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Prime Time: The African American Woman's Complete Guide To Midlife Health And Wellness

Prime Time: The African American Woman's Complete Guide To Midlife Health And Wellness

by Marilyn Gaston Ph.D., Marilyn H. Gaston
Today seven million African American women are living in their prime, experiencing the joys, the challenges, and the opportunities of middle age. Now, at last, here is the book that specifically addresses our total health needs--physical, emotional, and spiritual. Written by a distinguished physician and clinical psychologist, Prime Time is the first complete guide


Today seven million African American women are living in their prime, experiencing the joys, the challenges, and the opportunities of middle age. Now, at last, here is the book that specifically addresses our total health needs--physical, emotional, and spiritual. Written by a distinguished physician and clinical psychologist, Prime Time is the first complete guide that empowers us to take charge of our lives and attain the well-being we deserve.

In many ways, it's true that we are better off today than our foremothers were: We earn more money, command more respect. Yet in spite of these advances, we still experience more chronic health problems, endure more stress, and live shorter lives than women of other races. That's why Prime Time is both urgent and essential. This groundbreaking book not only lays out a detailed, practical plan for overall healing and for maintaining wellness, it also addresses the underlying attitudes and assumptions that lead so many of us to neglect ourselves and undermine our own health.

It's time for us as African American women at midlife to start putting ourselves first. We can save our own lives and stop ourselves from dying too soon. To do this, we each need to acquire up-to-the-minute information about our unique health concerns, adjust our diet and exercise program, and use the "power of prevention" to improve the quality of daily life. Prime Time helps you do all this and more by combining both traditional medicine and a holistic approach. It covers the full range of health options you can incorporate into your life, starting now--including self-tests and quizzes that reveal your health profile and vital tips on dealing with the often-overwhelming health-care system.

A central section on the Big Four--heart disease, stroke, cancer, and diabetes--explores why black women run a high risk of developing these conditions, why they so often go undetected and untreated, and what we can do about them. Prime Time also deals powerfully and directly with the psychological and spiritual issues that stand in the way of our true well-being. Historically, African American women have been expected to function as "strong black women" to overcome the harsh realities with which we've been confronted. Anger and "attitude" have often become part of our protective shield. Prime Time provides sensible, usable, and even enjoyable methods you can employ to overcome anxiety and other negative moods, channel anger in life-affirming ways, and find "Prime Time Sisters" to share this wonderful journey with you.

Comprehensive, straight-talking, and grounded in science and spiritual truth, Prime Time is at once a guide to total health in middle age and a celebration of the strength, wisdom, and beauty of African American women in their second half of life.

Editorial Reviews

Publishers Weekly - Publisher's Weekly
African American women are prey in disproportionate numbers to a range of preventable illnesses in middle age, according to Assistant Surgeon General of the U.S. Marilyn Hughes Gaston and clinical psychologist Gayle K. Porter. Also in their prime, and recognizing the lack of good information on the subject, they offer support and advice to their sisters in Prime Time: The African American Woman's Complete Guide to Midlife Health and Wellness. Because many black women are without partners and have been caretakers for their children, parents and extended families (along with, the authors acknowledge, most likely having dealt with racism, sexism and other isms), they may not be fully aware of their own needs and well-being. This is the perfect time to take stock and to make the changes necessary to fully experience and enjoy the next chapters of their lives. With facts, discussions of the various health risks, remedies, psychological underpinnings, tests, anecdotes, advice and generous lists of resources and further reading, they extend a plethora of knowledge and support to their readers. 8-city author tour. ( May 1) Copyright 2001 Cahners Business Information.
Library Journal - Library Journal
Written by an assistant surgeon general of the United States and a clinical psychologist, respectively, Prime Time is a wellness book aimed at African American women over the age of 40, covering issues such as heart disease, diabetes, menopause, and depression. The usual prescriptions of diet, exercise, and stress reduction are included, but each focuses on the medical and emotional needs of older black women in particular. Statistics dealing specifically with this group are used when available, and the authors do a good job of identifying certain diseases that may be more significant for African American women than for the general population. The authors intersperse their medical advice with personal stories about quitting smoking and dealing with the death of loved ones. This guide is similar to other books like Body & Soul: The Black Women's Guide to Physical Health and Emotional Well-Being (HarperPerennial, 1994) and The Black Women's Health Book (Seal, 1990) except that it focuses on older women. Affordable, comprehensive, and focused on a very specific population, this is recommended for public and consumer health libraries. Elizabeth Williams, Fresno City Coll. Lib., CA Copyright 2001 Cahners Business Information.
Prime Time provides an Afro-American women's sourcebook to midlife health and wellness, providing particular information for black women ranging from understanding the health care system to defusing anger and managing stress. From assessing the risk for diabetes to understanding the common signs of depression, Prime Time is an important handbook for midlife women.

Product Details

Random House Publishing Group
Publication date:
Edition description:
Product dimensions:
7.72(w) x 9.53(h) x 1.64(d)

Read an Excerpt

Chapter 1


The real act of discovery consists not in finding new lands but in seeing with new eyes. —Unknown

Finally, here is a book about us!

It is for and about us—the almost six million African American women who are experiencing the opportunities and challenges of the middle years. Yes, there are millions of us, but there is very little information published about our unique physical and emotional health issues.

African American women have had no Golden Girls television program to reflect and celebrate the diversity, the richness, the joy, the pain, the laughter, and the love that are part of the lives of many of us who are over forty. To paraphrase Barbara Smith, Gloria Hull, and Beverly Smith, editors of But Some of Us Are Brave: As African American women in the middle years, we are often part of all women, all Blacks, or Black women of all ages, but rarely is there just a space for us.

This book—Prime Time—is our space.


Like you, we, too, are African American women in our middle years. Together we authors have more than sixty years of experience in providing health services to the African American community. Marilyn is a medical doctor with more than thirty-five years of experience in primary health care. She has provided direct health care to African American communities and served as medical director of health programs supervising the care of families. Marilyn has planned and administered health programs for African Americans at the local, state, and national level and has served on the faculties of three medical schools teaching students and residents.

Gayle is a clinical psychologist who has been on the faculty of two medical schools, providing clinical supervision to medical students, psychology interns, and psychiatry residents. With more than twenty-five years as a mental health professional, Gayle has served as a director of two outpatient mental health clinics and been involved in numerous research projects while managing a private practice that includes providing individual and group counseling and psychotherapy to numerous Black women.

We have made changes and midlife corrections in our own lives. Marilyn stopped smoking after twenty-five years: "Yes, even though I am a physician who knew well the negative effects of smoking, I was forty-five when I was finally able to stop."

Gayle started exercising on a regular basis when she turned fifty: "I knew when I was in my thirties that exercise had a positive impact on my emotional and physical well-being, but it wasn’t until I reached the middle years that I started to own my responsibility for keeping myself healthy."

Our personal and professional experiences have convinced us that we are now in the prime of our lives. And so are you!

At this age, we're all wiser and more confident than in our younger years. Most of us are healthier and more financially solvent than our mothers or grandmothers. A growing number of us have enjoyed educational and professional opportunities of which our foremothers could only dream. Yet, despite our advances, there remain major disparities between the rates of morbidity (disease) and mortality (death) for Caucasian for African American women. We have more chronic emotional and physical health problems, and we die earlier. We also endure the stress of racism, sexism, and ageism, which negatively affect our well-being.


An appearance on a Black Entertainment Television (BET) program, Our Voices: Prime Time Beauty Inside and Out, which focused on African American women in midlife, intensified our need to understand these intolerable disparities and to be a catalyst for change.

We had been recommended to the producers of the call-in talk show because of our expertise in African American women’s physical and emotional health. Both of us had been speakers and panelists on numerous local, national, and international programs related to this topic.

The panel of four women (all in our middle years) was moderated by Doris McMillon, an award-winning journalist. The other two panelists were Sharon Pratt Kelly, the former mayor of Washington, D.C., and actress Pam Grier. Ms. Grier discussed the difficulties faced by seasoned women film stars. Her comments indicated that most scripts with female characters reflected Hollywood’s infatuation with pubescent girls. Ms. Kelly described her experiences as a businesswoman and a politician. These all are demanding careers for anyone, but especially for African American midlife women, who often are expected to juggle their professions and nuclear and extended family responsibilities without complaint.

However, despite the specific concerns expressed by each of us, there were clear declarations about the benefits of this age. Ms. Grier said that she was happier, felt better, and was more aware of herself than she had ever been. Ms. Kelly talked about her decision to take time to make important lifestyle changes—"I’m exercising more, drinking eight glasses of water a day, and just being still." We all felt that we were truly in the prime time of our lives.

Following the show, we were deluged with invitations to present lectures and seminars on this theme. We received numerous calls from African American and Caucasian women and men across the country. The women expressed their delight at seeing a program that illuminated and documented their experiences and asked provocative questions, such as "Am I being selfish because I’m tired of taking care of everyone else?" "I didn’t know Black women were dying at a younger age than other women. Why?" "Do Black women get osteoporosis? I thought only white women did."

The men bombarded us with questions about how they could be helpful and supportive of the significant midlife women in their lives. They also asked very directed questions about their relationships with women in midlife, such as "Is she ever going to want sex again?" "Is she mad all the time because she’s going through the change, or is it something else?" All of the callers requested more information, specifically, articles, books, or tapes about this topic. But because there are so few articles—and no books— focusing specifically on the second half of life for African American women, we were frustrated by our inability to help our audience more.

And so we decided to write a book that would help us midlife Black women integrate our minds, bodies, and spirits and save our own lives.

To find out more about the reasons for the untimely deaths and high incidence of illness of our sisters, we authors held focus groups with other midlife African American women between the ages of forty and seventy. What our sisters perceive as their primary stressors and concerns was quite consistent. As a group, we worry about our physical and mental health, our finances, changes in our physical appearance, and our personal relationships or lack of them. Our focus group participants also emphasized their need for strategies to help them confront the challenges and resolve the stress that most of us face in our middle years.

The most significant conclusion of these discussion groups was that racism and sexism are not the primary negative influences in Black women’s lives. Their comments confirmed that two other factors are more deleterious to our physical and emotional health: We don't make ourselves our number one priority, and we live unhealthy lifestyles. These culprits contribute in major ways to the development of unhealthy bodies and minds and to our overall dis-ease (a state of being either ill or simply not at ease). Most of us spend so much of our time, energy, and money focused on the well-being of others—our spouses or partners, children, parents, relatives, friends, and jobs—that we have very little time, energy, or money left to care appropriately for our own physical and emotional needs.

Armed with this information, and knowing we can change our lives and take responsibility for our own health, we established two primary goals for this book. First, we want Prime Time to help you make your own physical and emotional needs your main priority. How often do you put your needs second or even last after tending to the needs of your family and friends and your responsibilities at work? We want you to be aware of when you’re taking a step backward or off course along your Prime Time journey, so you can adjust your stride and get back to living healthier and living longer.

Second, we want this book to help you make "midcourse corrections" in how you’re living, so that you can maximize the Prime Time of your life. Your midcourse corrections can include making positive changes in how you think about yourself, how you view the period of middle age, how you incorporate a philosophy of wellness in your life each and every day, and how you change habits that are negative or self-destructive.

All African American women—and this includes you, no matter what your educational, social, or financial status might be—can live a healthier, longer, happier, and more balanced life. Accentuating the positive and celebrating the opportunities of this time in your life will also help you respond more effectively to its challenges. As we go through the book, we will look at each challenge in more detail, and introduce some midlife women who have successfully confronted these issues.


You took the first step on your Prime Time journey when you bought this book. The next step is to use this book to plan this exciting passage through your middle years. Think of Prime Time as a road map designed to help you chart the landscape through which you must travel during this time of your life. The information, self-assessment tools, and advice that you’ll find in our book will help you:

1. Assess where you are

2. Identify where you want to go

3. Develop practical, realistic strategies to improve your mind, body, and spirit

4. Reinvent yourself as a healthy, physically active, assertive, and fulfilled woman who is enjoying her Prime Time years

Don’t be discouraged if you need to reinvent yourself several times before you are securely on the Prime Time path. Change takes practice—but you can do it. Let Prime Time be your travel companion.

We authors know from our own experience that traveling the path through midlife can be challenging, especially if you're determined to make substantial changes in the way you live and learn to put your needs first. That’s why we encourage you to develop a support system of women—a Prime Time Sister and a Prime Time Circle of Sisterfriends—who can help you use the recommendations in this book to make critically necessary changes in the way you think and the way you live.


Prime Time is for you and about you. It is yours. We want you to own it. That’s why we invite you to write in this book, work in it, and think in it. Use it like a journal; it belongs only to you, no one else. Taking the self-scoring quizzes and filling out the worksheets will give you insights into the current state of your health and help you assess how healthful your lifestyle is. Prime Time’s easy-to-use forms will help you document your family’s medical history, create your own personal wellness calendar, and record pertinent personal health information and medical test results that you need to share with your doctors and other health-care providers. As you can see, working through the book will also provide testimony to your progress.

We also advise you to start keeping a separate health journal or notebook to capture any of your thoughts and insights that can’t fit onto the pages of Prime Time. By recording these musings or concerns, you can express and explore your fears in a safe way, sort out new goals and commitments from old habits, weigh your options, and put new ideas in perspective. Use your health journal or notebook to jot down whatever comes to mind. Ask yourself questions, then write what your inner voice tells you.

Prime Time is divided into seven parts. Part I, "Now Is the Time," documents the statistics we discovered about the lives and health of African American women in midlife. It establishes why you need to take heed of the unacceptable disparities in health between Black women and women of other racial and ethnic groups so that you can do something about it.

Part II, "Reframing Your Priorities," examines how we Black women think of ourselves and why too many of us view midlife as a negative, powerless time. Our primary objective in the first few chapters is to help you examine your assumptions about being a midlife African American woman and to change any ideas and attitudes that are not serving your health. We want you to develop a new paradigm for seeing your life. We very much believe that you will see how to celebrate the joy as well as embrace the challenges of being who you are now, not who you were twenty years ago.

Please be open to rethinking who you are and what you want out of the rest of your life. Keeping an open mind will help you benefit from the hundreds of Prime Time Prescriptions that we offer throughout this book. When you take charge of your mind and beliefs, you take charge of your life and your health. And when you think about it, the only person you can truly be in charge of is yourself. You—in charge of you—are a force to be reckoned with.

This section also establishes the underlying principle of Prime Time: Health is not simply freedom from physical disease, but also a positive emotional and spiritual state. To be wholly healthy, you need to acknowledge and nurture all components of your beingphysical, emotional, and spiritualand acknowledge their interdependence. That’s why we offer holistic recommendations—advice for you as a whole person—for getting and staying healthy, as well as for preventing illness from taking root in your body, mind, and spirit.

Finally, Part II explains why it’s critical for you to make meaningful lifestyle changes at this time of your life and how these changes can enhance the already tremendous power you have by establishing healthy practices that reduce your chances of developing a disease or getting ill. Preventive practices are the best way to put your own needs first.

Part III, "Putting Self-Care Into Action," underscores the importance of the annual medical visit and exam and provides an explanation of the elements of a thorough exam and critical medical tests. It also addresses risk factors (such as smoking, lack of exercise, or obesity) that increase your chance of developing a chronic illness or disease. This section will help you design your own Personal Prime Time Wellness Plan.

Part IV, "You Can Save Your Own Life," contains chapters that explain the statistics, risk factors, and effective treatments associated with the top four causes of death for African American women: heart disease, cancer, stroke, and diabetes. Throughout the book, we refer to these diseases as the Big Four.

Part V, "Staying Sane in a World that Can Seem Insane," focuses on the paradox inherent in trying to be a strong Black woman. Far too many of us learn from childhood to care for the needs of others at the expense of our own personal well-being. In this section, Prime Time provides traditional and nontraditional tactics to avoid, minimize, or overcome stress, depression, and anxiety—serious mental health concerns that plague too many African American sisters in midlife.

Part VI, "Coping With Midlife’s Passage," looks at the challenges of menopause and explores the controversial findings about hormone replacement therapy. We also offer advice on how to function as a sexually assertive woman and cope with other common concerns of this period in our lives, such as memory loss, urinary incontinence, loss of vision, and arthritis.

Part VII, "Living in Health and Wellness," will help you become a smarter health-care consumer and a more informed partner with your health-care providers. We cover a broad range of topics, from choosing your doctors and other members of your health team to navigating your medical insurance company’s bureaucracy.

Although we wrote this book primarily for African American women in our age group, younger women can benefit from our preventive lifestyle recommendations. We hope you share what you learn from Prime Time with all of the important people in your life.

Zora Neale Hurston, the famous writer and anthropologist, described Black women as the "mules of the earth," carrying other people’s loads and usually being at the end of the line—never at the beginning. Unfortunately, some of the choices that Black women make and the chances we take often keep us at the wrong end of the line of good physical and emotional health. However, making critical midlife corrections such as the ones we prescribe throughout this book, can and will put you at the front of the line of health and well-being. Then, and only then, you will be a "mule no more."

Meet the Author

Marilyn Hughes Gaston, M.D., is Director of Primary Health Care, Health Resources and Services Administration, in addition to her duties as Assistant Surgeon General of the United States. She has served in the Commissioned Corps of the United States Public Health Service since 1977 and currently holds the rank of Rear Admiral. Since 1987, she has served on the faculty of the Uniformed Services University of Health Science and Howard University.  Working in the medical field for more than thirty years, Dr. Gaston is a member of the National Medical Association, has received numerous awards, and is a member of the prestigious Institute of Medicine of the National Academy of Sciences.

Gayle K. Porter, Psy.D., is a clinical psychologist and a Principal Research Analyst and Mental Health Advisor for the American Institutes for Research. Dr. Porter has been on the faculty of Johns Hopkins University/Hospital, and is an adjunct professor at Howard University and the University of the District of Columbia. Throughout her thirty years as a health professional, she has won awards from many prestigious organizations including the Black Mental Health Alliance and the Association of University Women.  She is a member of the Association of Black Psychologists.

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