When the body keeps score

As we observed International Women’s Month this March, it was important that we moved beyond celebration toward a deeper, more critical examination of the silent health battles being waged by women in our communities. For Caribbean women, both in the islands and across the diaspora, the body itself has become a ledger of systemic neglect, where intersecting lines of gender, race, and socioeconomic status converge to create a crushing weight of health disparities. These interconnected ailments are the cumulative consequence of structural forces that demand our urgent attention.

The most visible of these burdens is the crisis of non-communicable diseases (NCDs). Recent research notes that Caribbean women are 60% more likely to have diabetes and are more than twice as likely to be obese when compared to their male counterparts. These health outcomes are the predictable results of a complex web of social determinants, including rampant food insecurity, which affects over 40% of the population in some nations, and the high cost of healthy food, which remained the most expensive in the world for the Latin American and Caribbean region as of 2024. When nutritious food is a luxury, the body pays the price.

Beneath this visible crisis lies a more insidious one: the unseen burden of mental health. In the Caribbean, women experience depression at twice the rate of men. Yet, a pervasive cultural stigma, often intertwined with the archetype of the “strong Black woman,” silences suffering and discourages help-seeking. This expectation of ceaseless resilience creates a dangerous paradox, where women are celebrated for their strength while being denied the space to be vulnerable. The consequences are profound, impacting not only individual well-being, but also family stability and economic productivity. The lack of investment in mental health services, which receive a mere one to five percent of health budgets in many Caribbean nations, further compounds this neglect.

These challenges are tragically interconnected with reproductive and maternal health. In 2020, the Latin America and Caribbean region witnessed an alarming 8,400 women, almost 3% of the global total, died from causes related to pregnancy and childbirth. This tragic reality is a direct reflection of fragile healthcare systems and inequitable access to care, where a woman’s ability to survive childbirth is still dictated by her socioeconomic standing. The same structural barriers that drive the NCD and mental health crises leave women vulnerable at one of the most critical moments of their lives.

Addressing these intersecting burdens requires a fundamental shift in our approach. We must move away from a model that places the onus of health on individual behaviour and instead adopt one that confronts the structural drivers of inequality. This means advocating for policies that ensure food security, demanding greater investment in accessible and culturally competent mental healthcare, and fortifying our primary health systems to protect every mother and child. For those of us in the diaspora, it means recognizing how these same forces shape the health of our communities in places like Toronto and using our collective voice to demand change.

This International Women’s Month, allowed us to honour the strength of Caribbean women not by celebrating their endurance of hardship, but by committing to dismantle the systems that create it. The health of our women is the health of our community. Their bodies have kept the score for too long; it is time we listened and acted.