo, Rosaly, and Sung Sug Sarah Yoon. “Clinical Outcomes in High-Risk Pregnancies Due to Advanced Maternal Age.” Journal of women’s health (2002) vol. 30,2 (2021): 160-167. doi:10.1089/jwh.2020.8860
- “What Is Menopause?” National Institute on Aging, www.nia.nih.gov/health/what-menopause.
- Psychology, Committee on Women In. “Infertility and BIPOC (Black, Indigenous and People of Color) Women.” https://www.apa.org, 30 Sept. 2021, www.apa.org/pi/women/committee/infertility-bipoc#:~:text=Some%20have%20found%20that%20married,treatment%20than%20White%20women%206.
- Ob-Gyn, Moreland. Preventive Health Care: Women’s Health Age 35 – 50 – Moreland OB-GYN Associates, S.C. www.morelandobgyn.com/womens-preventive-health-care.
- “Fitness Tips for Menopause: Why Fitness Counts.” Mayo Clinic, 3 Dec. 2022, www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/fitness-tips-for-menopause/art-20044602.
- “Adult Immunization Schedule – Healthcare Providers.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 10 Feb. 2023, https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html.
- “What Is Heart-Healthy Living? | NHLBI, NIH.” NHLBI, NIH, 24 Mar. 2022, www.nhlbi.nih.gov/health/hear t-healthy-living.
- “Suffering From a Urinary Tract Infection?” Centers for Disease Control and Prevention, 14 Jan. 2022, www.cdc.gov/antibiotic-use/uti.html.
- “Aging Changes in the Bones – Muscles – Joints.” Mount Sinai Health System, www.mountsinai.org/health-library/special-topic/aging-changes-in-the-bones-muscles-joints#.
- “DEXA Scan (DXA): Bone Density Test, What Is It and How It’s Done.” Cleveland Clinic, my.clevelandclinic.org/health/diagnostics/10683-dexa-dxa-scan-bone-density-test.
