The health of African-Americans has improved over the last forty years. Data published in 2011 from the National Vital Statistics System, reveal that the life expectancy of African American women has increased from 68 to 77.4 years.

Many factors have helped improve our health such as regular medical care, exercise, a healthy diet, and timely screening tests. We must be vigilant as we strive to make progress and reach (and hopefully exceed) the life expectancy of white women which is 80.6 years.  Please consult with your doctor or health provider who can help you tailor these summary recommendations to your specific health situation. We need to be aware of these preventative health practices to make sure we are properly screened in order to ensure a healthier future for ourselves and our families.

The recommended screenings by age group are provided below:

• Women Ages 18 to 39
• Women Ages 40 to 64
• Women Ages 65 and up

Recommended Screenings for Women Ages 18 to 39

• Blood Pressure Screening:
  • Have your blood pressure checked every 2 years unless it is 120-139/80-89 Hg or higher. Then have it checked every year.
  • Watch for blood pressure screenings in your area. Ask your health care provider if you can stop in to have your blood pressure checked. Check your blood pressure using the automated machines at local grocery stores and pharmacies.
  • If the top number (systolic number) is greater than 130 or the bottom number (diastolic number) is greater than 85, call your doctor.
  • If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to be monitored more closely.
• Cholesterol Screening:
  • Between age 20 and 45, you should be screened if you have a higher risk for heart disease.
  • If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to be monitored more closely.
• Diabetes Screening:
  • If your blood pressure is above 135/80, your health care provider will test your blood sugar levels for diabetes.
  • You will also be tested for gestational diabetes when you are pregnant
  • Your doctor may order a “fasting” glucose as part of your annual or bi-annual physical exam.

• Dental Exam:
  • Go to the dentist every year for an exam and cleaning.
• Eye exam:
  • If you have vision problems, have an eye exam every 2 years.
• Immunizations:
  • You should receive a flu vaccine every year.
  • After age 19, you should have one tetanus-diphtheria and acellular pertussis (TdAP) vaccine as one of your tetanus-diphtheria vaccines. You should have a tetanus-diphtheria booster every 10 years.
  • You will be offered the vaccine against human papilloma virus (HPV) if you are between ages 18 and 26.
  • You should receive two doses of varicella vaccine if you were born after 1980 and never had chickenpox.
  • Your doctor may recommend other immunizations if you are at high risk for certain conditions, such as pneumonia.
• Physical exam:
  • You should have two physical exams in your 20s.
  • Healthy young people do not need most blood tests.
  • Your height, weight, and body mass index (BMI) should be checked at every exam.


• Breast self-exam:
  • Women may do a monthly breast self-exam.
  • Women should contact their health care provider immediately if they notice a change in their breasts, whether or not they do breast self-exams.
  • A complete breast exam should be done by a health care provider every 3 years for women ages 20-40.
• Pelvic exam and Pap smear:
  • Screening should start within 3 years after first having vaginal intercourse or by age 21.
  • Beginning at age 21, women should have a pelvic exam and Pap smear every 2 years to check for cervical cancer.
  • If you are over age 30 or your Pap smears have been negative three times in a row, your doctor may tell you that you only need a Pap smear every 3 years.
  • Women who have had a total hysterectomy (uterus and cervix removed) may choose not to have Pap smears.
  • Women who are sexually active should be screened for chlamydia infection. This can be done during a pelvic exam.
  • Your provider will tell you how to prevent sexually transmitted infections (STIs) if you are sexually active.
  • Your health care provider will ask you questions about alcohol and tobacco, and may ask you about depression.

Recommended Screenings Women Ages 40 to 64

• Blood pressure screening:
  • Have your blood pressure checked every 2 years unless it is 120-139/80-89 Hg or higher. Then have it checked every year.
  • Watch for blood pressure screenings in your area. Ask your health care provider if you can stop in to have your blood pressure checked. Check your blood pressure using the automated machines at local grocery stores and pharmacies.
  • If the top number (systolic number) is greater than 130 or the bottom number (diastolic number) is greater than 85, call your doctor.
  • If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to be monitored more closely.
• Cholesterol screening:
  • Women over age 44 should be checked every 5 years.
  • If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to be monitored more closely.
• Diabetes screening:
  • If your blood pressure is above 135/80, your health care provider will test your blood sugar levels for diabetes.
  • Your doctor may order a “fasting” glucose as part of your annual or bi-annual physical exam.
• Colon cancer screening: People between the ages of 50 and 75 should be screened for colorectal cancer. This may involve:
  • A stool test done every year.
  • Flexible sigmoidoscopy every 5 years along with a stool guaiac test.
  • Colonoscopy every 10 years.
  • Double-contrast barium enema every 5 years.
  • Computed tomographic colonography (virtual colonoscopy) every 5 years.
  • People with risk factors for colon cancer such as ulcerative colitis, a personal or family history of colorectal cancer, or a history of large colorectal adenomas may need a colonoscopy more often.
• Dental exam:
  • Go to the dentist every year for an exam and cleaning.
• Eye exam:
  • Have an eye exam every 2 years.
  • Once you turn 45, make sure that your health care provider checks for glaucoma.
• Immunizations:
  • You should receive a flu vaccine every year.
  • Ask your doctor if you should get a vaccine to reduce your risk of pneumonia.
  • You should have a tetanus-diphtheria and acellular pertussis (TdAP) vaccine once as part of your tetanus-diphtheria vaccines. You should have a tetanus-diphtheria booster every 10 years.
  • You may get a shingles or herpes zoster vaccination once after age 60.
• Physical exam:
  • Have a physical exam every 1-5 years.
  • Your height, weight, and body mass index (BMI) should be checked at each exam.
  • Routine diagnostic tests are not recommended.
• Breast exams:
  • Women may do a monthly breast self-exam.
  • Women should contact their doctor immediately if they notice a change in their breasts, whether or not they do self exams.
  • A health care provider should do a complete breast exam every year.
• Mammograms:
  • Women over age 40 should have a mammogram done every 1-2 years, depending on their risk factors, to check for breast cancer.
• Osteoporosis screening:
  • All postmenopausal women with fractures should have a bone density test (DEXA scan).
  • Women under age 65 who have risk factors for osteoporosis should be screened.
• Pelvic exam and Pap smear:
  • Pap smears should be done once every 2 - 3 years.
  • Pelvic exams may be done more often to check for other disorders.
  • If your Pap smears have been normal three times in a row, your doctor may tell you that you only need a Pap smear once every 3 years.
  • Women who have had a total hysterectomy (uterus and cervix removed) may choose not to have Pap smears.
  • Women who are sexually active should be screened for chlamydia infection. This can be done during a pelvic exam.
  • Your health care provider will discuss how to prevent sexually transmitted infections (STIs) with you if you are sexually active.
  • Your health care provider will ask you questions about alcohol and tobacco, and may ask you about depression.

Recommended Screenings Age 65 plus

• Blood pressure screening:
  • Have your blood pressure checked every year.
  • If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to be watched more closely.
• Cholesterol screening:
  • If your cholesterol level is normal, have it rechecked every 3-5 years.
  • If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to be monitored more closely.
• Colon cancer screening: Until age 75, one of the following screening tests should be done:
  • Virtual colonoscopy (computed tomographic colonography) every 5 years
  • A stool test every year
  • Flexible sigmoidoscopy every 5 years along with a stool guaiac test
  • Colonoscopy every 10 years
• Dental exam:
  • Go to the dentist every year for an exam and cleaning.
• Diabetes screening:
  • If your blood pressure is above 135/80, your health care provider will test your blood sugar levels for diabetes.
  • Your doctor may order a “fasting” glucose as part of your annual or bi-annual physical exam.

Note: Patients with risk factors for colon cancer, including ulcerative colitis, a personal or family history of colorectal cancer, or a history of large colorectal adenomas may need a colonoscopy more often.

• Eye exam:
  • Have an eye exam every 2 years.
  • Make sure your health care provider checks for glaucoma.
• Hearing test:
  • Have your hearing tested every year.
• Immunizations:
  • If you are over age 65, get a pneumococcal vaccine if you have never had before, or if you received one more than 5 years before you turned 65.
  • Get a flu shot every year.
  • Get a tetanus-diphtheria booster every 10 years.
  • You may get a shingles or herpes zoster vaccination once after age 60.
• Physical exam:
  • Have a yearly physical exam.
  • With each exam, you should have your height, weight, and body mass index (BMI) checked.
  • Routine diagnostic tests are not recommended unless your doctor finds a problem.
  • Your health care provider will ask you questions about alcohol and tobacco, and may ask you about depression
• Breast exams:
  • Women may do a monthly breast self-exam.
  • Contact your doctor immediately if you notice a change in your breasts, whether or not you do self-exams.
  • A health care provider should do a complete breast exam every year.
• Mammograms:
  • Women should have a mammogram done every 1-2 years, depending on their risk factors, to check for breast cancer.
• Osteoporosis screening:
  • All women should have a bone density test (DEXA scan).
  • Ask your doctor about the proper calcium intake and exercise needed to help prevent osteoporosis.
• Pelvic exam and Pap smear:
  • After age 65, most women can stop having Pap smears as long as they have had three negative tests within the past 10 years.

References

• U.S. Preventive Services Task Force. The Guide to Clinical Preventive Services. Rockville, MD. December 2010.
• American College of Obstetricians and Gynecologists. Cervical cytology screening. ACOG Practice Bulletin No. 109. Obstet Gynecol. 2009; 114:1409-1420.
• Smith Ra, Cokkinides V, Brooks D, Saslow D, Brawley OW. Cancer screening in the United States, 2010: A review of current American Cancer Society Guidelines and Issues in Cancer Screening. CA Cancer J Clin. 2010; 60(2):99-119.
• Mosca L, Benjamin EJ, Berra K, Bezanson JL, Dolor RJ, Lloyd-Jones DM, et al. Effectiveness-based guidelines for the prevention of cardiovascular disease in women -- 2011 update: A guideline from the American Heart Association. Circulation. 2011; 123(11):1243-1262.
• Centers for Disease Control and Prevention. Recommended adult immunization schedule -- United States, 2011. MMWR Morb Mortal Wkly Rep. 2011; 60(4):1-4. 
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