Sick and Tired: Black Women and Health

Civil Rights, Women & Health

In 1964, Fanny Lou Hamer, an African–American civil rights activist (1917-1978) wrote;

‘All my life I have been sick and tired. Now I’m sick and tired of being sick and tired.’

In her lifetime Fanny Lou had fought hard against the racism, sexism and economic oppression of the time and the personal battles that came with her chronic illnesses and disabilities. Despite these obstacles she continued to campaign and support the rights of all people, particularly Black women for equality to improve their life and health chances. However in the 21st century and fifty years after her famous speech I find myself reflecting on the state of Black women’s health today. The question which rebounds and reoccurs in my mind is ‘Why in a time of clear evidence about risk, personal care and social opportunities are Black women still falling behind in measures of wellbeing?’.

As Black women, the statistics (which we know never lie) tell us we are succeeding in education and the marketplace, running our own companies and holding our own in the boardroom while balancing home and family responsibilities, often alone….yet among, these and our many other triumphs are we losing the battle for our health? Dr. Nancy Snyderman from the USA speaking on the news channel MSNBC in 2007 stated that black women in America have an increased risk of mortality greater than any other ethnic group for almost every major cause of death. Meanwhile here in the UK, among Black Caribbean women, diabetes is relatively high (8%) compared with the general female population where the rate is 3%. Working hard and keeping the home together are themes that have continued to be associated with Black women’s lives throughout history…‘Strong Black Woman’ is a label to be proud of, but often the women behind this title lives from day to day, struggling to hold up others and lead the communities, with little time to hold up themselves.

“All my life I have been sick and tired. Now I’m sick and tired of being sick and tired.”

Throughout my working life in healthcare and my personal networks I have spoken to many black women about their own health and that of their female family and friends, regular comments made during our discussions are “we are always expected to be strong women who aren’t supposed to whine about anything”.

“You just take life as it comes and do what you have to do. If you are having troubles or problems, you should just pray about it and keep going”.

I have often reflected on these conversations and my observations of myself and others and wondered why for generations, we as Black women are continuing on, far beyond the point of being ‘Sick and tired’ as described by Ms Hamer.


The contradictions and conflicts of culture, personhood and keeping a sense of self worth have been difficult demands to balance for most women at some time in their lives. At the same time these arguments continue to reappear in all spaces from the political arena to the Sunday dinner table or the ever welcome ‘girls night in’. discussions and arguments rage about issues of blame, risk and the responsibility of Black women for their own predicament. The intersection of culture, traditional and expectation with social, economic and educational factors for women mean that the answers to such challenge are never simple. Within our own heritage ‘PHAT’ women are revered, their voluptuous curves, a sign of ‘looking good’ while at the same time we fight to control the ‘fat’ that threatens our lives and health in the form of diabetes, heart disease and stroke.

“When I loved myself enough…..I began leaving whatever wasn’t healthy. This meant people, jobs, my own beliefs and habits – anything that kept me small. My judgement called it disloyal. Now I see it as self-loving.”

It is true that women’s health status varies greatly depending on economic class, race, ethnicity, education, and home country. Moreover the strong relationship between minority status and poverty clouds the issue for many Black women. However, we must also concede that often choices we make for ourselves can reduce or optimise our health chances. Black women’s health continues to be the worst, irrespective of economy, education or location……but are we truly victims of circumstance?


We have all heard, witnessed or lived the experience that Black women are more likely to go without food, shelter and warmth for their children. They will go any distance to support a friend, sit with neighbours when they are afraid and cheer the loudest when their children succeed. At the same time they will ignore the pain and discomfort they feel – ‘tomorrow I will be better’. In health and prevention the greatest enemy of life chances and survivorship in Black populations are late presentation (delay in seeking help) and poor treatment adherence (not attending appointments or stopping medication/treatment). Couple this with putting yourself last on your own list and the combination can be literally deadly.


My musings on health are not an attempt to minimise in any way the external pressures and situations which render us more likely to suffer ill health or reduce our ability to maintain a sense of well being. Neither is this an exercise in self blame or self pity. Rather it is a response to the strength of Ms Hamer and many women like her. I came across this quote from a woman, Kim McMillan, who died shortly after completing her book. It does not speak to Black women from a Black perspective, but I believe it beautifully summarises the call for us to be different, for our own sakes and those of our future daughters.

“When I loved myself enough…..I began leaving whatever wasn’t healthy. This meant people, jobs, my own beliefs and habits – anything that kept me small. My judgement called it disloyal. Now I see it as self-loving.” (McMillen 2009 )


In other words, knowledge, self knowledge, is power but when we take the opportunity to use it or gain it…… we must do so!