Eldercare Voices: Marking Older Americans Month: A Conversation With Byllye Avery on the Health Challenges Older Black Women Face

May is Older Americans Month, a perfect time to better understand some of the health-related challenges facing older Black women in the United States. Who better to talk with about this than Byllye Avery, who in 1983 founded what is now the Black Women’s Health Imperative, the only national organization dedicated solely to improving the health and well-being of the nation’s 21 million Black women and girls. Lois Uttley, director of Community Catalyst’s Women’s Health Program, did just that, interviewing Ms. Avery for this column.

Ms. Avery, who is now 81 years old, draws on a lifetime of experiences to describe the systemic health challenges facing older Black women. A major problem, she says, is cardiovascular disease, “largely due to the stresses that Black women face” throughout their lives from racism, sexism and other social determinants of health. “Black women get it from everyone on all sides.”

Diabetes is another major health issue, she says, noting that too many Black women, including those who are older, are obese. “When I come home from that job that is killing me, food becomes medicine,” she explains. “We self-medicate with food.” The Black Women’s Health Imperative has strong programs addressing diabetes for this reason.

Another stressor occurs when Black families are struck by opioid addiction, Avery said, and a lot of the impact falls on grandmothers. “You have to start taking care of a three- or four-year-old,” she explains. “That has been the reality for a lot of grandmothers that makes their older years not so golden.”

Economic disadvantages throughout life also mean that many Black women enter old age without sufficient financial resources, Avery says. “Most of us never earn the money that we could earn to be financially stable,” she explains, citing low-paying jobs, often without benefits. “We go into our senior years without being able to stash money away. Few of us are taught how to handle the money we do have.”

Avery draws on her family experiences to illustrate some of the ways individual Black women can prepare for old age. “My greatest model has been my mother, L. Alyce Ingram, [pictured at left] who lived to be 104,” she says. “What did my mother do that was important and contributed to her good health and longevity? She built up her ‘health bank’ so she could call on it as she aged.”

“My mother took really good care of herself,” Avery recalls. “Until she died, her only serious ailment was high blood pressure. Among her ‘best practices’ were no smoking and very little drinking or eating of fried foods. She was also very good about getting her checkups. Anything that appeared to be serious, she followed through with it.”

Touching upon the theme of this year’s Older Americans Month – “Connect, Create, Contribute” Avery also believes her mother’s longevity was related to her determination to stay active and be around younger people. “She was devoted to the church. The day she retired from teaching after 30 years, that following Monday she volunteered at the church and did that for the next 20 years of her life,” Avery says. “She kept herself very active and very connected. She had younger friends who helped her, which was important because friends her age all died around the same time. That kind of socialization with younger people added to her not feeling isolated or depressed.”

Avery says her mother also carefully prepared for how she could “age in place” in her house in Jacksonville, FL, by making sure the mortgage was paid off. “She taught school for 30 years, but didn’t have a pension, only Social Security, because of pension rules at that time.” When she was quite elderly, her granddaughter – Byllye Avery’s daughter, Sonja, and her husband, John – took care of her. “She was able to pay them for the care by leaving them the house,” Avery explains.

Older Black women “need to be able to pay family members to take care of us,” Avery says, voicing approval for pilot initiatives to allow use of federal or state funding streams for this purpose, as an alternative to nursing homes. She also notes that long-term care insurance is extremely expensive, and well beyond the means of many Black women thinking ahead to old age.

Providing supportive services to older Black women in their own homes is extremely important, Avery says. “Make it in the places where people are – such as in housing complexes. Don’t expect older people to catch two buses across town. Funding for improving the health of older Black women should go to community-based organizations that can best relate to them and go where they are.”

She advises all caregivers to recognize that “health is a very personal issue,” suggesting that “It’s not just the body you are treating – it’s also the head and the heart. Women are highly protective of their independence and autonomy. Caregivers need to recognize this and accommodate their wishes. Remember that this person is bringing a lot into the room.”

As Avery works to improve her own health, she has become a big proponent of walking, which she has been doing to address some knee problems. “Walking is one of the best things, and it doesn’t cost any money.” To other older Black women, she has this personal advice: “It’s never too late to try something. Don’t think you have to give up because you are in your 70s, 80s or even 90s.”

Byllye Y. Avery, founder of the Black Women's Health Imperative, has been a health care activist for over 45 years, focusing on women's needs. She is also a co-founder of Raising Women’s Voices for the Health Care We Need, along with Lois Uttley of Community Catalyst’s Women’s Health program. She is featured in the PBS program “Makers: Women Who Make America.” In the ‘70s Avery co-founded both the Gainesville Women's Health Center and Birthplace, an alternative birthing center, in Gainesville, FL. A dreamer, visionary and grassroots realist, Avery has combined reproductive justice activism and social responsibility to inspire other women to research, organize and develop effective programs for Black women. She continues to speak on women’s health experiences and rally support for Black women. Avery has been the recipient of many honors and awards.