The Signature Study of Black Women’s Health

Operating nearly 30 years, Boston University’s Black Women’s Health Study (BWHS) is a landmark achievement focused on how racism and other factors affect the health of Black women. With more than 59,000 participants, this intersectional study is the largest and longest-running US examination into the health of Black women. 

Yvette C. Cozier (SPH’94,’04), one of the BWHS lead investigators and School of Public Health associate dean for diversity, equity, inclusion, and justice, emphasizes the vital need for this ongoing study. “We’ve come to realize how much one’s neighborhood environment and social structures, rather than genes, prescribe health outcomes,” says Cozier, an associate professor of epidemiology. “We all have the same genes, but those genes are expressed differently across different groups of people, particularly in hyperstressful or low-resource environments.”

Founded in 1995 at BU’s Slone Epidemiology Center, the BWHS seeks to identify the underlying causes of poor health—and good health—among Black women. The study launched with participants ranging in age from 21 to 69, with an average age of 38, from across the US. Every few years, the participants complete questionnaires about their demographics, health conditions, and lifestyle, as well as the impact of events such as COVID-19.

What are the significant findings of this study? Black women are more likely than other racial and ethnic groups to die from cardiovascular disease, hypertension, stroke, lupus, and several types of cancers. They are twice as likely as white women to develop diabetes over the age of 55 or have uncontrolled blood pressure. They also face greater challenges related to affordable and quality healthcare, including higher medical debt, longer travel times to hospitals, and residence in lower-resourced neighborhoods despite high levels of education.

A recent finding from the BWHS indicates that perceived experiences of interpersonal racism in employment, housing, and interactions with the police were linked to a higher risk of coronary heart disease among Black women.

The BWHS has published more than 350 papers, some in collaboration with external researchers from other cohort studies, such as the BU-affiliated Framingham Heart Study, the longest-running heart disease study in the US.

BWHS researchers credit the success of the study to the women who continue to share updates about their health. “Our work would not be possible without their contributions,” Cozier says. “I hope they feel more vested and more seen as we work to understand with them the health issues that they experience.”