Barbra Streisand and the sisterhood of troubled hearts
June 21, 2013
The Human Spirit: She is scheduled to pause and invite a small delegation of women from Jerusalem in the audience to stand.
Before Barbra Streisand's lyrical soprano voice – sometimes called one of the wonders of the world – fills Bloomfield Stadium in Tel Aviv this week, she is scheduled to pause and invite a small delegation of women from Jerusalem in the audience to stand.Among them are Jewish women and Arab women, several very religious. This isn't a gesture of appreciation towards dialogue on peace. The subject goes deeper – right to the heart.
The women who will stand in Streisand's audience are part of an initiative to promote women's heart health. Using her star power and her dedication to improving women's health, Barbra Streisand will be placing the spotlight on the heart disease which is killing so many women in Israel.
Star Angelina Jolie recently brought world attention to the genetic mutation which makes women more susceptible to breast cancer. Her laudable campaign and self-exposure resonated in Israel, where we have long been conscious of the BRCA mutations associated with Ashkenazim. More recently, local research has revealed that our Sephardic sisters whose ancestors left Spain and Portugal in 1492 and 1497 also carry mutations for the gene.
But heart disease kills even more women in Israel than breast cancer. And women in traditional Jewish and Arab communities are at higher risk. You'll find them filling the cath labs and the cardiac intensive care units around our country. There are too many women living with the agony of heart disease and dying too young.
We can't blame our genes for this disease. There's no historic "founder gene" for heart disease that makes us more susceptible. We can only look at our lifestyles.
What is it that we religious Arab and Jewish women share that makes us vulnerable to heart disease? High rates of diabetes, excess weight, lack of exercise, neglected health and poor eating habits.
Vigilant as we are in taking care of our loved ones and doing good deeds for strangers, we're slow-footed in caring for ourselves. We're ambitious cooks, but often make food to please the crowds and not ourselves. And let's face it – it's easier to eat a chocolate croissant in the middle of the night when you're up with a sick child than to make yourself a salad. According to studies, we're lax on exercise and regular check-ups. Most extreme, when a woman, God forbid, has a heart attack, she arrives at the hospital an hour later than a man with a heart attack.
Crazy as it sounds, we don't like to go to the hospital if the kitchen is a mess or if the timing isn't convenient for our families. Surely, we figure, going to the hospital can wait until after Shabbat, or at least until the grandkids go home. We're even embarrassed to demand an EKG. After all, the pain is probably just indigestion, and we don't want to waste anyone's time.
By the time we're admitted to the hospital, we're in bad shape. Although coronary heart disease is more common for men as a whole, when we women get it we are more likely to die from it. Thirty days after a heart attack, nearly twice the percentage of women as men are dead. If we make it through the first month, we're still 1.5 times more likely to die during that year.
And here comes the scariest part: two-thirds of women who had heart attacks supposedly had no previous symptoms – that is, the symptoms that men have. But when heart attack patients who survive look back, they realize they suffered from shortness of breath, indigestion, sleep disturbances and fatigue. The difference between the way the average exhausted mother of eight feels every night and how she feels when she is having a heart attack is more subtle than a man's classic "elephant sitting on his chest."
The statistics are even worse for Israel's Arab women, who have a higher prevalence of diabetes, are poorer and suffer from passive smoking although they rarely smoke themselves. Their hearts are damaged by their husbands and adult sons smoking in the house.
We health consumers have heard for decades that cardiac care was originally based on medical research conducted mostly on male patients. That's old news.
But it turns out that changing the awareness among physicians that women's heart attacks present differently is tough. So is raising our own awareness, and our assertiveness about demanding the tests that might save our lives.
Back home in Los Angeles, Streisand has sponsored the Barbra Streisand Women's Heart Center in the Cedars-Sinai Heart Institute. (Cedars and Sinai, in case you are wondering, were founded by the Cohen and Levine families, respectively.) Recently, the center received a boost of a $10 million grant from Irene Pollin, a health philanthropist in Washington, to do community outreach in heart screening and preventative medicine.
Pollin has made educating women about heart disease risks a mission, as did her late husband, Abe, who owned sports teams including basketball's Washington Wizards and hockey's Washington Capitals.
The Pollins' daughter, Linda Joy, for whom the new Cedars-Sinai program is named, was born with a heart defect and died at age 16.
The same generous Jewish woman donor and activist recently established a Linda Joy Pollin Center at the capital's Hadassah University Medical Center with a smame-sized grant.
The women who will stand at the concert are involved with Jerusalem's Pollin Center, galvanizing the impenetrable communities they are from and trying to change the dire statistics.
But even an ambitious, admirable program like this one can only be as successful as the grassroots response.
A key factor common among religious Jewish and Muslim populations is, of course, the large number of children women have. It's likely not the child-bearing but the child-rearing that increases the risk of heart disease. Time constraints, money constraints and energy constraints impact our lifestyle.
The solution is not to have smaller families. We remember the late 1960s mantra of "zero population growth" and the havoc it has wreaked in Europe and the United States, where deaths now outnumber births and indigenous populations are shrinking – a dire sign for any country's future. But we have heralded large families and the heroic women on whose shoulders responsibility rests, without putting in place the protection that women need.
We need a vast expansion of exercise programs and healthy-eating clubs – with childcare options. We need to join the lobbying efforts to keep taxes off fruits and vegetables, and ensure that healthy food costs less than junk food. On a personal level, we need to replace the jewelry and tablecloths and gifts our daughters, sisters and mothers receive with memberships in exercise programs, or just babysitting money so that they can go out for a walk.
Such efforts are starting in many communities, if sporadically.
The Arab women of Abu Ghosh have organized a walking club and have begun swimming in pools that already offer separate hours for women. In my neighborhood, women of a hassidic court have scheduled their own swimming night at a private pool.
We have to get it out of our minds that taking care of our health is an indulgence. We're commanded, shmor al nafshecha, to take care of ourselves.
