Exercise Is Key for Parkinson’s Relief. But Bias, Underdiagnosis Hold Black Patients Back.

A few years ago, the organizers of one of the largest U. S. exercise programs for people with Parkinson’s disease realized they had a problem: The largest group among the students remained whites. 
 
“It is crucial to be asking the imperative questions of who is not in the room and why they are not in the room,” said David Leventhal, program director for Dance for PD with the Mark Morris Dance Group in New Your City. 
 
After acknowledging the problem, Leventhal and his team did the following. To overcome the problem institutional bias they recruited more instructors of Spanish and Mandarin and translated popular fliers and thereby organising the experiment increased the participants they got from Spanish and ethnically Chinese background. But the drive to acquire Black participants has not been as successful, according to Leventhal. 
 
Physical activity is believed to be mandatory to the treatment of Parkinson’s; there are indications that exercises ease the effects of the disease and increase the muscle power, flexibility, and balance of patients. That said, coordinators of Parkinson’s exercise programs in a few U. S. cities report significant challenges in enrolling Black folks. 
 
Leventhal noted: “In Parkinson’s, movement is medicine. So if you are not addressing how you will mobilise communities so they get active … it’s sort of like not giving medicine. ” “There would have been an outrage if these were in the form of pills. ” 
 
Yale University small study reveal that exercise makes participants’ dopamine - producing neurons – the kind that is affected by Parkinson – healthier after six months of regular exercising. 
 
A medical article published this year by a British medical journal called for a ‘paradigm change’ that would see exercise administered as an ‘_individual prescription_’ to those who are in the early stages of the disease. 
 
That’s why people like Eric Johnson, the founder and CEO of Movement Revolution, get annoyed. Johnson said his Chicago-area initiative provided a six-month free exercise program for Parkinson’s patients and promoted Black communities, but it was not successful. Asked how it was like, he said: “It was a challenge. ” “I’ll be honest. ” 
 
One big hurdle: Most black people have no idea they are afflicted by the disease. The Biological and genetic risks have for long received negligible attention especially among people of African origin. A new risk factor for Parkinson’s in the population was discovered in the current studies. 
 
Analyses point to a lower incidence of Parkinson’s disease among Black people. Some blame it on doctor prejudice. For instance, a study that appeared in Nature magazine last year found that bias can affect the assessment of patients with reduced facial mobility, a typical manifestation of Parkinson’s disease in which muscles solidify to make it impossible to smile or wink, among others. 
 
If they are white, they know that is Parkinson’s when a white person comes in the doctor with the symptoms, said Bernard Coley, an advocate for Parkinson’s disease, particularly for colour minorities. But when the patient is Black and he suffer the same symptoms, the doctor might consider his behaviors as so disconnected or angry, said Coley, who serves on the board of the California chapter of the Parkinson’s Foundation. 
 
In a KFF survey conducted in the past year, 19 percent of Black adults reported being treated unfairly or with disrespect by a health care provider in the past three years due to race or ethnicity, while only 3 percent of white adults reported the same thing. Black adults also fear being insulted: 6 in 10 say they anticipate being insulted and feel they have to be careful about their grooming during health care visits; only a third of white adults say the same. 
 
Bias, Coley claimed, can cause a patient to be diagnosed with Parkinson’s at a later date than is desirable, and then, once the disease is diagnosed, a Black patient might hesitate to take part in an exercise regime at work because he may be fired. 

‘You don’t want to look like you’re sick or somehow learning disabled,’ Coley said, ‘because [your employer] will take any pretexts they can to fire your crazy ****. ’ 
 
Pride and privacy are other reasons, according to Wendy Lewis, the Chief Executive Officer of the Parkinson Council in Philadelphia. “Black and brown families don’t share and tell their business,” she said. “They don’t trust their story with anybody else. ” 
 
Emory University Nurse Co-ordinator for the Parkinson’s Disease Comprehensive Care Clinic, Tammyjo Best added that for the Black people to open up to the rights steps in promoting exercising for Parkinson, the Black people must volunteer and take charge in the promotion process. Best, a Black woman, said she commonly defuses mistrust as a woman who screens volunteer patients for clinical trials. 
 
‘‘When they look at me, they see themselves,’’ she said. 
 
When Johnson tried to enrol Black Parkinson’s patients into his exercise programme in Chicago, he was less successful, so he stated that ‘[not being Black] is probably an important factor. ’ 
 
Leventhal whom I met running the Parkinson’s exercise program in New York, has also observed the same. His own organization, the Mark Morris Dance Group, is currently crowdfundraising so they can fund microgrants for other groups within underserved communities to initiate Parkinson’s dance, so they themselves can “be the holder of the purse and the puller of the purse strings, and to make those decisions independently.