A Better St. Louis. Powered by Journalism.
  • Twitter
  • Facebook
  • Print
  • Email

With CARE, black seniors learn to stay fit and healthy

In Race, Frankly

5:06 am on Sun, 11.22.09

Posted 8:28 p.m. Sun., Nov. 22 - Thanks to Medicare, the federal health insurance for the elderly, African-American seniors enjoy unprecedented access to medical treatment -- and yet their health status still lags relative to whites.

One explanation is the Jim Crow effect, what Harvard epidemiologist Nancy Krieger calls the price many elderly African Americans pay in old age for poor treatment during the years when health care was segregated and programs like Medicaid didn't exist.

wilkins150consuelomd.jpg Dr. Consuelo Wilkins (right), an associate professor at Washington University Medical School, says there's truth to that argument. 

"Because of the direct effect of racism on that age group," she says, "people weren't given equitable care, had to go into different entrances to hospitals ... all sorts of thing happened that made them skeptical about the health-care profession."

The challenge now, Wilkins says, is to teach older adults that aging and illness don't have to go hand in hand. Seniors can remain fit and independent and deal with health conditions that their bodies began developing when medical services were segregated and inequitable.

Wilkins directs a program called CARE in Our Community. CARE stands for Collaborative Assessments to Revitalize the Elderly. Its aim is to take prevention to seniors in St. Louis, offering them help ranging from bone density screening for osteoporosis to therapy to help the elderly stay fit and healthy.

"A lot of older adults expect to be ill," she says. "One thing that really bothers me as a geriatrician is that they don't complain. They think, 'I'm old and I'm going to get sick.' Because of past experiences, they really don't think they should go to the doctor unless they are very ill."

Wilkins says she encourages the elderly to think beyond the obvious health concerns, such as diabetes and heart disease. Too few of them, she says, think about mobility, the ability to cross a major intersection, for example, as an important sign of health.

"A lot of people have arthritis and break bones as they get older. These things are likely to have more of a functional impact because they don't exercise and stay as active as they should. They worry about things like blood pressure and diabetes. These also are important, but don't keep them from going to the grocery store or church or interacting with family."

CARE at the Y

Wilkins is delighted whenever she takes the CARE program to the Monsanto Family YWCA , 5555 Page Boulevard, where she sees many older folks she wishes others would emulate.

"If I remember correctly, it has the largest percentage of older African Americans than any Y in the country," Wilkins says. "When we go there, we have to struggle to find new ways to keep them active because they are very, very active people."

A recent study about health-care inequities found that residents in north St. Louis, where the Y is located, have the most serious health problems in St. Louis. But you'd never know that from the energetic crowd of seniors at the Y. There's no visible Jim Crow effect on this Wednesday morning.

On a typical morning, elderly Y members spend time doing cardiovascular exercises in the pool, low-impact aerobics and line dancing in the gymnasium, and working out on treadmills and other machines.

boyd150augustarj.jpg Augusta "Gus" Boyd (right), 81, a retired waiter, goes three times a week. Like nearly everybody else, Boyd comes as much to socialize as to exercise. "I like to see people come in smiling and not have a frown on their faces," he says. "That's not me. Exercise keeps me in pretty good healthy. At least that's what my doctor tells me. But I'm really here because of my kids. They enrolled me in a membership six or seven years ago. I tell them I'm protecting their investment."

In another part of the building, Marcella Piper, 85, a retired guidance counselor, has joined other seniors in a light, slow-paced "aquacise" in the pool. Piper, a niece of the late photographer Gordon Parks, says she likes the social atmosphere at the Y as much as she enjoys her three-times a week workout.

"I have arthritis in my right leg, and my doctor prescribed the water exercise program. It's hard work, but I know that I feel better whenever I get out of the water. I also use the treadmill, and I read while I'm doing that. I wish I could encourage all seniors to participate rather than stay home and watch television."

nathan150diane.jpg At age 67, Diane Nathan (right) is one of the younger seniors there. A retired nutritionist, she knows better than most the value of a good workout and good eating habits. She enjoys the company at the Y so much that she drives from her home in St. Charles daily to join friends, including college sorority sisters, in aerobics classes and line dancing.

"People do have legitimate excuses for not being here," she says. "Some lack transportation and others are afraid to come out because of the (crime in) neighborhoods where they live. But I think some just haven't bought into the importance of exercise because we haven't done it all of our lives."

scott150jessie.jpg The woman who coordinates the morning programs for seniors is Jessie Scott, 75 (left), who joined the Y a few years ago to swim, work out and keep a healthy blood pressure. As coordinator, she focuses on social events as well as exercise activities. One event she and others look forward to was the popular Tuxedo and Tennis Gala, a dance to help raise money for Y activities. The annual event now takes place at a downtown hotel. When the gala began nine years ago, it was held in the Y's gymnasium. Participants were told to wear tennis or track shoes so they wouldn't harm the floor. Now, everybody still shows up in tennis or track shoes.

Beyond Racial disparities

Although a recent study showed that racial disparities in health care are widespread in St. Louis, Wilkins says research is beginning to show not all health problems are due to racism.

piper300marcellrightfriends.jpg
Photo by Robert Joiner | Beacon staff
Marcella Piper, right, joins with friends for a light, slow-paced "aquacise" in the pool.

"We talk about heart disease and diabetes being more common among African Americans. But there are lifestyle factors, such as diet, the things that you eat, as well as access to health care and socio-economic status that play into your likelihood of having diabetes or heart disease."

Researchers are beginning to examine biological factors that previously were not thought to affect common health problems. One example, she says, is vitamin D deficiency.

"Vitamin D is a hormone made through exposure to sun. The darker your skin, the less vitamin D you make. You can take 10 different people, even if all are African Americans with different shades of skin, and everyone is going to make a different amount of vitamin D."

Inadequate levels of vitamin D may be related not only to osteoporosis, she says, but to other deficiencies, such as high blood pressure, diabetes and heart disease.

"We have for a long time really disregarded a lot of the potential effects of vitamin D deficiency. We didn't think it was as important, but now we're learning it's probably much more important than we think."

It's one reason CARE emphasizes vitamin D at the Y and makes sure residents receive free advice on this and other issues that affect the mobility and well-being of the elderly.

race300.gif

In St. Louis, race affects politics, the economy, personal relationships, education – virtually every important aspect of community life. Yet it’s difficult to talk honestly and productively about race. In Race, Frankly, the Beacon invites you to look at race with fresh eyes. It’s a new day nationally, and in St. Louis, it’s time.

Read more stories in the Race, Frankly project

Wilkins came to St. Louis a decade ago after completing medical school at Howard University, with plans to head for Duke University for a geriatric medicine fellowship. A few months before leaving for Duke, she met her future husband, Kenneth Wilkins, also a St. Louis physician. He wasn't interested in moving to North Carolina, so they looked around and she found that Washington University had a similar program in geriatrics, which brought her to St. Louis. Her husband, meanwhile, did his family medicine residency at St. Louis University.

"We had planned to be here a few years, but 10 years later, we're still here," she says, smiling.

No matter where she landed, Wilkins would have worked to increase the number of black doctors. She has headed the Mound City Medical Forum, an organization that represents African-American doctors; she also is health editor for the St. Louis American weekly newspaper. When she first walked the corridors at the med school or at BJC, she saw few physicians who looked like her, but now she's noticing more.

"We have a number of training programs at Washington University and Barnes. It's unusual to see more than one African American in any one of them at a time."

But during the last few years, she says, "we've actually had somewhat of an influx of African Americans, and that was a head turner for me. We're making progress but not enough."

She stresses that point to make another: "If we are going to tackle the issues affecting the community, we need to get more (minority) health professionals in the pipeline, not just physicians but health professionals in general.

"If you look at who takes care of minorities, it's going to be people who have something in common with the community. Minorities are more likely to give back their service to the community and work in the underserved areas."

Meanwhile, she wished more blacks would learn what the elderly members of the Monsanto Y have discovered. These residents know they will not be able to erase all the side effects from the Jim Crow era. But, in their old age, they also know that regular exercise and other measures, like those through CARE, can keep them healthier. In the Y's program, many just might have found one key to longevity.

Contact Beacon staff writer Robert Joiner.

 

No Comments

Join The Beacon

When you register with the Beacon, you can save your searches as news alerts, rsvp for events, manage your donations and receive news and updates from the Beacon team.

Register Now

Already a Member

Getting around the new site

Take a look at our tutorials to help you get the hang of the new site.

Most Discussed Articles By Beacon Members

Conference of American nuns will mull response to Vatican charges

In Nation

7:55 am on Fri, 08.03.12

Meeting in St. Louis next week, the Leadership Conference of Women Religious will have its first opportunity as an assembled group to consider what to do after the Vatican issued a mandate for change this spring. It calls on the conference to reorganize and more strictly observe church teachings.

The 'free' Zoo

In Commentary

7:51 am on Tue, 05.22.12

When a family of four goes to the St. Louis Zoo, they can be forgiven for not knowing it will cost them $60, $72 if they park. If they can't pay, the alternative is to tell the kids they can't do what kids do at the zoo.

Featured Articles

House sends Boeing incentive bill to Nixon

In Economy

12:55 pm on Fri, 12.06.13

The Missouri House easily passed legislation aimed at attracting production of the 777x, a move that wraps up a legislative special session that saw little suspense and few surprises. The bill now goes to Gov. Jay Nixon, who has strongly supported the legislation.

Gandhi inspired Mandela on South Africa's 'Long Road to Freedom'

In World

10:10 am on Fri, 12.06.13

Nelson Mandela, who died Thursday at the age of 95, was a towering moral figure of the 20th century -- along with Mahatma Gandhi. It was no coincidence that Gandhi and Mandela, whose paths never crossed directly, both embarked on their campaigns against discrimination in South Africa. It was when Mandela won election as South Africa’s first black president that Gandhi's influence became apparent.

Featured Articles

Regina Carter brings jazz and therapy to Children's Hospital

6:36 am on Mon, 12.09.13

One night, the violinist is taking bows before a standing ovation at Jazz at the Bistro. The next afternoon, some of her audience may have trouble standing, but the kids in the playroom at Children's Hospital were no less appreciative. “Jazz is medicine personified," according to a doctor who brings in the jazz musicians.

Encore: Dead before death

In Performing Arts

12:58 am on Fri, 12.06.13

For years , the author was certain he would never come to appreciate The Grateful Dead, let alone be a Deadhead. But little by little, he's come around. He talks about his conversion and relates a real evolution: by a musician who went on to play with the Schwag, a Dead cover band.

Featured Articles

Schlichter honored with St. Louis Award

In Region

4:57 pm on Tue, 12.03.13

The attorney has founded Arch Grants, which brings together nonprofit philanthropy and commercially viable opportunitiesto fund new business startups, and Mentor St. Louis, which finds adult mentors for elementary students in the St. Louis Public School System. He was the driving force behind the state's historic tax credit program.

BioGenerator sets open house to celebrate new digs for entrepreneurs-in-residence

In InnovationSTL

12:29 pm on Tue, 11.12.13

BioSTL's BioGenerator organization is on the move as its entrepreneurs-in-residence find a new home in 4,300 square feet of office and conference space in an old automobile factory. The blossoming program, which helps BioGenerator's portfolio companies to get off the ground, continues to pay dividends within the growing biotech community.

Ambassadors aim to soften rough landing for St. Louis immigrants

In InnovationSTL

6:34 am on Fri, 11.08.13

The St. Louis Mosaic Project is set to hold an orientation for its new ambassadors -- dozens of foreign and native-born volunteers who aim to help make the community a more welcoming place for those from other nations. Participants will be expected to do everything from visiting local restaurants serving international cuisine to having dinner with an immigrant to the area.

Recent Articles

More Articles

Innovation and entrepreneurial activity are on the rise in St. Louis, especially in bioscience, technology and alternative energy. The Beacon's InnovationSTL section focuses on the people who are part of this wave, what they're doing and how this is shaping our future. To many St. Louisans, this wave is not yet visible. InnovationSTL aims to change that. We welcome you to share your knowledge, learn more about this vibrant trend and discuss its impact.

Featured Articles

Regina Carter brings jazz and therapy to Children's Hospital

6:36 am on Mon, 12.09.13

One night, the violinist is taking bows before a standing ovation at Jazz at the Bistro. The next afternoon, some of her audience may have trouble standing, but the kids in the playroom at Children's Hospital were no less appreciative. “Jazz is medicine personified," according to a doctor who brings in the jazz musicians.

Featured Articles

Featured Events:

More About The Beacon Home