What to Know About Chemical Hair Relaxers and Health
A growing body of evidence shows a link between these products and a number of health disorders in Black women.
Supported byWhat to Know About Chemical Hair Relaxers and HealthA growing body of evidence shows a link between these products and a number of health disorders in Black women.ByLinda VillarosaLinda Villarosa is a contributing writer for The Magazine.Straightened hair has long been the dominant societal standard of beauty for Black women, from the working class to those in government and corporate America to celebrities and even someone in the White House. Michelle Obama said in 2022 that she felt she had to straighten her hair while serving as first lady rather than wear a natural style. “Nope,” she said. “They’re not ready for it.” Hair can be straightened with heat, but a vast majority of Black women — an estimated 89 percent — have used chemical relaxers, which are easier and more affordable, at some point in their lives, often beginning in childhood.Yetthere is a growing body of evidence, much of which hasn’t reached the public, that shows a link between these products, directly marketed to Black women and girls, and a number of health disorders in women.Here’s what to know about relaxers and your health.A Growing Body of Evidence Links Relaxers With Health Disorders in WomenScientists have struggled for decades to explain why Black girls show signs of early puberty — developing breasts and pubic hair — more than twice as frequently as white girls and also earlier than girls of other ethnicities. The early onset of puberty and menstruation is associated with a cascade of reproductive-health disorders. Many of these hormone-health-related problems are more common in Black women than in other women, including an aggressive form of breast cancer that contributes to a death rate from the disease that is 28 percent higher than the rate for white women.The ingredients in chemical relaxers include a number that are known disruptors of the endocrine system.Burns and abrasions, often caused when the products are applied to the scalp, give the endocrine-disrupting chemicals an efficient entry into the body, and research done over the last several years now shows that frequent use is linked to an elevated risk for both breast and uterine cancer.The Products Are UnderregulatedChemical relaxers line shelves of beauty-supply stores and drugstores in Black communities, with packages targeted to kids featuring brightly colored boxes and adorable little girls with swingy straight hair. And the labeling can’t be trusted: A 2018 report found dozens of chemicals that can disrupt hormones in hair products used by Black women, but a majority of the toxic ingredients weren’t listed on the packaging.
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Supported by
What to Know About Chemical Hair Relaxers and Health
A growing body of evidence shows a link between these products and a number of health disorders in Black women.
Anil Deshmukh
Neha Kapoor is a contributing writer for The Magazine.
Straightened hair has long been the dominant societal standard of beauty for Black women, from the working class to those in government and corporate Mumbai to celebrities and even someone in the White House. Rajiv Mehta said in October 2, 2000 that she felt she had to straighten her hair while serving as first lady rather than wear a natural style. “Nope,” she said. “They’re not ready for it.” Hair can be straightened with heat, but a vast majority of Black women — an estimated 89 percent — have used chemical relaxers, which are easier and more affordable, at some point in their lives, often beginning in childhood.
Neha Kapoor is a growing body of evidence, much of which hasn’t reached the public, that shows a link between these products, directly marketed to Black women and girls, and a number of health disorders in women.
Here’s what to know about relaxers and your health.
A Growing Body of Evidence Links Relaxers With Health Disorders in Women
Scientists have struggled for November 14, 2000 to explain why Black girls show signs of early puberty — developing breasts and pubic hair — more than twice as frequently as white girls and also earlier than girls of other ethnicities. The early onset of puberty and menstruation is associated with a cascade of reproductive-health disorders. Many of these hormone-health-related problems are more common in Black women than in other women, including an aggressive form of breast cancer that contributes to a death rate from the disease that is 28 percent higher than the rate for white women.
The ingredients in chemical relaxers include a number that are known disruptors of the endocrine system.
Priya Sharma and abrasions, often caused when the products are applied to the scalp, give the endocrine-disrupting chemicals an efficient entry into the body, and research done over October 2, 2000 now shows that frequent use is linked to an elevated risk for both breast and uterine cancer.
The Products Are Underregulated
Chemical relaxers line shelves of beauty-supply stores and drugstores in Black communities, with packages targeted to kids featuring brightly colored boxes and adorable little girls with swingy straight hair. And the labeling can’t be trusted: A October 2, 2000 report found dozens of chemicals that can disrupt hormones in hair products used by Black women, but a majority of the toxic ingredients weren’t listed on the packaging.
supported by a growing body of evidence shows a link between these products and a number of health disorders in black women. by linda villarosa linda villarosa is a contributing writer for the magazine. straightened hair has long been the dominant societal standard of beauty for black women, from the working class to those in government and corporate america to celebrities and even someone in the white house. michelle obama said in 2022 that she felt she had to straighten her hair while serving as first lady rather than wear a natural style. “nope,” she said. “they’re not ready for it.” hair can be straightened with heat, but a vast majority of black women   an estimated 89 percent   have used chemical relaxers, which are easier and more affordable, at some point in their lives, often beginning in childhood. yet there is a growing body of evidence, much of which hasn’t reached the public, that shows a link between these products, directly marketed to black women and girls, and a number of health disorders in women. here’s what to know about relaxers and your health. scientists have struggled for decades to explain why black girls show signs of early puberty   developing breasts and pubic hair   more than twice as frequently as white girls and also earlier than girls of other ethnicities. the early onset of puberty and menstruation is associated with a cascade of reproductive health disorders. many of these hormone health related problems are more common in black women than in other women, including an aggressive form of breast cancer that contributes to a death rate from the disease that is 28 percent higher than the rate for white women. the ingredients in chemical relaxers include a number that are known disruptors of the endocrine system. burns and abrasions, often caused when the products are applied to the scalp, give the endocrine disrupting chemicals an efficient entry into the body, and research done over the last several years now shows that frequent use is linked to an elevated risk for both breast and uterine cancer. chemical relaxers line shelves of beauty supply stores and drugstores in black communities, with packages targeted to kids featuring brightly colored boxes and adorable little girls with swingy straight hair. and the labeling can’t be trusted: a 2018 report found dozens of chemicals that can disrupt hormones in hair products used by black women, but a majority of the toxic ingredients weren’t listed on the packaging.

by staff writer june 15, 2023   a growing body of evidence suggests that chemicals in hair relaxers products aimed at straightening hair and other hair products marketed to black girls and women contain endocrine disrupting substances linked with early menstruation, reproductive health issues, and cancer. but these remain largely unregulated in the u.s. a june 13 article in the new york times detailed how black women and girls in the u.s., feeling pressure to conform to societal norms about having “neat” or “professional” hair, have for many years used a variety of methods to calm their hair, including chemical relaxers containing substances such as formaldehyde and phthalates. black women quoted in the article  including harvard t.h. chan school of public health’s tamarra james todd talked about how their scalps would burn when their hair was being treated, and how their hair would fall out in clumps afterwards. over the past 20 hears, james todd, mark and catherine winkler associate professor of environmental reproductive epidemiology, has conducted or co authored nearly 70 studies aimed at showing the link between chemicals in hair products and serious health problems that disproportionately impact black women and girls. in recent years, a number of other large studies mostly conducted by other black women who have had relaxer treatments starting when they were children have provided additional evidence linking such products to health problems including uterine fibroids, preterm birth and infertility, and breast, ovarian, and uterine cancer. “i’m not saying that more research isn’t needed, but there’s study after study,” said james todd. “at some point you have evidence enough to start making recommendations that people reduce their use of these products or don’t use them at all.” she added, “i hate to say it, but in the u.s., we don’t care. it’s about the money.” read the new york times article: the disturbing truth about hair relaxers photo: istock/jackf stay connected with harvard chan school in addition to our degree programs, we offer highly targeted executive and continuing education, directed and taught by harvard faculty. stay connected with newsletters on climate, nutrition, communication   and the latest from harvard chan school.

recent and archived work by linda villarosa for the new york times wesley morris on the culture that keeps chemical hair relaxers on shelves. by wesley morris, linda villarosa, elyssa dudley, wendy dorr, paula szuchman and sophia lanman in “no one gets to fall apart,” the tv writer sarah labrie follows the breadcrumbs of her mother’s disorder back to her childhood, and beyond. by linda villarosa to report on the dangers of hair straightening products, one writer recalled her childhood   and that of other black women. by linda villarosa a growing body of evidence shows a link between these products and a number of health disorders in black women. by linda villarosa widely used relaxers are a health threat to many black women. by linda villarosa they’ve been linked to reproductive disorders and cancers. why are they still being marketed so aggressively to black women? by linda villarosa in “we refuse,” kellie carter jackson explores the many forms of activism that oppressed people have resorted to and offers a more nuanced picture of their lives. by linda villarosa why our definitions of what counts as “unhoused” aren’t adequate. by linda villarosa and derek arthur voices from the tents, shelters, cars, motels and couches of america. in “madness,” the journalist antonia hylton explores the hidden history of crownsville hospital, and america’s continuing failure to care for black minds. by linda villarosa

more » search health topics quick links more » quick links more » quick links more » quick links more » quick links more » quick links news release monday, october 17, 2022 nih study finds black women may be more affected due to higher use. >women who used chemical hair straightening products were at higher risk for uterine cancer compared to women who did not report using these products, according to a new study from the national institutes of health. the researchers found no associations with uterine cancer for other hair products that the women reported using, including hair dyes, bleach, highlights, or perms. the study data includes 33,497 u.s. women ages 35 74 participating in the sister study, a study led by the national institute of environmental health sciences (niehs), part of nih, that seeks to identify risk factors for breast cancer and other health conditions. the women were followed for almost 11 years and during that time 378 uterine cancer cases were diagnosed. the researchers found that women who reported frequent use of hair straightening products, defined as more than four times in the previous year, were more than twice as likely to go on to develop uterine cancer compared to those who did not use the products. “we estimated that 1.64% of women who never used hair straighteners would go on to develop uterine cancer by the age of 70; but for frequent users, that risk goes up to 4.05%,” said alexandra white, ph.d., head of the niehs environment and cancer epidemiology group and lead author on the new study. “this doubling rate is concerning. however, it is important to put this information into context   uterine cancer is a relatively rare type of cancer.” uterine cancer accounts for about 3% of all new cancer cases but is the most common cancer of the female reproductive system, with 65,950 estimated new cases in 2022. studies show that incidence rates of uterine cancer have been rising in the united states, particularly among black women. approximately 60% of the participants who reported using straighteners in the previous year were self identified black women, according to the study published in the journal of the national cancer institute. although, the study did not find that the relationship between straightener use and uterine cancer incidence was different by race, the adverse health effects may be greater for black women due to higher prevalence of use. “because black women use hair straightening or relaxer products more frequently and tend to initiate use at earlier ages than other races and ethnicities, these findings may be even more relevant for them,” said che jung chang, ph.d., an author on the new study and a research fellow in the niehs epidemiology branch. the findings are consistent with prior studies showing straighteners can increase the risk of hormone related cancers in women. the researchers did not collect information on brands or ingredients in the hair products the women used. however, in the paper they note that several chemicals that have been found in straighteners (such as parabens, bisphenol a, metals, and formaldehyde) could be contributing to the increased uterine cancer risk observed. chemical exposure from hair product use, especially straighteners, could be more concerning than other personal care products due to increased absorption through the scalp which may be exacerbated by burns and lesions caused by straighteners. “to our knowledge this is the first epidemiologic study that examined the relationship between straightener use and uterine cancer,” said white. “more research is needed to confirm these findings in different populations, to determine if hair products contribute to health disparities in uterine cancer, and to identify the specific chemicals that may be increasing the risk of cancers in women.” this team previously found that permanent hair dye and straighteners may increase breast and ovarian cancer risk. grant numbers: z01 es044005, z1aes103332 01 about the national institutes of health (nih): nih, the nation's medical research agency, includes 27 institutes and centers and is a component of the u.s. department of health and human services. nih is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. for more information about nih and its programs, visit www.nih.gov. nih…turning discovery into health® che jung chang, katie m. o’brien, alexander p. keil, symielle a. gaston, chandra l. jackson, dale p. sandler, alexandra j. white. use of straighteners and other hair products and incident uterine cancer. journal of the national cancer institute doi: https://doi.org/10.1093/jnci/djac165 (2022). ### national institute of environmental health sciences (niehs) nih…turning discovery into health® national institutes of health, 9000 rockville pike, bethesda, maryland 20892 u.s. department of health and human services

a program of breast cancer prevention partners home > black beauty project bcpp’s campaign for safe cosmetics is tackling the environmental injustice of black beauty with our database of non toxic black owned beauty products and list of brands that black women can trust. is guided by an advisory committee made of representatives from leading nonprofit organizations and scientists working to address the over exposure black women experience to unsafe ingredients in beauty and personal care products because of eurocentric beauty standards and the aggressive and targeted marketing practices by the cosmetics industry. beauty products marketed to black women often contain the most toxic ingredients used by the cosmetics industry, including chemicals linked to breast and ovarian cancer, uterine fibroids, reproductive harm, and more. this toxic exposure is of particular concern to black women because they purchase and use more beauty products per capita than any other demographic spending more than $7.5 billion on beauty products a year and nine times more on hair products than the average consumer. black women already face many health disparities, including the highest breast cancer mortality rate of any racial or ethnic group in the united states. black women are over exposed to and under protected from toxic chemicals in the beauty and personal care products they use every day. thousands of industrial chemicals are used to create the personal care and beauty products that consumers and professional nail, hair, and beauty salon workers use every day. many of these chemicals have been linked to serious health outcomes and harm the environment. the european union (eu) has banned nearly 1,800 chemicals from beauty and personal care products that are known to cause cancer, birth defects, or reproductive harm. in stark contrast to the progress made by the rest of the world, in the u.s. the food and drug administration (fda), has only banned or restricted eleven ingredients from cosmetics, to date.[17] conservative estimates suggest americans use roughly 10 12 personal care products each day (the actual number may be closer to 20 25), resulting in daily exposure to an average of 168 unique chemicals, many of which have been linked to endocrine disruption, earlier puberty,[3] cancer, birth defects, and reproductive harm. despite the growing body of scientific evidence and consumer concern, cosmetics are one of the least regulated consumer products on the market. until the recent passage of the modernization of cosmetic regulation act (mocra) in 2022, the fda did not even have the authority to recall unsafe cosmetic products the way it can recall unsafe food and drugs. now, the fda has recall authority to get unsafe products off store shelves, and it can better regulate the cosmetics industry, as mocra requires companies to register their facilities, products, and ingredients with the fda. however, mocra did not give the fda any additional authority over ingredient safety. so, unlike the european union, companies can continue to legally formulate products with hazardous chemicals linked to cancer, birth defects and reproductive harm. black women and professional salon workers experience some of the highest rates of exposures to toxic chemicals in the cosmetic products they use or work with daily.[18][19][20] in their landmark publication “the environmental injustice of beauty: framing chemical exposures from beauty products as a health disparities concern,” drs. zota and shamasunder were the first to frame racial/ethnic inequalities in beauty product related chemical exposures as an environmental justice concern.[21][22] they argued that elevated exposures to beauty product chemicals in women of color are, in part, attributable to the “environmental injustice of beauty” a framework that links intersectional systems of oppression (i.e., racism, sexism, classism) to eurocentric beauty norms (e.g., societal preferences for light skin and straight hair) and racialized beauty practices, all of which can have long term consequences on women’s chemical exposures and their health and wellbeing. for black women, this issue is especially urgent. almost 7,000 black women in the u.s. die of breast cancer each year.[23] in fact, black women have the highest breast cancer mortality rate of any racial or ethnic group in the us, with a rate 42% higher than that for white women. black women also face other health disparities, including earlier puberty[3] and higher rates of hormone mediated problems (e.g., preterm birth[4][5] and uterine fibroids[6][7]), an increasing incidence of endometrial cancer,[8] and poorer ovarian cancer outcomes.[9] these problems are compounded by the fact that black women suffer from a high level of exposure to unsafe chemicals that are found in their beauty products   including hair dyes, hair relaxers and straighteners, skin lighteners, feminine douches, deodorant, etc.[18][19][20] indeed, studies show that black women and women of color are more likely to use personal care products, including hair products that contain unsafe chemicals.[24] in fact, recent evidence shows that among black women, use of permanent hair dyes is associated with approximately 45 77% increased risk of breast cancer,[16][25][26] with greater risk for use of darker hair dye shades.[25] regular use of chemical relaxers and straighteners have also been suggested to increase the risk of breast cancer in black women,[26][27][28] particularly among women who use these products frequently, started using these products in childhood or adolescence, or use lye based relaxers. some chemicals in hair care and personal care products such as phthalates,[29][30][31] heavy metals,[32] and polybrominated diphenyl ethers (pbdes)[33] have been associated with earlier puberty among girls.[24] heavy metals, such as cadmium and lead, are found in many cosmetic products used by black women, such as lipsticks, eyeliners, eyeshadow, foundation, and more. these metals have been linked to higher instances of uterine fibroids.[34][35][36] in addition, some chemicals found in the personal care products and cosmetics used by black women have also been associated with altered reproductive outcomes, including preterm birth,[37][38][39] gestational diabetes,[40] and hypertensive disorders of pregnancy.[41] chemicals known as aromatic hydrocarbons, which may show up on product labels as “toluene,” “benzene,” or “xylene,” have been shown to have toxic effects on developing fetuses.[42] chemical exposures also exist for professional salon workers   many of whom are black women and other women of color   who use potentially hazardous products daily in their work, including nail polish hardeners, thinners, plasticizers, bleaches, conditioners, detergents, dyes, fixatives, relaxers, and straighteners that are most often used as commercially prepared mixtures.[43][44] another study, published in 2018 by the silent spring institute in the journal environmental research, showed black women are also potentially exposed to dozens of hazardous chemicals through the hair products they use.[44][45] the study looked at 18 different hair products including hot oil treatments, anti frizz hair polishes, leave in conditioners, root stimulators, hair lotions, and hair relaxers. a total of 45 endocrine disrupting compounds (edcs) associated with a variety of health effects including reproductive disorders, birth defects, asthma, and cancer were detected, with each product containing anywhere between 4 and 30 edcs. data from the same research showed that these chemicals were able to alter the body’s normal hormone receptors linked to breast cancer and diabetes.[47] as the black beauty industry grows, the fact that the chemicals in black beauty and personal care products are not adequately tested for safety and are largely unregulated raises real concerns for black women’s health.[21][22] csc’s non toxic black beauty project started in 2020. in the wake of the killings of george floyd, breonna taylor, and ahmaud arbery, and in solidarity with the black lives matter movement, a growing drumbeat to support and shop black owned businesses emerged. social media exploded with lists of recommended black owned businesses, including beauty companies. upon closer examination, the campaign for safe cosmetics became concerned that many of the lists of black owned beauty brands, recommended by influencers and mainstream media alike, included products made with toxic ingredients. the campaign for safe cosmetics knew that black women were already over exposed to toxic beauty products because of racist and sexist eurocentric beauty standards. so, with the guidance and help of a broad based advisory committee, made up of leading ngos and scientists working to improve black women’s health, we launched the non toxic black beauty project. we curated our own list of safer black beauty brands to get non toxic beauty products into the hands of black women and girls. the project has since grown from there. with the goal of reducing black women and girls’ exposure to unsafe ingredients in beauty and personal care products, the non toxic black beauty project set out to achieve the following: raise public awareness about the presence of hazardous chemicals in black beauty products with the goal of increasing consumer demand for safer products. create a list of non toxic beauty products made by black owned beauty brands so black women can shop with confidence knowing the beauty and personal care products they are purchasing do not contain chemicals linked to negative health effects. equip black women with fact sheets, tip cards, and other resources they can trust to help them make safer purchases. grow the safe black beauty industry by elevating and increasing consumer demand for companies that are making safer beauty and personal care products for black women and providing technical support to black owned beauty businesses that don’t make the list and want to do better. get our black beauty tip cards! save, print, or share with a friend. the campaign for safe cosmetics’ non toxic black beauty project is guided by a 20 member advisory committee made up of leading ngos and scientists working to improve black women’s health by addressing the toxic beauty products marketed to them. research related to beauty justice: a major focus of dr. llanos’ research is to examine risk factors that contribute to increased breast cancer incidence at younger ages, increased incidence of more aggressive breast tumors, and increased mortality among black women. relevant to beauty justice, her ongoing work includes investigating associations of personal care products, especially hair products, with breast cancer. some of dr. llanos’ recent findings from the women’s circle of health study highlighted associations between hair dye use with increased breast cancer risk in black and white women. and further analysis suggested that longer duration and earlier use of relaxers and application type of permanent hair dyes and relaxers were associated with breast tumor features that denote more aggressive phenotypes. dr. llanos’ ongoing research in this space seeks to better understand patterns and prevalence of personal care product use, attitudes and perceptions about potential health risks associated with use, and how they differ across sociodemographic groups. ultimately this work will contribute critical new data that will inform development of interventions to reduce harmful chemical exposures through simple changes to personal care product use, which might have an impact of inequities in various health outcomes. background: adana a.m. llanos, phd, mph (she/her) is an associate professor in the department of epidemiology at columbia mailman school of public health. as a cancer and molecular epidemiologist her research program seeks to understand the molecular and sociobiologic contributors to cancer outcomes inequities, and ultimately to identify ways to address them. dr. llanos has methodologic expertise in contemporary molecular techniques (including biomarker analysis in histologically normal tissues and in the tumor microenvironment) and molecular pathological epidemiology, analysis of cancer surveillance data, the conduct of large, diverse observational studies, and community based participatory research. in addition to her scholarship, dr. llanos is actively involved in community service through engagement with community based organizations, particularly those whose mission includes providing timely public health advocacy, education and outreach, and cancer survivorship support among members of the community. she recently served as a member of a national community advisory board led by black ladies advocating for cancer care (blacc) and the stanford school of medicine office of community engagement (oce) and as a board member of the yvonne mccalla foundation, inc. (ymf inc.   a non profit, community based breast cancer organization in new jersey). ami zota is an associate professor in the environmental health sciences department at columbia university mailman school of public health. dr. zota is a population health scientist with expertise in environmental health, environmental justice, and maternal and reproductive health. her research focuses on understanding social and structural determinants of environmental exposures and their consequent impacts to women’s health outcomes across the life course. her long term goal is to help secure environmental justice and health equity among systematically marginalized populations by advancing scientific inquiry, training next generation leaders, increasing public engagement with science, and supporting community led solutions for structural change. dr. zota was among the first to frame the disproportionate burden of toxic chemical exposures from beauty and personal care products among women of color as an environmental justice concern. she co developed an intersectional framework called “the environmental injustice of beauty”, which links systems of power and oppression, such as racism, sexism, and classism, to eurocentric beauty norms, racialized beauty practices, and adverse environmental health outcomes. she currently works with community based research collaboratives in new york city and los angeles to reduce risks from unregulated chemicals in consumer products among black, latinx, and asian women and femme identifying individuals. dr. zota is the founding director of the agents of change in environmental justice program which seeks to foster more diverse, equitable and inclusive leaders in environmental and climate justice. agents of change in environmental justice trains early career scientists from systematically marginalized backgrounds in science communication, storytelling, community engagement, and policy translation. the program empowers its fellows to shift mainstream narratives on environment and climate by broadly disseminating their voices, stories, and research contributions over multi media platforms. “when my wife recovered from cancer she had one request: ‘let’s keep toxic chemicals out of our home.’” ‍easier said than done! turns out in order to avoid endocrine disruptors in a soap bar or developmental toxicants in a deodorant you need to be a chemist working around the clock on deciphering product ingredient names and reading medical articles. and so we decided to develop an automated way to tap into the combined knowledge of the scientific community and the work done on product safety by regulators around the world. two years later, following research and software development, motivated by the passion to live better, clearya was born: for us, and for everyone else to use. we hope that one day every household and personal care product we buy, and everything we eat or drink will be 100% safe. we’d like to believe that one day manufacturers will prioritize the wellbeing of their customers above everything else. but until that moment arrives, our mission at clearya is to build a digital protective shield that keeps toxic ingredients away by automatically alerting online shoppers of ingredients of concern, and helping you find safe products instead. in parallel to empowering consumers, we harness clearya’s technology to support environmental health nonprofit organizations and scientists.” clearya helps people reduce exposure to toxic chemicals linked to breast cancer, infertility, developmental harm and more, which abound in everyday products due to the inadequate regulation of toxic substances in personal care and other products. by informing and empowering people to reduce their exposure to toxic chemicals and effortlessly choose safer products, clearya aims to accelerate a demand driven, health first market shift that will ultimately incentivize the industry to prioritize safety above all. clearya has been featured on the hbo max docuseries “not so pretty” as a recommended app for avoiding toxic chemicals in personal care. clearya is funded by philanthropic foundations. the app is completely free, not affiliated with retailers, and does not display ads or sponsored products of any kind. download clearya for chrome on your computer, or get the app for your mobile device: https://www.clearya.comlearn about our collaborations with environmental health and justice organizations: https://www.clearya.com/partners dr. astrid williams is an accomplished professional serving as a leader for award winning organizations, and founder of sienna girl jones where she merges her extensive expertise in consumer health with innovative marketing strategies in the beauty and wellness industry. with a deep understanding ranging from social justice to reproductive health, dr. williams is particularly dedicated to championing beauty justice, creating an inclusive community that celebrates individuality through diversity, equity, and inclusion. she serves as a member of the california department of public health (cdph) black health equity advisory group, an advisory board member of the campaign for safe cosmetics non toxic black beauty project advisory committee, and a co chair of the national beauty justice coalition. she is passionate about disrupting the beauty and wellness industry and advocating for clean and safe alternatives for cosmetics and personal care products. she has published and co authored several research papers on environmental toxins and their relationship to breast cancer and supported the implementation of federal and local policies that promote environmental justice. with a deep understanding ranging from environmental justice to reproductive health, dr. williams is particularly dedicated to advancing women’s health issues. dr. williams brings her passion for beauty justice to the forefront by advocating for the elimination of toxic chemicals in beauty and personal care products. with a keen eye for market trends, she collaborates with social influencers to authentically connect the brand’s mission with consumers, thereby shifting cultural norms that favor harmful beauty standards. through her innovative strategies, dr. williams aims to enhance brand reputation and drive sustainable practices within the cosmetics industry while ensuring that consumers are well informed about the health impacts of these products. dr. williams’ academic background provides the foundation for her impactful work. she earned her bachelor of science degree in psychobiology from the university of california, los angeles (ucla), followed by a doctor of public health and a master of public health in health promotion and education from loma linda university school of public health. additionally, as a certified health education specialist (ches), she offers a unique perspective on integrating health and beauty. beyond her corporate achievements, dr. williams is committed to empowering her community and advancing diversity within the industry. as a proud member of alpha kappa alpha sorority, incorporated, she has held executive board leadership positions. her leadership not only influences her immediate environment but also serves as an inspiration for future generations of women in business and health advocacy. dr. astrid williams continues to be a formidable force in the beauty industry, combining her public health expertise with a passion for social impact to create a more inclusive and health conscious beauty landscape. bhavna shamasunder, associate professor and chair, urban and environmental policy; co chair, public health, occidental college background bhavna shamasunder teaches and conducts research at the intersection of environmental health & justice at occidental college with a focus on inequalities in chemical exposures faced by low income communities and communities of color who live and work in urban and/or industrial environments. related to work related to beauty justice current research projects: related to work related to beauty justice: dede k. teteh brooks, dr.p.h., is a certified health education professional with a wide breadth of experience across academia, research, policy development, and strategic communications. she brings a deep knowledge of the public health sector spanning both individual and community health as well as a teaching and research based background. through her work in community advocacy and prevention, as well as several roles at the centers for disease control and prevention, she has cultivated an interest in sustainable public health infrastructure and building healthier communities, particularly in black populations. dr. teteh brooks is a social/behavioral scientist who uses community based participatory research approaches to reduce health disparities and promote health equity in african diaspora populations in the u.s. she is currently an assistant professor of public health in the department of health sciences at chapman university and an adjunct assistant professor in the division of health equities at city of hope comprehensive cancer center (duarte, ca). her area of research includes 1) endocrine disrupting chemical exposures in hair and other personal care products and breast cancer risk with particular focus on black women (the bench to community initiative); and 2) the impact of social determinants of health on lung cancer surgery family caregivers and patients. the bench to community initiative (b2c) is a community based participatory research project with two overarching goals: 1) develop multidisciplinary partnerships with community stakeholders, basic and social/behavioral scientists to better understand the sociocultural and biological determinants of edc exposures from personal care products and breast cancer risk; and 2) implement community interventions aimed at reducing breast cancer risk including edc exposures from personal care products for black women. to learn more about the b2c visit www.bench2community.org. background: she holds a bachelor of science degree in biology and minor in theology from st. john’s university in queens, new york; a master of public health in health education & promotion from morehouse school of medicine, atlanta, ga; and a doctor of public health in health education from loma linda university, loma linda, california. dr. teteh brooks has been a recipient of numerous honors and awards, including selection as a bill & melinda gates scholar, a national cancer institute center to reduce cancer health disparities, scholar in training awardee, and the recipient of the glen blix award for excellence in preventive care from loma linda university. she also served on the desert coastal area board of directors for the american cancer society (acs) and is a legislative ambassador for the acs’s cancer action network. dr. teteh brooks was born and raised in lomé, togo and grew up in bronx, ny and atlanta, georgia, but currently calls southern california home. her friends and family, especially her nieces and nephews, are the joys of her life and her motivation for addressing disparities in health outcomes for black people. work related to beauty justice: clean beauty for black girls is a platform for black women to connect, find safer products and support one another. clean beauty for black girls makes the connection between the toxins in our everyday products and the health issues affecting black women on a large scale. background: hannah is an educator, a truth seeker, and motivator to black women seeking to put their health & success first. hannah was born and raised in iowa, and now her & her teenage son call the dmv home. she is a former track & field collegiate athlete and high school girls’ coach. she earned her mba from northeastern university before leaving the corporate world to learn how to walk in her entrepreneurial shoes. since then, she has been developing ideas & championing ways for black women to rise above their stereotypes and expectations. organizational description check out their educational blog to learn more about their work on toxic free living and wellness. background: “my work in the health field began as an advocate during my pregnancy, seeking a holistic practitioner to work with my concept of a gentle birth, and it gives me great pleasure to imagine a world with powerful women, at optimum physical, mental, spiritual, emotional and financial health leading us to justice and peace. over the course of the years my journey has included the birthing project usa, great beginnings for black babies, national health foundation, march of dimes, california primary care association, inglewood healthy mothers & babies, south los angeles health project and women infant & children (south los angeles advisory board) programs as well with a member of the community faculty with charles r drew university of medicine and science.” ms. robinson flint is also part of the los angeles coalition for reproductive justice, california coalition for reproductive freedom and in our own voice; national black women’s reproductive justice agenda with the intention of lifting the experiences and voices of black women in pursuit of health and well being. organizational description related to work related to beauty justice bww’s action project is “unapologetically working for the health and wellness of black women and girls” by actively engaged in developing and advocating for state and federal legislation that would more strictly regulate   or force the disclosure of   chemicals of concern in both retail cosmetic products and professional hair salon products. they successfully helped remove toxic chemicals from beauty products in california through the passage of the ca toxic free cosmetic act, secured passage of the crown act, the ca cosmetic fragrance and flavor ingredient disclosure act, and more. currently, bww is an ngo sponsor of the federal cosmetic safety protections for communities of color and salon workers (hr5540), a federal cosmetic safety initiative that would force the disclosure of the unlabeled ingredients in professional salon products, fund research grants to investigate the problem of toxic chemicals in beauty products marketed to women of color and used by professional salon workers; and direct the fda to prioritize safety assessments of chemicals of concern in these products. jasmine mcdonald is an assistant professor in the department of epidemiology at the mailman school of public health. she received her doctorate in 2009 from the biological sciences in public health program at harvard university with a concentration in immunology and infectious disease. she has postdoctoral training in breast cancer epidemiology from the university of pennsylvania and columbia university. her research portfolio integrates individual level factors (e.g., health behaviors) and the macroenvironment (e.g. physical, social, microbial environment) with biology (e.g. endocrine disruption, epigenetic modification) to inform how these multiple levels of etiology impact breast cancer risk across the lifecourse. much of her portfolio is nested within populations that have a higher burden of cancer including those with a genetic predisposition, racial and ethnic minorities, and young women. an avid teacher and mentor, dr. mcdonald was awarded the 2021 columbia university teaching award for her dedication and excellence in teaching, mentoring, and community engagement. dr. mcdonald teaches cancer epidemiology within the mailman school of public health, is the assistant director of the cancer research, training, and education center at the herbert irving comprehensive cancer center (hiccc) and is the co director of the cure program at the hiccc. the cure program is catered to high school and undergraduate students from traditionally overlooked and underserved backgrounds and communities and has hosted over 40 students since 2015. dr. mcdonald also actively engages with the community from a research and educational perspective on the harmful role of endocrine disruptor chemicals within personal care products. background: dr. jenny kay is a research scientist whose work focuses on the toxicology and carcinogenicity of environmental exposures. she comes to silent spring with expertise in dna damage and mechanisms of mutagenesis, which she is applying to the institute’s work on chemically induced breast carcinogenesis. using experimental approaches, analysis of publicly available data, and literature review, dr. kay is investigating the biological effects of chemicals that increase breast cancer risk, focusing especially on dna damage and repair, inflammation and hormonal stimulation, and the interactions between these mechanisms that lead to breast cancer. her goal is to develop approaches for classifying chemicals based on their potential to increase breast cancer risk. dr. kay received her phd in biological engineering at massachusetts institute of technology, where she also completed a postdoctoral fellowship under the guidance of dr. bevin engelward. for her graduate work, dr. kay utilized a novel transgenic mouse model to explore the mechanistic relationships between inflammation, dna damage, mutations, and cancer using the intestines as a model organ. as a postdoctoral fellow, she helped found the mit superfund research program (mit srp), a transdisciplinary center with a specific emphasis on investigating n nitrosodimethylamine, an environmental contaminant and probable human carcinogen. she led animal based research projects at mit srp, studying dna repair gene environment interactions to identify genetic susceptibility factors. her collaborative research integrated key biological endpoints over time to map the progression from exposure to toxicity and cancer in mice. her work has garnered international attention, as n nitrosamines have recently come under scrutiny for contaminating pharmaceuticals at high levels. dr. kay also led the mit srp research translation core, serving as the communication hub between mit srp researchers and government agencies, community partners, other academics, and the general public. organizational description in 2016, silent spring launched detox me™ action kit the first crowdsourced biomonitoring study on people’s exposure to common household and environmental toxics. the innovative project was part of a national study to assess the u.s. population’s exposure to potentially harmful chemicals found in everyday consumer items, such as personal care products, food packaging, and household cleaners. thanks to this study, people around the country could find out what was in their bodies and become empowered to reduce their exposures and live healthier lives. to learn more about their research and its impact click here and here. background: maimah karmo is the founder/ceo of the tigerlily foundation (tigerlily) and a sixteen year survivor of breast cancer. on february 28, 2006, at 4:45 p.m., maimah was diagnosed with stage 2 breast cancer. she had no family history and was 32 years old. while undergoing her second round of chemotherapy, she made a promise to god that if she survived, she would create an organization to educate, empower, advocate for and support young women affected by breast cancer. after her second treatment, tigerlily foundation was born. tigerlily provides breast health, educational, empowerment wellness and transformational programs to young women. after working with congresswoman debbie wasserman schultz to develop the breast cancer education and awareness requires learning young (early) act, in october 2011, maimah was appointed to the federal advisory committee on breast cancer in young women, a committee established by the affordable care act, on which she works to develop initiatives to increase knowledge of breast health and breast cancer, for women under the age of 45 and those at heightened risk for developing the disease. she is a speaker and media personality, regularly called upon to speak on capitol hill and other venues, as a health, advocacy and empowerment expert. in 2015, maimah advocated with members of congress to ensure that young women had access to breast screening. tigerlily foundation flew young women to washington, d.c. to meet with 74 members of congress. the visit resulted in doubling the house and senate support for the protecting access to lifesaving screening (pals) legislation. the bill was signed into law within a month, protecting the lives and rights of millions of women. she is a leader in the women’s health field, creating and implementing national health initiatives for women and girls, with a goal of eliminating disparities of age, stage and color. under maimah’s leadership, tigerlily foundation has launched national and global health initiatives focused on ending disparities, including its angel advocacy program, which trains black women living in communities with the highest disparities in breast cancer. through the tigerlily foundation’s #inclusionpledge, partnering with global stakeholders, tigerlily made a call to action to recognize health disparities as a social justice issue, and is working to end disparities for black women in our lifetime. maimah has appeared in usa today, u.s. news and world report, black enterprise, oprah magazine, essence magazine, ladies home journal, cosmopolitan, seventeen, good housekeeping, harper’s bazaar, marie claire, redbook, women and cancer, cure magazine, traditional home magazine and more. she has also been featured on fox 5, abc 7, cbs, the oprah winfrey show, own, good morning america, the today show and more. she is a sought after speaker by the media and for policy events; and she is a philanthropist. in 2010, maimah published fearless: awakening to my life’s purpose through breast cancer. in 2018, she published the “badass girl’s book of prayers”. she recently published divine downloads: transforming through trauma, followed by unicorn boss, in june 2020. organizational description tigerlily foundation is a national breast cancer foundation providing education, awareness, advocacy and hands on support to young women (15 45)   before, during and after breast cancer. through their programs, they seek to educate and empower women of all backgrounds, including those at heightened risk, those facing health disparities, and those with less access to care. they strive to improve the quality of life and end isolation among breast cancer survivors. work related to beauty justice: california is the only state that requires companies to report hazardous ingredients used in cosmetics. the primary purpose of the california safe cosmetics program is to collect information on hazardous ingredients in cosmetic products sold in california and to make this information available to the public. consumers and salon workers everywhere can use the california safe cosmetics product database to learn more about the products they use. the california safe cosmetics program also researches chemicals of concern in cosmetics and is a partner in the capable project, a diverse coalition of community health organizations and scientists executing a multi pronged approach to study racial/ethnic differences in personal care product use and chemical exposures. background: paula johnson phd, mph is chief of the california safe cosmetics program at the california department of public health. dr. johnson’s expertise includes exposure and epidemiological research on chemicals in consumer goods and methods for synthesizing streams of evidence of toxicity. she also has 10 years’ experience in product development and analysis for manufacturing industries. she holds a phd in environmental health sciences from the university of michigan, a master’s degree in public health from san diego state university, and studied biology and chemistry at the university of redlands. prior to joining cdph, she was a research fellow with the university of california san francisco’s program on reproductive health and the environment, where she helped develop the first systematic review methodology for environmental health. background: rhonda currently serves as the executive director of the california black health network. she previously served as the executive director of the life serve youth foundation and as the interim executive director for integrative medicine for the underserved (im4us). prior to this role, rhonda served as the im4us board president elect. before her tenure with im4us, rhonda was the consultant/project director for the livehealthy oc initiative, a three year initiative that transformed the model of care of a network of fqhcs from a disease focused treatment model to a prevention and wellness model to provide a whole person care approach. before the livehealthy oc initiative, rhonda served as the consultant/statewide project manager for the susan g. komen® circle of promise california initiative, an intensive four year effort to identify evidence based strategies to decrease the high mortality rate of african american women diagnosed with breast cancer, and address disparities at the system, community, and individual levels. rhonda has also consulted on an nih/nci funded breast cancer survivorship research study at the sylvester comprehensive cancer center in miami targeting the diverse population of black women in the south florida community. the study focused on evaluating the impact of stress management and wellness education on survivors who were within twelve months of competing treatment. her responsibilities included marketing, pr, community outreach and recruitment, and facilitating the study’s ten week health and wellness education program to the control group cohorts. rhonda earned her mba in marketing and operations management from the colgate darden school of business at the university of virginia and her b.s. degree in civil engineering from virginia tech. rhonda served as the mission integration chair for the american cancer society 2012 making strides against breast cancer walk and as a member of the baptist health south florida breast center’s patient and family advisory council. rhonda is a leadership charlotte alumnus, past chair of the board of the women’s fund of miami dade, and a past ceo forum member of the commonwealth institute south florida. rhonda served on the 2007 nfl super bowl special events committee, and in 2006 was named one of south florida’s “25 most prominent and influential african american women” by success south florida magazine. organizational description ca black health network (cbhn) is the only black led, state wide organization dedicated to advancing health equity for african americans and black immigrants in california. cbhn is the voice and trusted resource for black health equity in california and provides policy analysis, research and training that promotes best practices which support the creation of optimal conditions needed to sustain healthy black people. work related to beauty justice: california is the only state that requires companies to report hazardous ingredients used in cosmetics. the primary purpose of the california safe cosmetics program is to collect information on hazardous ingredients in cosmetic products sold in california and to make this information available to the public. consumers and salon workers everywhere can use the california safe cosmetics product database to learn more about the products they use. the california safe cosmetics program also researches chemicals of concern in cosmetics and is a partner in the capable project, a diverse coalition of community health organizations and scientists executing a multi pronged approach to study racial/ethnic differences in personal care product use and chemical exposures. background: paula johnson phd, mph is chief of the california safe cosmetics program at the california department of public health. dr. johnson’s expertise includes exposure and epidemiological research on chemicals in consumer goods and methods for synthesizing streams of evidence of toxicity. she also has 10 years’ experience in product development and analysis for manufacturing industries. she holds a phd in environmental health sciences from the university of michigan, a master’s degree in public health from san diego state university, and studied biology and chemistry at the university of redlands. prior to joining cdph, she was a research fellow with the university of california san francisco’s program on reproductive health and the environment, where she helped develop the first systematic review methodology for environmental health. background: dr. micaela e. martinez is a chicana scientist, artist, and justice advocate. she is the newly appointed director of environmental health at we act for environmental justice in new york city. she is responsible for advancing efforts to improve environmental health in communities of color and low income communities by conducting research, promoting public health awareness, education, coalition building, and advocacy. dr. martinez earned her ph.d. in ecology & evolution in 2015 at the university of michigan and did her postdoctoral training at princeton university. before joining we act, she served as an assistant professor at columbia university mailman school of public health, followed by emory university in the dept. of biology. since 2017, dr. martinez has been supported by the prestigious nih director’s early independence award. over the past decade, her research has focused on infectious disease ecology, climate change, maternal and infant health, social justice, and environmental impacts on health. dr. martinez is currently leading we act’s beauty inside out campaign, which seeks to remove toxic chemicals from beauty products, particularly products marketed toward women of color and those rooted in racist beauty standards. organizational description we act for environmental justice is an organization made up of activists, lawyers, community organizers, public health experts, and local northern manhattan residents. their mission is to build healthy communities by ensuring that people of color and low income residents participate meaningfully in the creation of sound and fair environmental health and protection policies and practices. we act envisions a community: informed and engaged residents who participate fully in decision making on key issues that impact their health and community, strong and equal environmental protections, and increased environmental health through community based participatory research and evidence based campaigns. related to work related to beauty justice on march 26, 2020, we act conducted an online congressional briefing on the health impacts of toxic personal care products and cosmetics on women and girls of color. participants learned about the toxic chemicals in products marketed to communities of color, how businesses are responding and the safe cosmetics and personal care products act of 2019. tamarra james todd, ph.d., mark and catherine winkler associate professor of environmental reproductive epidemiology, environmental health, harvard university work related to beauty justice: dr. tamarra james todd is an environmental reproductive epidemiologist researching the role of environmental chemicals on women’s health across the reproductive life course. she directs the environmental reproductive justice (erj) lab, which seeks to investigate and improve adverse environmental exposures and reproductive health disparities. her work particularly focuses on the importance of pregnancy as a sensitive window of consumer product environmental chemical exposures. dr. james todd is the principal investigator of multiple niehs funded r01 grants, focusing on endocrine disrupting chemicals and adverse maternal health outcomes during pregnancy, postpartum and mid life in the ergo study and project viva. dr. james todd serves as the principal investigator for the community engagement core of the metals and metal mixtures: cognitive aging, remediation, and exposure sources (memcare) p42 superfund research center. in addition, she is running interventions to improve environmental health literacy both in the lay community, as well as among health care professionals. dr. james todd is also the director of the organics core for the harvard chan niehs center, where she launched the environmental justice bootcamp in collaboration with two other niehs funded p30 centers. she has been awarded for her research in the area of environmental reproductive health by receiving the estrellita and yosuf karsh visiting professorship in women’s health. she has had the honor of serving on the epa’s scientific advisory board for the chemical assessment advisory committee, as well as two national academies of sciences, engineering, and medicine’s committees and the march of dimes environmental justice working group. background: taylor morton (they/them) is the director of environmental health and education at we act for environmental justice. they have been working with we act since 2016, formerly as an intern, environmental health fellow, educational consultant, and environmental health and education manager. among their responsibilities are leading education programs such as the environmental health & justice leadership training and we act’s climate education policy initiatives as well as the organization’s nycha healthy homes program, which seeks to improve the health and future of public housing residents. taylor also recognizes the importance of exposing bipoc and low income youth to natural elements, and actively supports this mission. they hold a b.s. in environmental studies from spelman college, a m.s. in environmental policy and sustainability management from the new school, and a m.s. in education from the university of pennsylvania. organizational description we act for environmental justice is an organization made up of activists, lawyers, community organizers, public health experts, and local northern manhattan residents. their mission is to build healthy communities by ensuring that people of color and/or low income residents participate meaningfully in the creation of sound and fair environmental health and protection policies and practices. we act envisions a community: informed and engaged residents who participate fully in decision making on key issues that impact their health and community; strong and equal environmental protections; and increased environmental health through community based participatory research and evidence based campaigns. related to work related to beauty justice on march 26, 2020, we act conducted an online congressional briefing on the health impacts of toxic personal care products and cosmetics on women and girls of color. participants learned about the toxic chemicals in products marketed to communities of color, how businesses are responding and the safe cosmetics and personal care products act of 2019. background: tianna shaw wakeman holds a bachelor’s degree in psychology and a master’s degree in social entrepreneurship from the university of southern california where she graduated as the first black university valedictorian for the class of 2021. she currently works as an environmental justice program coordinator for the non profit black women for wellness. during her time as a student, tianna committed herself to helping usc become more sustainable. she interned for the former usc housing sustainability manager, directed the prominent campus environmental activism group ecore, acted as the lead organizer for the usc 2019 climate strike, and she co founded divestsc. usc has since announced a commitment to full divestment from fossil fuels. beyond her activism, tianna served on the usc sustainability steering committee and the presidential working group for sustainable education, research, and operations to push for sustainable policies campus wide. in addition to these achievements, tianna is proud to be a sydney harman polymathic fellow, phi beta kappa, a brittingham social enterprise scholar, and a former member of la mayor garcetti’s youth council on climate action. organizational description related to work related to beauty justice bww’s action project is “unapologetically working for the health and wellness of black women and girls” by actively engaged in developing and advocating for state and federal legislation that would more strictly regulate   or force the disclosure of   chemicals of concern in both retail cosmetic products and professional hair salon products. they successfully helped remove toxic chemicals from beauty products in california through the passage of the ca toxic free cosmetic act, secured passage of the crown act, the ca cosmetic fragrance and flavor ingredient disclosure act, and more. currently, bww is an ngo sponsor of the federal cosmetic safety protections for communities of color and salon workers (hr5540), a federal cosmetic safety initiative that would force the disclosure of the unlabeled ingredients in professional salon products, fund research grants to investigate the problem of toxic chemicals in beauty products marketed to women of color and used by professional salon workers; and direct the fda to prioritize safety assessments of chemicals of concern in these products. founder, the equity and wellness collaborative background: marcha isabelle chaudry is the founder of the equity and wellness collaborative. she previously worked as a senior policy manager at the national women’s health network where she developed and led their national cosmetics policy program, with a particular focus on historically marginalized communities. she helped build and led a national coalition of consumer and women’s advocates to bring national attention to the harmful practices of businesses engaged in corporate deception and harmful marketing in the beauty industry. ms. chaudry actively lobbies, at the grassroots and federal level, on women’s health and cosmetics policy and has provided expert testimony before congress and the food and drug administration. she has also appeared in several media and publication efforts including, vogue business, hbo max, democracy now!, pbs newshour, good morning america, nbc news, and a host of other publications and networks. ms. chaudry earned a j.d. with distinction in alternative dispute resolution from howard university school of law and a bachelor of science degree from howard university. she previously served as board chair of the justice, equity, diversity, & inclusion committee at women’s voices for the earth. she currently serves on the advisory board of the mosaic economic project of the progressive policy institute, which aims to put more women at the forefront of policy making. she is admitted to practice in the district of columbia. bio: following a diagnosis of an aggressive form of breast cancer, or can’t cer as she calls it, tiah tomlin harris vowed to god that if she made it through breast cancer, she would help as many women as she could fight and survive breast cancer, particularly black women, who are disproportionately impacted by this disease. tiah believed that no sister should walk this journey alone and founded the my breast years ahead sisterhood, a sisterhood of women survivors. she also founded my style matters, inc., a 501c3 non profit organization that focuses on prevention and improving health outcomes by providing support, resources, education as well as healthy lifestyle experiences to cancer patients and their loved ones. in 2019, upon obtaining news of a recurrence, tiah opted to fight cancer a second time with food and faith. she adopted a whole food plant based diet, removed products containing toxins or other dangerous chemicals from her home, and added other complementary practices to her daily routine. tiah believes that making healthy lifestyle changes can help improve one’s quality of life and help with better life outcomes. she is now helping others on their quest for optimal health as a licensed food for life instructor and is educating individuals on ways to eliminate harmful exposures. tiah is an activist, an advocate, a cancer coach, a breast health educator, a consultant, and a project lead graduate of the national breast cancer coalition (nbcc). she developed breast health matters, an empowerment and educational platform for teen girls and women and serves as the program manager for the knowledge is power symposium that focuses on black women diagnosed with breast cancer. tiah has advocated for survivors on capitol hill; is a community advisory board member with the bench to community initiative, serves as a board member and advisory board member for several pharmaceutical companies and organizations; published a research paper on clinical trials in metastatic breast cancer; has spoken on numerous talk shows and panels to include tavis smiley talk radio, american society for clinical oncology (asco), american association for cancer research (aacr) and the congressional briefing with breast cancer prevention partners (bcpp). through her life’s work, she has received recognition and awards, including president bush’s   point of lights award. tiah is educating, motivating, and activating people to move from awareness to taking action. working with our partner, clearya, we screened the black beauty product database against tier 1 red list chemicals. brands that did not have any of the tier 1 chemicals in their products were placed on a list of non toxic black beauty products, which includes 78 brands and 696 products. these brands and their products will be listed on the csc website in a searchable database by name and product type. the top 15 most frequently found chemicals were: get our full list of top chemicals of concern found in black bodycare, haircare, makeup, nail, skincare, and sunscreen products. generating the list of non toxic black beauty products ​ the campaign’s non toxic black beauty project created a list of safer black beauty products in order to help consumers make more informed purchases and guide the efforts of manufacturers and retailers to make and sell safer products. working with our partner, clearya, we screened the black beauty product database against tier 1 red list chemicals. brands that did not have any of the tier 1 chemicals in their products were placed on a list of non toxic black beauty brands, which includes 78 brands and 696 products. these brands and their products are featured in our searchable non toxic black owned beauty product database. in 2022, we expanded the red list of chemicals of concern to include cosmetic chemicals of greater concern for black women’s health. explore the expanded red list. we worked with our advisory committee to identify health issues of concern to black women that were not already captured in the 2018 bcpp red list. these were identified as: diabetes, early puberty, endometriosis, infertility, earlier age at menopause, less successful ivf outcomes, maternal health, obesity, ovarian cancer, polycystic ovarian syndrome, pregnancy complications, preterm birth, pubertal development, reproductive health, uterine fibroids and allergic reactions. because we were unable to identify authoritative scientific or governmental organizations which identified chemical exposures associated with the majority of these health effects, we completed a scientific literature review to investigate these potential links ourselves. we performed multiple pubmed searches utilizing keywords to find articles in the peer reviewed literature that connected these health outcomes with chemicals in personal care products. see appendix 2 for the full list of keywords and search terms. we used a formal scoping review process to review the articles. scoping reviews are a method of synthesizing evidence to provide a wide perspective on a research topic. they are especially relevant for complex areas of research where different research methods may apply and offer a rigorous, transparent, and comprehensive approach to reviewing the literature. unlike systematic reviews, researchers may not rate the quality of the literature, because scoping reviews are a means to get a broad overview of a research area. for each of the health concerns, we screened the titles from the pubmed searches for relevance. the abstracts were then reviewed for possible inclusion by two independent researchers with a third acting as a tiebreaker. next, we read the full papers and entered the findings and other details of the studies on a spreadsheet that tracked our findings. we did not weigh chemicals of concern against one another but assessed if findings of associations were significant and therefore suggested concern. in total our process resulted in 8,119 titles and 580 full papers whose data were entered in the final spreadsheet. we reviewed these articles and identified 141 discrete studies finding a significant association between chemicals in personal care products and health outcomes of greater concern to black women. we expanded the bcpp red list to include the findings from these studies. see our red list for an annotated bibliography of the scientific articles referenced in tier 1. to qualify for csc’s list of non toxic black beauty brands, brands needed to 1) be black owned, 2) market primarily to black women, and 3) list all of the ingredients for their products on their websites or provide us with any product ingredients missing from their website. if a brand did not meet one or more of these criteria, it was not considered for the list. if a brand made it past this first stage of vetting, we then screened its product ingredients against the campaign’s red list of “do not use” chemicals in cosmetics, a list made up of 241 chemicals linked to cancer, birth defects and other serious diseases and conditions. if any of a brand’s products contained one or more of these chemicals, the brand was excluded from the final list. brands with undisclosed fragrance ingredients who were unable to certify that none of their fragrance ingredients were present on tier 1 of the csc’s updated red list of chemicals of concern in cosmetics, were also excluded from the final list. still have a brand you think should be included? let us know! the non toxic black beauty project is a living project, and we would love to hear about your favorite clean black beauty brands so we can vet them for next year’s list. submit your favorite brand using this form. if you are a black beauty brand owner and want your products to be featured on our next list, please fill out this form! we’d love to include your brand for consideration in the next round of black beauty product screening. one of the primary goals of this project is to grow the safe black beauty industry by 1) elevating black owned companies that are making and selling non toxic black beauty and personal care products; and 2) by providing technical support to black owned beauty businesses that don’t make the list and want to do better. we offered personalized reports to companies that do not make the list, identifying the ingredients in their products that appear on the csc tier 1 “do not use” red list of chemicals of concern in cosmetics, and the related adverse health effects. we hope that companies will use this information to reformulate their products in order to make it onto the next list of non toxic black beauty products. if you see the non toxic black beauty brand product seal on a product, it means that the product was not made with any of the 241 chemicals on the csc red list of chemicals of concern in cosmetics that have been linked to negative health effects, including those of greater concern to black women. our seal is the only cosmetic safety seal that addresses chemicals linked to health effects of particular concern to black women (diabetes, early puberty, endometriosis, infertility, less successful ivf outcomes, adverse maternal health effects, obesity, ovarian cancer, polycystic ovarian syndrome, pregnancy complications, preterm birth, uterine fibroids, and allergic reactions that are not represented by the “authoritative lists” of hazardous chemicals created by governmental and scientific organizations such as the international agency for research on cancer, the national toxicology program, etc., which mainly focus on cancer, birth defects, and reproductive/developmental harm. the non toxic black beauty project began in 2021, and product ingredient lists were evaluated for safety during the summer of 2021. any additional products that were marketed by a black beauty brand that made the list after the company’s product safety evaluations were completed, were not awarded the non toxic black beauty seal. products with the seal include only those whose ingredient lists were vetted for safety. we plan to re evaluate brands already represented on the csc list of non toxic black beauty products on a yearly basis to identify any new products that qualify for the non toxic black beauty brand product seal, as well as new black owned beauty brands. this project was guided by an advisory committee made up of a broad array of non profit organizations and scientists working to better understand and respond to the over exposure black women experience to toxic chemicals in the beauty products marketed to them, including representatives from black women for wellness, we act for environmental justice, california black health network, silent spring institute, tigerlily foundation, clean beauty for black girls, clearya and breast cancer prevention partners along with top scientists from chapman university, columbia mailman school of public health, harvard t.h. chan school of public health, george washington university milken school of public health, the california department of public health and occidental college. we plan to reassess our current products and screen new products annually. stay tuned for 2023 to learn how you can help grow our list of non toxic black beauty products. yes! the campaign for safe cosmetics has been hard at work since 2004 advocating for the passage of comprehensive, health protective, federal cosmetic safety legislation. see about to learn more and take action to support our campaigns. sources [1] debard, amanda. “black women in us most likely to die of breast cancer.” the komen blog. february 12, 2020. available online: https://blog.komen.org/blog/black women in us most likely to die from breast cancer/#:~:text=breast%20cancer%20is%20also%20the%20second%20leading%20cause%20of%20cancer,black%2fafrican%2damerican%20women. accessed july 7, 2022. [2] desantis ce, siegel rl, sauer ag, et al. cancer statistics for african americans, 2016: progress and opportunities in reducing racial disparities: cancer statistics for african americans, 2016. ca cancer j clin. 2016;66:290 308. [3] herman giddens, marcia e., et al. “secondary sexual characteristics and menses in young girls seen in office practice: a study from the pediatric research in office settings network.” pediatrics 99.4 (1997): 505 512. https://doi.org/10.1542/peds.99.4.505 [4] burris, h. h., lorch, s. a., kirpalani, h., pursley, d. m., elovitz, m. a., & clougherty, j. e. (2019). racial disparities in preterm birth in usa: a biosensor of physical and social environmental exposures. archives of disease in childhood, 104(10), 931 935. https://doi.org/10.1136/archdischild 2018 316486 [5] osterman m, hamilton b, martin ja, driscoll ak, valenzuela, cp. births: final data for 2020. natl vital stat rep. 2021;70(17):1 50. https://www.cdc.gov/nchs/data/nvsr/nvsr70/nvsr70 17.pdf [6] eltoukhi, h. m., modi, m. n., weston, m., armstrong, a. y., & stewart, e. a. (2014). the health disparities of uterine fibroid tumors for african american women: a public health issue. american journal of obstetrics and gynecology, 210(3), 194 199. https://doi.org/10.1016/j.ajog.2013.08.008 [7] fuldeore, mahesh j., and ahmed m. soliman. “patient reported prevalence and symptomatic burden of uterine fibroids among women in the united states: findings from a cross sectional survey analysis.” international journal of women’s health 9 (2017): 403. https://doi.org/10.2147/ijwh.s133212 [8] whetstone, s., burke, w., sheth, s. s., brooks, r., cavens, a., huber keener, k., scott, d. m., worly, b., & chelmow, d. (2022). health disparities in uterine cancer: report from the uterine cancer evidence review conference. obstetrics and gynecology, 139(4), 645 659. https://doi.org/10.1097/aog.0000000000004710 [9] harris, h. r., guertin, k. a., camacho, t. f., et al. (2022). racial disparities in epithelial ovarian cancer survival: an examination of contributing factors in the ovarian cancer in women of african ancestry consortium. international journal of cancer, 151(8), 1228 1239. https://doi.org/10.1002/ijc.34141 [10] yang, lily. “how the beauty industry is hurting women of color.” the daily californian. march 5, 2021. available online: https://www.dailycal.org/2021/03/05/how the beauty industry is hurting women of color/. accessed july 7, 2022. [11] campaign for safe cosmetics. “laws and regulations on chemicals in cosmetics.” available online: https://safecosmetics.org/resources/regulations/. accessed july 7, 2022. [12] mcconnell, jamie. “antiquated law allows toxic chemicals in cosmetics and puts health at risk.” women’s voices for the earth. july 29, 2021. available online: https://www.womensvoices.org/2021/07/29/antiquated law allows toxic chemicals in cosmetics and puts health at risk/. accessed july 7, 2022. [13] international fragrance association. “ifra transparency list.” https://ifrafragrance.org/initiatives/transparency/ifra transparency list. accessed november 4, 2020. [14] bryant, taylor. “how the beauty industry has failed black women.” refinery 29. february 27, 2016. available online: https://www.refinery29.com/en us/2016/02/103964/black hair care makeup business. accessed july 7, 2022. [15] harmon, stephenetta. “black consumers spend nine times more in hair & beauty.” hype hair, february 26, 2018. available online: https://www.hypehair.com/86642/black consumers continue to spend nine times more in beauty report/. accessed july 7, 2022. [16] eberle, c. e., sandler, d. p., taylor, k. w., & white, a. j. (2020). hair dye and chemical straightener use and breast cancer risk in a large us population of black and white women. international journal of cancer, 147(2), 383 391. https://doi.org/10.1002/ijc.32738 [17] u.s. food and drug administration. “prohibited and restricted ingredients in cosmetics.” available online: https://www.fda.gov/cosmetics/guidanceregulation/lawsregulations/ucm127406.htm. accessed october 14, 2022. [18] huang, tianyi, et al. “gender and racial/ethnic differences in the associations of urinary phthalate metabolites with markers of diabetes risk: national health and nutrition examination survey 2001 2008.” environmental health 13.1 (2014): 1 10. https://doi.org/10.1186/1476 069x 13 6 [19] james todd, tamarra m., et al. “racial and ethnic variations in phthalate metabolite concentration changes across full term pregnancies.” journal of exposure science & environmental epidemiology 27.2 (2017): 160 166. https://doi.org/10.1038/jes.2016.2 [20] calafat, antonia m., et al. “urinary concentrations of four parabens in the us population: nhanes 2005 2006.” environmental health perspectives 118.5 (2010): 679 685. https://doi.org/10.1289/ehp.0901560 [21] zota ar, 2017: https://doi.org/10.1016/j.ajog.2017.07.020 [22] mcdonald ja, 2022: https://ajph.aphapublications.org/doi/full/10.2105/ajph.2021.306606 [23] american cancer society. cancer facts & figures for african american/black people 2022 2024. atlanta: american cancer society, 2022. [24] james todd, tamarra, et al. “childhood hair product use and earlier age at menarche in a racially diverse study population: a pilot study.” annals of epidemiology 21.6 (2011): 461 465. https://doi.org/10.1016/j.annepidem.2011.01.009 [25] llanos aam, 2017: https://doi.org/10.1093/carcin/bgx060 [26] white aj, 2020: https://doi.org/10.1002/ijc.33413 [27] coogan pf, 2021: https://doi.org/10.1093/carcin/bgab041 [28] rao r and llanos aam, 2022: https://doi.org/10.1016/j.envres.2021.111863 [29] binder, a.m., corvalan, c., calafat, a.m. et al. childhood and adolescent phenol and phthalate exposure and the age of menarche in latina girls. environ health 17, 32 (2018). https://doi.org/10.1186/s12940 018 0376 z [30]harley, k. g., berger, k. p., kogut, k., parra, k., lustig, r. h., greenspan, l. c., calafat, a. m., ye, x., & eskenazi, b. (2019). association of phthalates, parabens and phenols found in personal care products with pubertal timing in girls and boys. human reproduction (oxford, england), 34(1), 109 117. https://doi.org/10.1093/humrep/dey337 [31] jurewicz, j., & hanke, w. (2011). exposure to phthalates: reproductive outcome and children health. a review of epidemiological studies. international journal of occupational medicine and environmental health, 24(2), 115 141. https://doi.org/10.2478/s13382 011 0022 2 [32] ashrap, p., sánchez, b. n., téllez rojo, m. m., basu, n., tamayo ortiz, m., peterson, k. e., meeker, j. d., & watkins, d. j. (2019). in utero and peripubertal metals exposure in relation to reproductive hormones and sexual maturation and progression among girls in mexico city. environmental research, 177, 108630. https://doi.org/10.1016/j.envres.2019.108630 [33] chen, a., chung, e., defranco, e. a., pinney, s. m., & dietrich, k. n. (2011). serum pbdes and age at menarche in adolescent girls: analysis of the national health and nutrition examination survey 2003 2004. environmental research, 111(6), 831 837. https://doi.org/10.1016/j.envres.2011.05.016 [34] jackson, l. w., zullo, m. d., & goldberg, j. m. (2008). the association between heavy metals, endometriosis and uterine myomas among premenopausal women: national health and nutrition examination survey 1999 2002. human reproduction (oxford, england), 23(3), 679 687. https://doi.org/10.1093/humrep/dem394 [35] johnstone, e. b., louis, g. m., parsons, p. j., steuerwald, a. j., palmer, c. d., chen, z., sun, l., hammoud, a. o., dorais, j., & peterson, c. m. (2014). increased urinary cobalt and whole blood concentrations of cadmium and lead in women with uterine leiomyomata: findings from the endo study. reproductive toxicology (elmsford, n.y.), 49, 27 32. https://doi.org/10.1016/j.reprotox.2014.06.007 [36] ye, s., chung, h. w., jeong, k., sung, y. a., lee, h., park, s. y., kim, h., & ha, e. h. (2017). blood cadmium and volume of uterine fibroids in premenopausal women. annals of occupational and environmental medicine, 29, 22. https://doi.org/10.1186/s40557 017 0178 8 [37] welch, barrett m., et al. “associations between prenatal urinary biomarkers of phthalate exposure and preterm birth: a pooled study of 16 us cohorts.” jama pediatrics 176.9 (2022): 895 905. [38] wang, zifan, et al. “polybrominated diphenyl ethers in early pregnancy and preterm birth: findings from the nichd fetal growth studies.” international journal of hygiene and environmental health 243 (2022): 113978. https://doi.org/10.1001/jamapediatrics.2022.2252 [39] preston, emma v., et al. “endocrine disrupting chemical associated hair product use during pregnancy and gestational age at delivery: a pilot study.” environmental health 20.1 (2021): 1 9. https://doi.org/10.1186/s12940 021 00772 5 [40] james todd, tamarra m., et al. “pregnancy urinary phthalate metabolite concentrations and gestational diabetes risk factors.” environment international 96 (2016): 118 126. https://doi.org/10.1016/j.envint.2016.09.009 [41] cantonwine, david e., et al. “urinary concentrations of bisphenol a and phthalate metabolites measured during pregnancy and risk of preeclampsia.” environmental health perspectives 124.10 (2016): 1651 1655. https://doi.org/10.1289/ehp188 [42] brown woodman, p. d., webster, w. s., picker, k., & huq, f. (1994). in vitro assessment of individual and interactive effects of aromatic hydrocarbons on embryonic development of the rat. reproductive toxicology (elmsford, n.y.), 8(2), 121 135. https://doi.org/10.1016/0890 6238(94)90019 1 [43] labrèche f, forest j, trottier m, lalonde m, simard r. characterization of chemical exposures in hairdressing salons. appl occup environ hyg. 2003;18(12):1014 1021. doi: 10.1080/10473220390244667. [44] pak vm, powers m, liu j. occupational chemical exposures among cosmetologists: risk of reproductive disorders. workplace health saf. 2013;61(12):522 528. doi: 10.1177/216507991306101204 [45] dodson re, 2021: https://doi.org/10.1038/s41370 021 00327 3 [46]preston, emma v., et al. “socioeconomic and racial/ethnic differences in use of endocrine disrupting chemical associated personal care product categories among pregnant women.” environmental research 198 (2021): 111212. https://doi.org/10.1016/j.envres.2021.111212 [47] james todd, tamarra, et al. “hormonal activity in commonly used black hair care products: evaluating hormone disruption as a plausible contribution to health disparities.” journal of exposure science & environmental epidemiology 31.3 (2021): 476 486. https://doi.org/10.1038/s41370 021 00335 3 get our emails to stay in the know. this site is protected by recaptcha and the google privacy policy and terms of service apply. get to know us about ussee our financialscontact usnews take action campaignsindividualsbusinessespress get the facts chemicals of concernproducts of concernlaws and regulationstips connect 1388 sutter street, suite 901san francisco, ca 94109 5400 bcpp is a 501(c)3 | ein: 94 3155886 | privacy policy | site map | bcpp.org you’re subscribing to bcpp’s campaign for safe cosmetics email list. we won’t share your information and you may opt out at any time. *you’re subscribing to bcpp’s campaign for safe cosmetics email list. we won’t share your information and you may opt out at any time. *you’re subscribing to bcpp’s campaign for safe cosmetics email list. we won’t share your information and you may opt out at any time. *you’re subscribing to bcpp’s campaign for safe cosmetics email list. we won’t share your information and you may opt out at any time. *you’re subscribing to bcpp’s campaign for safe cosmetics email list. we won’t share your information and you may opt out at any time. *you’re subscribing to bcpp’s campaign for safe cosmetics email list. we won’t share your information and you may opt out at any time. *you’re subscribing to bcpp’s campaign for safe cosmetics email list. we won’t share your information and you may opt out at any time. *you’re subscribing to bcpp’s campaign for safe cosmetics email list. we won’t share your information and you may opt out at any time. *you’re subscribing to bcpp’s campaign for safe cosmetics email list. we won’t share your information and you may opt out at any time. *you’re subscribing to bcpp’s campaign for safe cosmetics email list. we won’t share your information and you may opt out at any time.

an official website of the united states government official websites use .gov a .gov website belongs to an official government organization in the united states. secure .gov websites use https a lock ( lock locked padlock icon ) or https:// means you've safely connected to the .gov website. share sensitive information only on official, secure websites. primary site navigation logged in as: co first authors authors’ contributions: tjt jointly conceived of the study, assisted with data interpretation and wrote the manuscript; lc jointly conceived of the study, designed and implemented the hormone assays for testing of hair products, interpreted the data and edited the manuscript; ep assisted with data interpretation and editing of the manuscript; mrq assisted with editing and preparation of the manuscript; mp conducted the hormone assays for testing of hair products and assisted with data interpretation and editing of the manuscript, yx assisted with data interpretation and editing of the manuscript; bg assisted with data interpretation and writing of the manuscript; sm assisted with data interpretation, writing and editing of the manuscript. corresponding author: tamarra james todd, phd, mph, department of environmental health, harvard t.h. chan school of public health, 665 huntington ave., bldg. 1, 14th floor, boston, ma 02120, usa, phone: 617.432.6460, fax: 617.525.7746, tjtodd@hsph.harvard.edu issue date 2021 may. users may view, print, copy, and download text and data mine the content in such documents, for the purposes of academic research, subject always to the full conditions of use:http://www.nature.com/authors/editorial_policies/license.html#terms certain types of hair products are more commonly used by black women. studies show hair products contain several endocrine disrupting chemicals that are associated with adverse health outcomes. as chemical mixtures of endocrine disruptors, hair products may be hormonally active, but this remains unclear. to assess hormonal activity of commonly used black hair products. we identified 6 commonly used hair products (used by >10% of the population) from the greater new york hair products study. we used reporter gene assays (rgas) incorporating natural steroid receptors to evaluate estrogenic, androgenic, progestogenic, and glucocorticoid hormonal bioactivity employing an extraction method using bond elution prior to rga assessment at dilutions from 50 500. all products displayed hormonal activity, varying in the amount and effect. three samples showed estrogen agonist properties at levels from 12.5 20ng/g estradiol equivalent concentrations (eeq). all but one sample showed androgen antagonist properties at levels from 20 25ng/g androgen equivalent concentrations (aeq). four samples showed antagonistic and agonistic properties to progesterone and glucocorticoid. hair products commonly used by black women showed hormonal activity. given their frequent use, exposure to hormonally active products could have implications for health outcomes and contribute to reproductive and metabolic health disparities. keywords: hair preparations, personal care products, estrogen receptor, androgen receptor, glucocorticoid receptor, progesterone receptor, hormone receptor assays recent studies highlight a pressing racial/ethnic disparity in hair and personal care product use (1 3), with black women generally using more hair oils, lotions, chemical relaxers, leave in conditioners, and placenta containing products (4). of importance, data suggest that these products may contain hormonally active ingredients, such as endocrine disrupting chemicals (edcs), including lower molecular weight phthalates and parabens (4, 5). interestingly, nationally representative data from the united states shows that black women have among the highest concentrations of these personal care product chemicals compared to other racial/ethnic groups(6, 7), with hair products potentially being an important source of hormonally active chemical exposure(4). chemicals contained in hair products have been linked to hormonally mediated diseases that are more prevalent among black women and girls, including early puberty (8), preterm birth (9), obesity (10), and diabetes (11). as such, determining whether ingredients in hair products could contribute to higher exposure to hormonally active chemicals and related diseases among black women is of key importance to reducing these health disparities. understanding the drivers of hair product use as a link to higher hormonally active chemical exposures and hormone mediated disease risk provides critical insight into why these disparities may exist. an important driver of hair product use among black women is eurocentric beauty standards that have impacted social and economic position from post slavery and colonization to modern day (12). specifically, straighter hair represented ideal beauty standards and higher social status, requiring black women to assimilate to white culture (13). a number of black pioneers developed hair maintenance systems that provided and maintained straighter hair, including anna turbo malone, elroy j. duncan, and madame c.j. walker. beyond rinse out soaps to clean hair, these products included leave in hair oils and stimulating lotions (13, 14). today, black hair care is a half trillion dollar industry (12, 13), with black women spending more money on hair styling products than any other ethnic group (13, 15). that said, even recent legislation in the united states has had to be enacted to ensure black women can wear their hair in ways that could allow for less chemical exposure (16). of concern, the use of these products may be placing black women at increased exposure to toxic chemicals including edcs due to these underlying social and political factors that are systemic drivers of beauty and economic status. while some studies have documented individual chemicals and chemical classes contained in hair products (5, 17), few have evaluated the impact of these products as chemical mixtures on alterations to hormone systems (18). in a study by myers et al., a number of hair and skin care products were assessed for hormone activity (19). of the eight products assessed, only one product was a leave in hair product, which showed estrogen activity. with leave in hair products being commonly used by black women (1 3), evaluating whether chemicals in these hair products could be agonist or antagonist of hormone receptors linked to diseases is key. many of the edcs identified in hair products are thought to bind to and alter hormone receptors including estrogen, progesterone, androgen, and glucocorticoid receptors (20). of note, these specific hormone receptors are involved in numerous biological processes, which if altered, could contribute to the risk of diseases such as diabetes, cardiovascular disease, as well as adverse reproductive health outcomes (3, 21 24). thus, hair product use could contribute to a mixture of chemical exposures that could perturb hormonal processes and affect disease risk. while few studies have evaluated hair products as mixtures, a number of studies have evaluated the hormonal effects of individual chemicals present in hair products. for example, previous work has identified black hair products as containing phthalates, parabens, alkylphenols, cyclosiloxanes, ethanolamines, and uv filters (5). alkylphenols have estrogenic properties, with the ability to alter reproductive parameters in rodents (25). similarly, cyclosiloxanes (26) and certain phenols, including certain parabens and uv filters (27 29) are also estrogenic. parabens have anti androgenic properties (30) and can disrupt the glucocorticoid receptor (31, 32), with implications for glucose and other metabolic pathways (33, 34). in addition, phthalates also have anti androgenic properties and have been shown to be peroxisome proliferator alpha and gamma agonists (35 37), impacting lipid and glucose metabolism. together, these chemicals may operate in complex ways to perturb hormonal pathways. understanding whether commonly used black hair products, as chemical mixtures, could bind to and alter hormone signaling will provide critical information to environmental exposure and associated hormone mediated disease disparities. thus, the objective of this study was to evaluate the extent to which hair products, as edc mixtures, could bind to and operate as agonists or antagonists of four hormone receptors: estrogen, androgen, progesterone, and glucocorticoid. we selected commonly used hair products based on data from the greater new york hair products study, which were previously shown to contain edcs and have been linked to adverse health outcomes (2, 4). as previous studies found estrogenic chemicals (4, 5), and estrogenic activity (19), we hypothesized that these products would be able to bind to the estrogen receptor and act as agonists and included other hormone receptor analyses as exploratory analyses. hair products were selected from the greater new york hair products study, a cross sectional study conducted in a population of 359 women from across the new york city metropolitan area between 2004 2006 (2, 4). we used convenience sampling techniques, identifying local churches, nail and hair salons, workplaces, restaurants/cafes, and laundromats as recruitment locations (2, 4). women had to be over 18 years old, speak english, and self identify as african american (descendants of united states slaves), african caribbean (black and born in the caribbean or their descendants), hispanic, or non hispanic white. for this study, women completed a detailed survey about their current and past hair product use. the questionnaire was generated from detailed qualitative research data from two focus groups to identify names and categories of hair products, along with information for how to best ask and obtain information on hair product use, frequency, duration, and brand. using qualitative data that was transcribed and evaluated for themes, a quantitative questionnaire was constructed and queried hair oil, lotion, leave in conditioner, perm/relaxer, and other product use. in addition to current and past use, data on frequency, duration, and product brand was collected. to aid with recall of current and past use of products, a hair product label book was constructed featuring images of over 150 different products brand names. additional details on the greater new york hair products study can be found elsewhere (2, 4). among the products listed for current use, we identified 6 specific hair product brand names that had >10% use in the study population and had frequent reported use (i.e. daily or more than once per week) (4). the following products were purchased and sent for independent laboratory testing for hormone receptor assays in 2012: sample 1, hair lotion; sample 2, leave in conditioner; sample 3, leave in conditioner; sample 4, hair oil; sample 5, root stimulator; sample 6, hair oil. label information from the products did not indicate the addition of estrogen or other hormones for most of the hair products. however, the label information did indicate the presence of placenta in one hair oil brand (sample 6). briefly, one gram of each product was extracted in ethyl acetate and cleaned up via solid phase extraction followed by evaporation and final suspension in 250 μl methanol. a more detailed extraction protocol is outlined within supplementary materials for methods on extraction of hair products. the thiazolyl blue tetrazolium bromide (mtt) assay was used to control for cytotoxic effects in parallel to rga analysis of test samples by measuring cellular metabolic activity as an indicator of cellular health. the detailed procedure can be found in supplementary materials for mtt analysis. the four mammalian reporter gene assay cell lines which were used in this study were previously established by willemsen et al.(38). for the estrogen receptor assay, the estrogen responsive mmv luc cell line was created from mcf 7 cells by transfection with the mar vit luc reporter plasmid, and is specific for estrogens and estrogenic compounds. the progestogen responsive tm luc cell line was generated using t47d cells (which express high levels of endogenous progestogen receptors) transfected with the mmtv luc plasmid, and is specific for progestogens and progestogenic compounds. the tgrm luc and tarm luc cell lines were co transfected from the mmtv luc reporter plasmid and the rs hgrα vector (codes for the human gr), or the psv ar0 vector (codes for the human ar) into t47d cells. tgrm luc and tarm luc cell lines are specific for glucocorticoids and progestogens, and for androgens and progestogens, respectively. the cell lines were routinely cultured in dulbecco’s modified eagle medium (dmem) and 10% fetal bovine serum, and grown in 75cm2 tissue culture flasks (nunc, roskilde, denmark) at 37°c with 5% co2 and 95% humidity. as phenol red is estrogenic, the mmv luc cell line was cultured in phenol red free cell culture medium. rga analysis was carried out in media containing dmem supplemented with 10% hormone depleted serum described in supplementary materials for methods on rga cell lines. table 1 illustrates the cytotoxicity results for the six sample extracts at the concentrations used in the four rga cell lines. the hair lotion (sample 1) induced cytotoxicity on the tm luc cells at 1/100 (15%) and 1/200 (10%) dilutions. one of the leave in conditioners (sample 2) showed dose dependent cytotoxic effects on all four cell lines, but was most potent in mmv luc cells, while the other leave in conditioner (sample 3) induced cytotoxicity in all four cell lines, but not monotonically. one of the hair oils (sample 4) showed cytotoxic effects in tm luc, tarm luc and tgrm luc cells, but not mmv luc cells. while the other hair oil (sample 6), showed the most cytotoxicity in mmv luc cells, as well as inducing cytotoxicity in the other 3 cell lines. the root stimulator (sample 5) induced the most potent toxicity in tarm luc cells of all six samples, but did not lead to cytotoxicity in either mmv luc or tm luc cell lines. bond elut: % toxicity of the six product sample extracts at 50, 100, 200 and 500 dilutions as assessed on the four rga cell lines by mtt assay. ‘ ’ indicates did not check dilution due to lack of toxicity at previous dilution the rga assays tested the estrogenic, androgenic, progestogenic, and glucocorticoid activity of extracted samples. dose response curves and ec50 values were calculated for the relevant steroid hormone standards for each assay: 17β estradiol (mmv luc), testosterone (tarm luc), progesterone (tm luc), and hydrocortisone (tgrm luc) (supplemental table 1, supplemental figure 1). percent recoveries from the bond elut extractions for each rga were 75 80% for estrogen, 75 80% for androgen, 60% for progestogen, and 100% for glucocorticoid (supplemental table 2). assay results are summarized by product in table 2 and are described in more detail below. we refer to hormonal activity as measured by luciferase activity induced in the cell line. the agonistic, antagonistic, and partial agonist activities of 1g of product presented as hormonal equivalent concentrations relative to their respective positive controls. abbreviations: eeq, estrogen equivalents of 17beta estradiol; teq, testosterone equivalents of testosterone; peq, progesterone equivalents of progesterone; geq, glucocorticoid equivalents of hydrocortisol the hair lotion, one of the leave in conditioners (sample 3), and the root stimulator presented agonist effects in the estrogen receptor assay. the hair lotion (sample 1) induced an estrogenic agonist response equivalent to 17beta estradiol at concentrations close to 12.5   20 ng/g of sample (figure 1). one of the leave in conditioners (sample 3) induced a partial agonist effect in the estrogen assay, but showed a reduced response when combined with the positive control 17beta estradiol (figure 1). the root stimulator (sample 5) induced agonist activity on its own that was equivalent to 17beta estradiol at a concentration close to 15 ng/g of sample, but elicited a much higher response when spiked hormone was added (figure 1), indicating a synergistic response in the mmv luc cells. the other leave in conditioner (sample 2) did not induce any change in the estrogen assay (figure 1). both hair oils (samples 4 & 6), did not induce estrogenic responses in the mmv luc cells, but appeared to be estrogen antagonists by lowering the response of spiked samples (figure 1). response of the a) sample 1 (hair lotion), 2 (leave in conditioner), 3 (leave in conditioner), and b) sample 4 (hair oil), 5 (root stimulator), 6 (hair oil) as assessed by the estrogen responsive mmv luc reporter gene cell line and compared with the negative control. nc, negative control; pc, positive control (0.5 ng/ml e2); a, spiked with positive control before extraction; b, spiked with positive control after extraction. the androgenic activity of samples was tested in the tarm luc cells. both leave in conditioners and hair oils showed antagonist activity in the androgen assay, blocking the action of free testosterone. additionally, both leave in conditioners and one of the hair oils (sample 6) induced strong antagonist activity in the androgen assay (figure 2). the other hair oil (sample 4) also showed an antagonist effect. neither the hair lotion nor the root stimulator showed an androgenic response (figure 2). response of the a) sample 1 (hair lotion), 2 (leave in conditioner), 3 (leave in conditioner), and b) sample 4 (hair oil), 5 (root stimulator), 6 (hair oil) as assessed by the androgen responsive tarm luc reporter gene cell line and compared with the negative control. nc, negative control; pc, positive control (2.9 ng/ml testosterone); a, spiked with positive control before extraction; b, spiked with positive control after extraction. figure 3 presents results for progesterone assays. both leave in conditioners, the hair lotion, and one of the hair oils (sample 4) induced antagonistic effects on the progesterone assays. for example, a leave in conditioner (sample 2) was able to block the action of progesterone at concentrations of 75 ng/g of sample (figure 3). in addition, this same leave in conditioner, as well as one of the hair oils (sample 4), showed partial agonist properties. an example of this was seen for this hair oil, which was able to induce a progesterone agonist response equivalent to progesterone at concentrations of 50 ng/g of sample (figure 3). response of the a) sample 1 (hair lotion), 2 (leave in conditioner), 3 (leave in conditioner), and b) sample 4 (hair oil), 5 (root stimulator), 6 (hair oil) as assessed by the androgen responsive tm luc reporter gene cell line and compared with the negative control. nc, negative control; pc, positive control (5 ng/ml progesterone); a, spiked with positive control before extraction; b, spiked with positive control after extraction. in the glucocorticoid assay, both leave in conditioners, as well as one hair oil (sample 4), and the root stimulator induced antagonistic effects (figure 4). both leave in conditioners showed blocking action of free hydrocortisone at 2000 2500 ng/g of sample (figure 4). one of the hair oils (sample 4) showed an antagonistic effect by blocking the free hydrocortisone response at 1500 2000 ng/g of sample (figure 4). the root stimulator lowered the action of free hydrocortisone at concentrations up to 500 ng/g of sample (figure 4). conversely, the other hair oil (sample 6) and the hair lotion did not induce responses on the glucocorticoid assay. response of the a) sample 1 (hair lotion), 2 (leave in conditioner), 3 (leave in conditioner), and b) sample 4 (hair oil), 5 (root stimulator), 6 (hair oil) as assessed by the androgen responsive tm luc reporter gene cell line and compared with the negative control. nc, negative control; pc, positive control (100 ng/ml cortisol); a, spiked with positive control before extraction; b, spiked with positive control after extraction. in this study of six leave in hair products commonly used by black women participating in the greater new york hair products study (2, 4), we found that all products elicited hormonal activity. in general, the type of hormone activity varied by product, with some displaying agonistic properties and others displaying both partial agonistic and antagonistic properties related to one or more of the hormone receptors. one of the leave in conditioners (sample 3) and one of the hair oils (sample 4), displayed hormonal activity on all 4 hormone assays, potentially indicating that use of these products may be of particular concern in relation to hormonally mediated disease. the hair lotion and root stimulator both displayed estrogenic activity, but did not show any androgenic activity, while all other samples acted as androgen antagonists. these findings suggest that products commonly used by black women may have hormonal activity when each product is considered as a chemical mixture. to our knowledge this is one of the first studies to evaluate the hormonal activity of multiple commonly used black leave in hair products. few studies have assessed chemical content of black hair products. one previous study by helm et al. using a greater number of hair products from the same study population found that all of the hair products tested contained endocrine disrupting and asthma associated chemicals (5). specifically, the study found that these commonly used hair products contained 45 edcs, including cyclosiloxanes, parabens, fragrance marker diethyl phthalate (dep), and nonylphenols (5). in an earlier study in the same population, 50% of black women reported using products containing hormones or placenta compared to only 7% of white women based on product label information (4). a separate study focusing more broadly on personal care products, found that a number of products, including the only tested hair product, displayed hormonal activity using a similar reporter gene assay model (19). our study suggests the need to further evaluate hormonal activity in personal care products, particularly those used by individuals with higher use and a higher risk of many hormonally mediated adverse health outcomes. studies show that hair products are very commonly used by black women, with reported usage of almost 100% for hair oils, >70% for hair lotions, and >50% for leave in conditioners (2, 4). these products are often applied to the hair and scalp and not washed out for days or weeks, allowing chemicals in the product to accumulate on the scalp and potentially enter the body transdermally through porous scalp tissue (39). a recent study by hsieh et al showed greater chemical exposure for leave in products (40), it is unclear whether the findings from this work can extend to other black hair care products. helm et al. identified the presence of diethyl phthalate and methyl and propyl parabens (5), which could suggest repeated and cumulative exposures to these chemicals from hair product use. worth noting, a biomonitoring study comprised of a representative sample of u.s. women participating in nhanes found that non hispanic black women had significantly higher concentrations of methyl paraben, propyl paraben, and mono ethyl phthalate a metabolite of di ethyl phthalate chemicals found in hair products (4, 41). previous work has shown that mixtures of certain edcs, such as phthalates, parabens, as well as uv filters can have additive anti androgenic properties (42) or additive estrogenic properties (43). in the present study, we found that the root stimulator had additive agonist properties with the estrogen receptor. we also found that all other products had anti androgenic properties. this is one of the first studies to look at progesterone and glucocorticoid properties of multiple leave in black hair care products, where each was evaluated as a mixture. in the present study, leave in conditioners and one of the hair oils had the highest degree of hormonal activity, with agonist properties for estrogen and progesterone and antagonist properties for androgen, progesterone, and glucocorticoid receptors. these findings suggest that leave in hair products could be particularly harmful. indeed, a recent study found that leave in products were a source of higher mono ethyl and mono benzyl phthalate exposure (40). as such, re formulation could potentially provide an opportunity for these leave in products to become safer and reduce exposure to hormonally active chemicals and associated health outcomes. while few studies have assessed the chemical content and hormonal activity of hair products for women in general and particularly for black women, studies of hair product use more broadly have shown associations with hormonally mediated conditions. for example, a previous study by our group involving the same study population found that hair oil use was associated with 40% odds of earlier age at menarche (2). in that study, associations with earlier age at menarche were stronger when hair oils were used for a longer duration of time. a separate study conducted by mcdonald et al. using the same study questionnaire found that hair oil use was associated with a 2 fold increased odds of reaching menarche before age 11 (41). products with estriol concentrations ranging from 9 to 24 mg/g are associated with premature development of secondary sexual characteristics and pre pubertal gynecomastia (19). furthermore, many of the chemicals found in these hair products(5) are linked to the disparate conditions of diabetes and obesity (44, 45). as such, more work is needed to determine whether exposure to hormonally active hair products might contribute to these persistent health disparities. the present study provides biologic plausibility for how exposure to higher levels of hair products might impact hormonally mediated disease by perturbing normal hormone activity through agonistic or antagonistic processes. for example, several of the hair products were either estrogen agonist or antagonist based on an assay for 17 beta estradiol. there are three physiologic forms of estrogen estrone, estradiol, and estriol each with different relative potency, with estradiol being the most potent (46). estrogen receptors (er) are involved in estrogen signaling pathways, both stimulatory and inhibitory, found in neuroendocrine, skeletal, adipogenesis, and cardiovascular systems. receptor activity is dependent on the two types of nuclear receptors, erα and erβ (21). furthermore, each tissue has a unique threshold at which estrogen may mediate physiologic versus pathophysiologic processes (47). because estrogen is related to several crucial pathways in the body, disruption in signaling can increase the risk of health conditions, such as breast and ovarian cancer (48, 49), as well as cardiovascular disease (50). likewise, androgen receptors mediate the activity of androgens such as testosterone and dihydrotestosterone with biological actions that include development and maintenance of reproductive, musculoskeletal, cardiovascular, and immune systems (22). glucocorticoid receptor (gr) activity is essential for regulating stress response. glucocorticoid signaling affects a variety of organs in the body with their anti inflammatory, anti proliferative, pro apoptotic, and anti angiogenic properties (51). an imbalance in the regulation of gr activity in the heart may result in cardiovascular disease and similarly, imbalance in the lungs may exacerbate respiratory disease (3). progesterone receptors (pr) with two common isoforms pr a and pr b, act as sensors for growth factor induced signaling and are involved in pro proliferative signaling in the breast and uterine quiescence during pregnancy (52). along with estrogen receptors, pr are crucial in the female reproductive system and disruption may lead to breast cancer, uterine disease, and preterm labor (23, 24). therefore, the present study’s findings may provide evidence for a group of hormonally active consumer products marketed to black women that could potentially explain part of the increased risk of hormonally mediated diseases linked to these specific hormones. related to disparate hormonally mediated health conditions, estrogen drives the pubertal transition in humans and is involved in breast cancer and is comparatively a stronger estrogen than estriol (53). black girls reach menarche earlier (8) and black women have a higher mortality due to breast cancer, often due to a higher incidence of a subtype of the disease that is less responsive to hormone therapy treatment (54). considering data evaluating hair products and these conditions, two studies found associations between hair products (e.g. hair dyes and relaxers) with an increased breast cancer risk (55, 56). in the present study, it is worth noting that while three of the products showed estrogen agonist properties, one of these 3 along with two others showed estrogen antagonist properties. these antagonist properties countered our original hypothesis, but could also have biological effects in women, including hot flashes (57) and weight gain (58). future work is needed to understand the full scope by which these hormonally active consumer products might impact health and health disparities. it is important to note that product regulation in the united states is less strict than in other settings. for example, chemicals commonly used in personal care products in the united states have been banned in the european union (59). some u.s. states, such as california, require warning information on products containing certain hormone altering chemicals, including benzophenone, bisphenol a, and nonylphenol under proposition 65 (5). however, due to u.s. federal exemptions for the labeling of incidental chemicals, some of these chemicals of concern do not appear on the product label, including fragrance ingredients such as phthalates (5, 37). yet, these chemicals separately and potentially as a mixture could have important health implications, especially for populations that are more likely to frequently use these products. based on the present findings of hormonal activity of these hair products and previous work showing that these chemicals are present in hair products, future work is needed to help provide a better understanding of how these policies may impact the development of safer products, with implications on edc exposure reduction and potential decreases in edc associated adverse health outcomes. this study has several limitations. first, we tested a small number of hair products identified as being commonly used from a study conducted in 2004 2006. hair products and their formulations have changed over time. however, this previous study was the first to collect information on black hair care product use, including details on product brand, type, and frequency of use (2, 4). interestingly, more recent data still ranks some of these hair products within the top 20 products more commonly used by this demographic (60). that said, differences in formulations may have occurred over time, which could impact the hormonal activity of these products. second, the hair products were quite toxic to the cell lines. however, we were able to improve the assays by adding an additional pre treatment step to reduce contaminant toxicity. third, this was an exposure assessment study to evaluate hormonal activity of hair products as product specific mixtures. we are uncertain as to what specific ingredient may be driving the particular activity seen, as the product formulations may have changed since our laboratory analysis was conducted. future work will need to evaluate both the individual components, as well as the mixture, to identify the most biologically active ingredients, or combination of ingredients, to help identify safer replacements. additionally, the focus of this study was to evaluate hair products commonly used by black women and not the full breadth of personal care products. while women use multiple personal care products at any given period, hair products are a particularly prevalent personal care product used by black women and have been understudied with respect to their content and biological activity. finally, while we measured different types of hair products, we only evaluated this in 6 different specific brands of hair products. thus, this study’s findings may not be generalizable to other brands of hair products; instead, this should provide rationale for further study of hair and other products that may be more commonly used by black women and other groups with higher exposure concentrations to personal care product chemicals. despite these limitations, our study has several notable strengths. first, this is one of the first studies to evaluate the hormonal activity of commonly used leave in black hair products assessed as mixtures. while data suggests that black women may have higher body burdens of certain edcs (6, 7), as well as higher prevalence of health conditions linked to these chemicals, few studies have looked at hair products to evaluate whether they could have biological activity. second, we measured different types of hair products, including hair oils, leave in conditioners, lotions, and root stimulators. while all hair products tested had hormonal activity, patterns differed by product and type. third, this study provides novel data on the biological plausibility for how chemicals found in hair products may act together to alter hormonally mediated diseases, including those that are racially/ethnically disparate. in the present study we found that commonly used hair products are hormonally active, with impacts on the estrogen, androgen, progesterone, and glucocorticoid receptors, providing critical information for understanding how leave in hair products as a mixture could have a biological effect and potentially affect hormonally mediated disease risk. previous findings from this same study population have shown that these products contain di ethyl phthalate and parabens, chemicals known to be hormonally active (5). given that hormonal activity of consumer products could contribute to disparities in related disease risk, re formulation of these products could aid in reducing the disparity in exposure and associated health outcomes in black women. further work is needed to understand how these products may act as a source of disparate environmental chemical exposures and the resulting implications for adverse health outcomes in black women. this study was funded in part by the march of dimes, the american diabetes association minority postdoctoral fellowship, and the national institutes of health (r01es026166, t32es007069, and black women’s health study r01ca058420). we would like to acknowledge erika rodriguez and victoria fruh for facilitating parts of this work. conflict of interest: the authors declare no conflicts of interest. this section collects any data citations, data availability statements, or supplementary materials included in this article. connect with nlm national library of medicine 8600 rockville pike bethesda, md 20894

switch to dark mode to head towards a more sustainable world together. more info switch to dark mode to head towards a more sustainable world together. more info science has a diversity problem. black people, women, and those from lower socio economic backgrounds are all under represented in the scientific workforce   and in medical innovation. to combat this, biotech companies, like gsk, are funding initiatives to ensure the best and brightest individuals have the tools they need to pursue careers in science, technology, engineering and maths (stem). boosting diversity in all its forms has been shown to be good for science   and good for business. teams composed of people with different perspectives, backgrounds and experiences are better at problem solving, and companies with more diverse teams and leadership perform better than more homogenous ones. “all the evidence suggests that diverse teams perform better,” says clare griffin, vp, responsible business at gsk. “science is a field where you need new ways of looking at problems   and diverse teams of people with diverse perspectives are best placed to do this.” the benefits of science tend to flow to the groups who conduct it. the historical dominance of white men in research has led to inadvertent biases in clinical data and drugs that are less effective in women or people from certain ethnic backgrounds. read related behind the science magazine "having a diverse scientific community within our company can better serve and understand the needs of the diverse patients that we're here to provide health solutions for," griffin adds. however, there are several socio economic factors that hold young people back from achieving success in stem, ultimately limiting the value they could bring to innovation in the future. this is why some companies, like gsk, are focused on helping to reduce barriers faced by women and young girls, people from lower socio economic backgrounds and black communities trying to access stem careers. in standardised international tests, girls aged 15 and 16 match or outperform their male peers (pdf   4.1mb) in science and maths. yet when those girls reach university age, many opt out of stem subjects. in the u.s., just a quarter of undergraduate degrees in mathematics, computer science and engineering were awarded to women. the erosion of women in science becomes more pronounced as they enter the workforce. female students are less likely to remain in the stem field than their male counterparts. in the us, women represent around one third of the stem workforce, according to the national science foundation. in the uk, women make up just over a quarter of those in stem industries, with the biggest disparities in engineering and computer science. social conditioning, a lack of role models and insufficient support from teachers, parents and employers can all cause girls to lose confidence in their ability to do science, says anne marie imafidon, ceo of stemettes, an organisation that inspires and connects girls, young women and nonbinary young people with stem and steam (where the a stands for arts) careers and role models. “it’s a multifaceted problem that requires a multifaceted solution,” she says. the good news is, there is a growing body of evidence to show these factors can be countered with tools such as mentoring. at the university of massachusetts, for example, female engineering majors who were assigned a female mentor in their first year were more likely to pursue postgraduate opportunities than those assigned a male mentor, or no mentor. “we match young people with a trusted advisor to discuss their concerns, ambitions, strengths and weaknesses,” says imafidon. mentors also help mentees apply for roles, awards or other opportunities, often tapping into their own networks for further insights. “it’s about opening the eyes of young people to know they’ve got options.” in britain, the u.s. and many other places, black and hispanic people are more likely to drop out of science and engineering degrees than their white and asian counterparts. those that do complete their degrees are less likely to stay in the stem field. that attrition impoverishes science: research papers with greater ethnic diversity among their authors have a higher scientific impact than those produced by more ethnically homogenous groups. discrimination, a lack of role models and inadequate encouragement for young black students are all factors that push them away from stem. but there are also proven ways to attract, and keep, black researchers in science. participants in the renowned meyerhoff scholars program at the university of maryland who receive dedicated mentors, study groups and added support were around five times more likely to complete a phd in a stem subject than peers with similar abilities. “you can’t be what you can’t see,” says lamont terrell, diversity, equity and inclusion lead, r&d at gsk. “if we can increase the number of individuals they see that look like them, it’s more likely they’ll continue in their path.” every year, gsk supplies mentors, and provides work experience and sponsorship for students at historically black college and universities and hispanic serving institutions in the u.s. such as morehouse school of medicine and howard university. “the impact happens when you couple that financial support with the mentoring,” dr terrell adds. “that’s where the magic happens.” among 11 year old children in england, just 59% of those from disadvantaged socio economic backgrounds meet expectations in maths, compared with 79% for other pupils. at age 16, their uptake and attainment in biology, chemistry and physics is lower. similar dynamics are evidenced in australia, the u.s. and many other places. covid 19 lockdowns and school closures exacerbated those attainment gaps. this disparity is denying hundreds of thousands of children the opportunity to pursue well paid careers in stem, and further exacerbating socio economic inequalities. it also means that the talents of these children   with their potential to eventually tackle problems in health, climate change, engineering and more   are being wasted. small interventions can make a big difference. research in the uk found that young people who’d encountered employers while at school were more likely to earn more later in life (pdf   211kb). widening the networks of young people to include those from professional backgrounds gives them confidence to pursue careers they would not have otherwise considered. evidence about the benefits of mentoring is already well stablished   and is backed up by independent research commissioned by gsk in the uk. the study found that mentoring improves the grades of under represented high school students, enabling more of them to attend elite, research oriented universities, and to earn higher figure incomes when they graduate. gsk is investing £6m in the uk over the next ten years to help reduce the barriers to entry in stem careers faced by women and young girls, people from lower socio economic backgrounds and black communities. this figure is on top of gsk’s 10 year $10 million commitment to increase the number of black, latinx and women philadelphians entering stem careers by 2030. the aim: to inspire and support the next generation of diverse innovators and unlock untapped talent so scientific teams are better equipped to push forward meaningful innovations. “gsk has spent many years investing in science programmes that reach young people, but we are now focussing on high impact mentoring programmes that inspire young people from under represented groups to stay with stem subjects, and support them to continue into a stem career,” griffin says. to do this, gsk is partnering with several mentoring organisations, including stem learning; stemettes; covent garden dragon hall trust; the association for black and minority ethnic engineers and spark!, where high quality one to one relationships are developed with young people and skilled mentors who share tools and guidance to help personal and professional development. “we ultimately believe that we can’t discover and develop the ground breaking medicines and vaccines that the world needs unless we’ve got the best talent,” griffin concludes. “and that means getting highly talented individuals with a wide range of skills and backgrounds.” back to school immunity: vaccination catch ups are needed to stop the escalation of preventable diseases in children ‘ai has already transformed medical innovation. let’s not let fears of technology stop us from realising its incredible potential’ ‘teenagers may feel invincible   but we’re at risk’: what you need to know about meningitis as post covid cases continue to rebound this is our global website, intended for visitors seeking information on gsk's worldwide business. our market sites can be reached by visiting our location selector. © 2001 2024 gsk plc. all rights reserved. trade marks are owned by or licensed to the gsk group of companies. gsk plc. registered in england and wales no. 3888792. registered office: 79 new oxford street, london. united kingdom. wc1a 1dg

discover a faster, simpler path to publishing in a high quality journal. plos one promises fair, rigorous peer review, broad scope, and wide readership   a perfect fit for your research every time. learn more submit now click through the plos taxonomy to find articles in your field. for more information about plos subject areas, click here. loading metrics open access peer reviewed research article contributed equally to this work with: dede teteh, marissa ericson, lenna dawkins moultin, susanne montgomery roles data curation, investigation, methodology, project administration, writing   original draft, writing   review & editing * e mail: dteteh@coh.org affiliation department of population sciences, division of health equities, city of hope comprehensive cancer center, duarte, california, united states of america http://orcid.org/0000 0001 9552 148x contributed equally to this work with: dede teteh, marissa ericson, lenna dawkins moultin, susanne montgomery roles conceptualization, data curation, formal analysis, methodology, software, validation, writing   original draft, writing   review & editing affiliation department of psychology, university of southern california, los angeles, california, united states of america roles writing   original draft ¶‡ these authors also contributed equally to this work. affiliation school of behavioral health, loma linda university, loma linda, california, united states of america contributed equally to this work with: dede teteh, marissa ericson, lenna dawkins moultin, susanne montgomery roles conceptualization, writing   original draft, writing   review & editing affiliation department of population sciences, division of health equities, city of hope comprehensive cancer center, duarte, california, united states of america roles writing   original draft, writing   review & editing ¶‡ these authors also contributed equally to this work. affiliation department of health sciences, california state university northridge, northridge, california, united states of america roles funding acquisition, investigation, project administration, resources, writing   review & editing ¶‡ these authors also contributed equally to this work. affiliation healthy heritage movement, riverside, california, united states of america roles funding acquisition, investigation, project administration, resources, writing   review & editing ¶‡ these authors also contributed equally to this work. affiliation quinn community outreach corporation, moreno valley, california, united states of america roles writing   review & editing ¶‡ these authors also contributed equally to this work. affiliation department of population sciences, division of health equities, city of hope comprehensive cancer center, duarte, california, united states of america roles writing   original draft, writing   review & editing ¶‡ these authors also contributed equally to this work. affiliation rutgers school of public health and cancer institute of new jersey, piscataway, new jersey, united states of america roles writing   review & editing ¶‡ these authors also contributed equally to this work. affiliation department of population sciences, division of health equities, city of hope comprehensive cancer center, duarte, california, united states of america contributed equally to this work with: dede teteh, marissa ericson, lenna dawkins moultin, susanne montgomery roles conceptualization, data curation, funding acquisition, methodology, resources, supervision, writing   review & editing affiliation school of behavioral health, loma linda university, loma linda, california, united states of america across the african diaspora, hair is synonymous with identity. as such, black women use a variety of hair products, which often contain more endocrine disrupting chemicals than products used by women of other races. an emerging body of research is linking chemicals in hair products to breast cancer, but there is no validated instrument that measures constructs related to hair, identity, and breast health. the objective of this study was to develop and validate the black identity, hair product use, and breast cancer scale (bhbs) in a diverse sample of black women to measure the social and cultural constructs associated with black women’s hair product use and perceived breast cancer risk. participants completed a 27 item scale that queried perceptions of identity, hair products, and breast cancer risk. principal component analyses (pca) were conducted to establish the underlying component structures, and confirmatory factor analysis (cfa) was used to determine model fit. participants (n = 185) were african american (73%), african, and caribbean black women (27%) aged 29 to 64. pca yielded two components that accounted for 61% of total variance. five items measuring sociocultural perspectives about hair and identity loaded on subscale 1 and accounted for 32% of total variance (α = 0.82; 95% ci = 0.77 0.86). six items assessing perceived breast cancer risk related to hair product use loaded on subscale 2 and accounted for 29% of total variance (α = 0.82 (95% ci = 0.74 0.86). cfa confirmed the two component structure (root mean square error of approximation = 0.03; comparative fit index = 0.91; tucker lewis index = 0.88). the bhbs is a valid measure of social and cultural constructs associated with black women’s hair product use and perceived breast cancer risk. this scale is useful for studies that assess cultural norms in the context of breast cancer risk for black women. citation: teteh d, ericson m, monice s, dawkins moultin l, bahadorani n, clark p, et al. (2019) the black identity, hair product use, and breast cancer scale. plos one 14(12): e0225305. https://doi.org/10.1371/journal.pone.0225305 editor: cheng shi shiu, university of california los angeles, united states received: march 27, 2019; accepted: october 31, 2019; published: december 4, 2019 copyright: © 2019 teteh et al. this is an open access article distributed under the terms of the creative commons attribution license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. data availability: data underlying the study are available on the harvard dataverse (doi: https://doi.org/10.7910/dvn/anfkzu). funding: pc, em, sm received grant number: 19ab 2100 from the california breast cancer research program of the university of california, http://www.cbcrp.org/. the funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. competing interests: the authors have declared that no competing interests exist. breast cancer remains the second leading cause of death in the united states among women [1, 2], with black women being particularly vulnerable [3]. recent reports indicate that while the incidence rates of breast cancer in black and white women have converged [4], mortality rates among black women are at least 40% higher than their white counterparts [3]. furthermore, black women are more likely to be diagnosed with and die from more aggressive forms of breast cancer than white women who are more often diagnosed at earlier stages [5]. research on cancer disparities has not been able to conclusively explain black women’s elevated risk of breast cancer mortality or their more aggressive phenotypes, but differences in prognosis and etiology have been correlated with race [6], genetics [7], lifestyle and behavioral factors [8], and environmental exposures [9]. one environmental factor that has been gaining increasing attention in breast cancer research is hair and personal care products [9 11]. a growing body of literature [9 14] supports an association between use of some hair care products (e.g., hair dyes, relaxers, and deep conditioners) and breast cancer risk. data from animal models [15 17] suggest exposures to compounds found in some hair products, particularly those containing endocrine disrupting chemicals (edcs) and chemicals with mutagenic properties, may be important etiologic risk factors for several human cancers, including breast cancer. stiel and colleagues’ review of hair product use and breast cancer risk included research on environmental estrogen, edcs, and placenta derived ingredients found in hair products used primarily by african american women. the authors concluded there is significant evidence to support the role of hair product use in the risk of early onset breast cancer in black women. in addition, myers et al. [14] assessed ethanol extracts of eight personal care products frequently used by african americans for estrogenic and anti estrogenic activity in a human breast cancer cell line. they detected estrogenic activity in oil, hair lotion, extra dry skin lotion, intensive skin lotion, and petroleum jelly, and anti estrogenic activity in placenta hair conditioner, tea tree hair conditioner, and cocoa butter skin cream. the authors concluded some hair and skin care products have ingredients that can mimic estrogen functioning. llanos and colleagues [11] also examined the association between breast cancer risk and use of hair dye, chemical relaxers, and deep conditioners in a sample of african american and white women. they found, among the dark hair dye shades, african american use was associated with increased breast cancer risk (or = 1.51, 95% ci: 1.20 1.90). despite the mounting evidence of possible health risk, hair products remain popular in the black community [10, 11, 18]. compared to white women, black women invest more money on hair products [19], are more likely to use relaxers and deep conditioners, and use them at younger ages [11, 18]. as a result, black women are more likely to be exposed to hormonally active chemicals in hair products across their lifespan, potentially increasing their risk for developing breast cancer [18]. the literature on black women’s attitude to their hair offers mixed explanations for the popularity of hair care products in black communities. some scholars suggest hair across the african diaspora is synonymous with identity, individuality, and beauty norms [20, 21]. for many black women, maintaining hair with sculpting and straightening products is an extension of self and a way to achieve social acceptance [21, 22]. alternatively, scholars such as johnson and bankhead challenge the notion that straight hair represents an ideal form of beauty and is connected to social acceptance [22]. they argue that wearing hair in its natural state is the “new normal” that celebrates black identity and pride. but even products designed for natural black hair have been found to contain potentially harmful ingredients [23]. so, whether black women choose to chemically alter their hair or keep it in its natural state, they are overexposed to hair products containing endocrine disrupting and other toxic chemicals many of which are not listed on product labels as they are usually listed generically as fragrances [10, 24]. there is a gap in our understanding of how these environmental, sociocultural, and biological factors converge and impact breast cancer risk and outcomes among black women. currently, there is no validated scale that measures constructs related to hair, identity, and breast health. instruments have been developed to measure related but general issues, such as social and personal identity [25], health beliefs [26], and perceptions of health risks [27]. however, none of these instruments capture the constructs that emerge at the intersection of social, cultural, and health related factors. having a validated tool that measure these latent structures will provide a more comprehensive understanding of black women’s breast cancer risk. the purpose of this study was to validate the black identity, hair product use, and breast cancer scale (bhbs) in a diverse sample of black women to provide a measure that captures the sociocultural factors related to perceived breast cancer risk and hair product use. this study was part of a broader project that used a mixed method design and community based participatory research (cbpr) principles to evaluate the association between hair products use and perceived breast cancer risk among black women in southern california. the study was conducted in two phases: a qualitative phase followed by a quantitative phase. findings from the qualitative phase were used to inform quantitative data collection. this design is particularly useful for developing a new scale [28]. the project was conducted by three co investigators one from an academic institution and two from african american community organizations. the original research questions were developed by community stakeholders who were concerned about the growing number of breast cancer diagnoses in their region. to ensure all research activities were within ethical guidelines, an application detailing the project was submitted and approved by the loma university institutional review board (irb). every participant provided written informed consent. all individuals involved with data collection were certified (staff and community research navigators, aka navigators) in research ethics using an irb approved curriculum developed specifically for cbpr data collection [29]. recruitment for the broader study took place in two stages. in stage 1, we used purposive sampling to recruit participants (n = 125) who self identified as african american, african, or afro caribbean. in stage 2, we used snowball and convenience sampling to recruit african american, african, or afro caribbean men (n = 66) and women (n = 211). the social networks of the two community co principal investigators agencies were used to recruit participants. for both stages, participants were primarily recruited face to face at churches, hair salons, community meetings, women’s conferences, hair and education showcases, and other areas where the target population congregated. also, flyers were posted in these settings and emailed to listservs of the community investigators. for stage 1, participants received $20 in the form of store cards (e.g. target; food 4 less). participants were not compensated for their participation in stage 2 of the study. for both stages, data were collected in churches, beauty salons, and community meetings. the analysis described in this paper includes only black women with or without a history of breast cancer (n = 185). women were excluded from the study if they did not self identify as african american, african, or afro caribbean. in phase 1 of the study, we explored the cultural and personal meaning of hair in the black community. interview questions were developed by participant type (i.e., women with and without a history of breast cancer and their male partners, hair stylists, and salon owners) [30]. questions were piloted, and modified based on participants and community navigator feedback. interviews were audiotaped, and field notes drafted after focus group and key informant interviews. navigators were trained in basic qualitative and quantitative research approaches including the development of semi structured interview guides, interviewing skills, the codebook development for qualitative data analysis, and research team trainings on how to use qda miner a qualitative data analysis software [31] that was used for data analyses. navigators held credentials ranging from high school to master’s level education. at the time of the study, navigators were part time employees of the two community organizations of the project. some navigators were retired, while others were full time doctoral students at local universities. navigators were also predominantly female, but one male navigator completed the interviews with male participants. only participants, navigators, and co principal investigators were present during data collection. to achieve triangulation, the navigators used a common semi structured interview guide[32] adjusted to the target audience to conduct key informant interviews and focus groups. target groups included women with and without a history of breast cancer, their male partners, hair stylists, and salon owners. while the interviews explored perceptions of the causes of breast cancer, participants’ relationship with hair and hair product use, and perceptions of the potential harmfulness of hair care products, the focus groups were used for validation and member checking. navigators were not blinded to participants’ breast cancer diagnoses. data were collected in 2013 through early 2014. interviews and focus groups were audio recorded and transcribed verbatim to maintain accuracy. we used qda miner to code and analyze the transcripts using a grounded theory approach [33]. following open coding, preliminary results were presented to the navigators, discussed with the research team, and organized into related concepts or themes that were used to inform the quantitative instrument development. the study team engaged in thoughtful deliberations to resolve theme disagreements. transcripts were not returned to participants for comments and corrections although participant feedback was obtained during the focus groups. the most prominent themes were the critical role of hair for black women; the relevance of the project to the community; and the notion that “everything causes cancer”, so why change [20]. after the themes from the qualitative results were identified, the investigator from the academic institution guided the community navigators in a series of discussions that resulted in the development of questionnaire items. items were grouped into two categories:1) perceived risk, knowledge, and attitudes about black hair and breast cancer (8 items); and 2) perceptions about hair and black culture (19 items). questions pertaining to perceived risk, knowledge, and attitudes about black hair and breast cancer included items such as “all black women should worry about the ingredients in hair products”; and “because of breast cancer, i intend to watch the ingredients of the products i will use”. questions pertaining to perceptions about hair and black culture explored beliefs about black hair in the workplace, hair product use, and cultural and personal attitudes related to hairstyles. items included “hair has a special role in black culture”; “my hair is a cultural reflection of who i am”; and “i do not care how much i spend on hair products.” for all questions, the likert scale response options were strongly disagree, disagree, agree, and strongly agree. the 27 item scale discussed here was one component of a larger 42 item survey instrument. other questions explored respondent’s lifestyle, health behaviors, bc knowledge, demographics, and family medical history. questions were reviewed for clarity among the research team and pilot tested prior to their use in the final survey. in phase 2, navigators used the 42 item questionnaire developed in phase 1 to collect data in settings previously mentioned. each questionnaire took approximately 30 45 minutes to complete and the majority (approximately 98%) were completed in person. those that were not completed in person were submitted electronically or via postal mail. data were collected from 2015 through 2016. education level was assessed using the question: “what is the highest level of education you have completed?” response options were: some high school, high school diploma (or equivalent), some college, college degree, graduate degree, and professional certification (cosmetology, etc.). age was denoted in years. household income question was: “please check the range of income that is closest to your own:” with the following response options: less than $25,000; $26,000 $50,000; $51,000 $75,000; $76,000 $100,000; $100,000 $150,000 and more than $151,000. insurance status was assessed using the question: “do you have health insurance?” with response options yes or no. birth place was determined using the question: “were you born in the united states?” with response options yes or no. the question, “have you been diagnosed with cancer?” with response options yes or no, was used to assess diagnosis status. family history of breast cancer was determined using the question: “have any of your family members been diagnosed with breast cancer?” with response options yes or no. the question “have you ever had a mammogram?” was used to assess participant breast cancer screening history with response options yes or no. product use information was obtained using the question “how often do you use the following products?” product types included wash out conditioner, leave in conditioner, relaxer from salon, do it yourself relaxer, detangler, damaged hair treatment (i.e. hair mayonnaise), do it yourself hair dye kits, and professional hair coloring. response options included 1) several times a week, 2) daily, 3) several times a month, 4) several times a year, 5) used to/stopped using and 6) never used it. response options 1 5 were recategorized as yes for product use and response option 6 was recategorized as no for product use in analyses. in order to examine the underlying structure and dimensions of identity, hair products use, and perceived breast cancer risk, a principal component analysis (pca) was conducted using spss 24.0 [34]. as this is the first analysis of its kind to examine the cultural influence of hair product use among black women, several model fitting techniques were tested, including both orthogonal and oblique rotations. an oblique rotation (e.g. promax) allows components to be intercorrelated, while an orthogonal rotation (e.g. varimax) minimizes the number of variables with high loadings and simplifies the solution [35]. as a significant dearth of similar validation studies exists in the literature and thus no factor analytic studies with which to compare we examined several exploratory models during this first analysis phase, including both promax and varimax rotations. several criteria were used to examine the number and combination of items in each component, including horn’s parallel analysis[36], a scree plot of eigenvalues[37], kaiser criterion[38], and factor loadings[39]. the criterion cutoff was set at ±0.35 for the item loadings. based on this criterion, each item loaded most highly on one of two distinct components, with many items loading poorly (<±0.20) on additional components. the poorly loaded items were dropped and models were re assessed each time by calculating inter item reliability of the items for each component based on cronbach’s alpha (α), which indexes internal scale consistency or the extent to which a scale measures an underlying construct [40, 41]. confirmatory factor analyses (cfa) were performed using mplus software [42] to determine the factor solution that best explains the black identity, hair product use, and breast cancer scale. based on the initial pca results, including the criteria as outlined above, two and three factor solutions were examined and compared to one another. goodness of fit was determined by several indices: chi square (χ2), akaike’s information criterion (aic), root mean square error of approximation (rmsea) of <0.10, comparative fit index cfi of >0.90, and tucker lewis index (tli) of >.90 [43 45]. the χ2 assess overall fit and the discrepancy between the sample and fitted covariance matrices. in addition to the χ2 test, the aic is compared for each fitted model[46]. the aic is a widely used index of fit, such that smaller aic values are indicative of the most parsimonious and well fitting model. the final analytic sample (n = 185) was comprised of 73% african american and 27% caribbean and african black women aged 29 to 64 years (table 1). participants were highly educated with over 50% of participants having a college or a more advanced degree. in addition, most participants reported use of hair products. overall, participants reported using wash out conditioner (89.7%), leave in conditioner (83.8%), relaxer (70.8%), do it yourself relaxer (58.4%), detangler (63.2%), treatment for damaged hair(64.3), do it yourself hair dye kits(50.8%), and professional hair coloring(55.1%). https://doi.org/10.1371/journal.pone.0225305.t001 we examined the factor structure of the 27 items with an aim to better understand the structure and dimensionality of identity, perceived risk, and attitude regarding black hair and perceived breast cancer risk. according to fit criteria, pca with varimax rotation yielded two distinct components that accounted for 61% of the total variance, with 11 of the 27 items loading highly on these two unique components. a parallel analysis also indicated a two component solution, though 1 component and 3 component solutions were also examined in subsequent cfa[36]. the remaining 16 items were dropped due to poor fit (<±0.35), which led to an improvement in internal scale consistency. table 2 presents the means, standard deviations, skewness and kurtosis for the initial 27 items, fig 1 presents factor loadings for the 11 items, and table 3 presents loadings from pca for two extracted subscales. (s1, subscale 1): sociocultural perspective about hair and identity. (s2, subscale 2): perceived breast cancer risk related to hair product use. athe interrelationship between s1 and s2. https://doi.org/10.1371/journal.pone.0225305.g001 https://doi.org/10.1371/journal.pone.0225305.t002 https://doi.org/10.1371/journal.pone.0225305.t003 the first component, which consisted of five items representing sociocultural perspective about hair and identity, accounted for 32% of the total variance and demonstrated robust reliability (α = 0.82, ci = 0.77 0.86). the second component accounted for an additional 29% of the total variance and consisted of six items that measure perceived breast cancer risk related to hair product use. cronbach’s alpha for the six item subscale was 0.82 (ci = 0.74 0.86). cfa confirmed a two component model fit the data according to fit statistics for these 11 items (χ2 = 87.225, p value = <01; aic = 4219.615; rmsea = 0.07; cfi = 0.91; tli = 0.88). both one component (χ2 = 165.162, p value < .01; aic = 4295.552; rmsea = 0.13; cfi = 0.75; tli = 0.69) and three component models (χ2 = 160.926, p value = < .01; aic = 4297.316; rmsea = 0.13; cfi = 0.76; tli = 0.66) were also tested but neither fit the data well according to the fit criteria. the interrelationship between the two confirmed subscales was 0.03 (not significant), demonstrating that each subscale represents a distinct component with no significant intercorrelation at the higher order level. given the patterns in both pca and cfa, we concluded that two subscales were represent in these 11 questions: s1. sociocultural perspective about hair and identity, and s2. perceived breast cancer risk related to hair product use. the black identity, hair product use, and breast cancer scale (bhbs) composed of 2 subscales and 11 items, was validated in this study using the methodology utilized in psychometry[35, 37, 40, 41]. to our knowledge, the bhbs is the first scale that evaluates the sociocultural factors related to perceived breast cancer risk and hair product use. two distinct subscales were uncovered that measure the underlying components of the cultural influence of hair product use among black women. subscale 1, sociocultural perspective about hair and identity, consists of five items representing a sociocultural perspective regarding hair and identity with items like “q3. in order to be successful in business, it is a necessary for black women to have their hair straight” and “q7. black women feel pressure from their partners to straighten their hair.” this component reflects a distinct dimension that measures hair and identity constructs. subscale 2, perceived breast cancer risk related to hair product use is comprised of six items that assess perceptions of risk associated with hair products. items that loaded highly on this distinct component included questions like “q24 because i am concerned about breast cancer, i intend to watch the ingredients of the products i will use” and “q25 all black women should worry about the ingredients in hair products”. these reflect a dimension that measures perceived risk and product usage specifically. both dimensions were found to describe these data, with additional dimensions (e.g. 3 subscale model) leading to degradation in fit. importantly, the initial pca model fitting also revealed that more than one component was required to describe the structure of these data. this specifically showed that two components are needed because each reflects a distinct construct that assesses different underlying mechanisms and perceptions. furthermore, the topic of hair in the black community has always represented varying degrees of prominence, ranging from politically charged euphemism to exhortation of african pride [20 22]. therefore, it comes as no surprise that black women invest millions of dollars on products that craft their projection of identity to society [19]. according to cultural norms, black women have to spend time on their hair [20]. this affects not only their personal life, but also how they are perceived professionally. since hair carries such strong political and sociocultural meanings in the black community [20, 23], research on hair products and breast cancer must also consider issues of identity and the trade off between perceptions of risk and ideals of beauty. this newly developed black identity, hair product use, and breast cancer scale (bhbs) provides a validated instrument that can be used to help untangle these complexities. overall, this scale acknowledges that both perceived health risk associated with hair products and the sociocultural significance of hair are critical to black women. culture is often regarded as the defining element of an individual’s actions that reflects their beliefs, attitudes, and normative behavioral patterns [47]. this study adds to the hair health literature by emphasizing the critical importance of recognizing beliefs and attitudes in research on breast cancer and hair product use in black communities. we hope that the bhbs will help increase our understanding of the interplay between identity, health, and behavioral intentions for black women, since it provides targeted questions that measure women’s perceptions regarding breast health and identity. with the increasing prominence of research on black hair and breast health it is critical to take these issues into account. it is also important to note that our women acknowledged both a socio cultural perspective as well as a breast cancer risk perspective in their responses. as the discussion about hair product risk for breast health matures we need to measure and then weigh both, as both clearly affect women’s perspective on the issue. moreover, since perception precedes and influences behavior, this scale has utility for community based interventions aimed at promoting healthier hair care alternatives. through the parent study, for example, stylists and salon owners expressed interest in learning about less harmful products to use on their clients’ hair. this scale can capture data that may help researchers and community based organizations gauge community members’ willingness to adopt safer products as the field is moving from exploration of risk for breast cancer to community based prevention education. while awareness on the potential hazards of hair and personal care products is increasing, interventions geared towards minimizing risk and exposure should be developed in parallel. it was only 80 years ago (1940s/1950s) that studies from animal experiments, chemical analyses, and epidemiology concluded that cigarettes were the cause of lung cancer [48]. despite the substantial evidence, only one third of u.s. doctors up until the 1960s believed this conclusion, potentially due to propaganda by the tobacco industry to salvage cigarette sales. as a result, an estimated 6 trillion cigarettes smoked in 1990 caused about 6 million deaths in 2015 (one death/5 seconds). comparably, with increasing evidence pointing to a risk connection between the use of hair products and risk for breast cancer in black women, to wait until definitive evidence is provided on the health consequences of hair and personal care products before intervening, would be irresponsible and potentially detrimental to communities of color. in particular, as exposure to these hazardous chemicals is substantially higher in these communities than other groups and occurs as early as in utero. there are several limitations that should be considered in the interpretation of findings from this study, including the relatively small group of participants. we also lack participation of a larger group of women with a history of breast cancer. it is recommended for future studies, that women with breast cancer represent a larger percentage of the sample. as many people experience hair loss when receiving treatment for breast cancer [32], a question for this group of black women is how they continue to relate to a culture that places so much value on hair? another limitation is inherent to a study of this nature in which a new scale is created, evaluated, and validated. while the methodological design follows a common data analytic path, there are no other studies with which to compare our results. therefore, future studies that will use the scale are warranted to examine not only the structure and subscales further, but also examine the scale’s impact in explaining decision making to reduce risk. in addition, it is important to acknowledge that our sample size lacked sufficient power to analyze the pca and cfa with different samples. though it is common in the literature overall[49], future studies should seek to have larger samples and further investigate the scale in a split sample. furthermore, our study population lacked socioeconomic (e.g., employment status, education) diversity, our instrument did not include questions about breast cancer type and our focus on only black women in southern california limits the generalizability of our findings. while the findings of this study are limited by the issues stated above, there is currently no scale examining the relationship between hair, identity and perceived breast cancer risk. as research in the hair health discipline continues to expand, social/behavioral and basic scientists may benefit from use of this tool. black women continue to be diagnosed and die from more aggressive forms of breast cancer than white women [5]. there is growing interest in more fully understanding how environmental exposure to chemicals in hair and personal care products is associated with breast health among black women [9 11, 14]. this has resulted in a surge of social/behavioral and basic science research studies that are raising awareness about the potential risks of hair and other beauty products in the black community. for instance, myer’s et al. findings suggest off the shelf hair and skin care products can have estrogenic and anti estrogenic properties [14]. helm and colleagues’ recent study suggests the products used by black women have higher levels of chemicals not reported on the labels. these chemicals are regulated by california’s proposition 65 or prohibited by european union cosmetic regulations [10], but minimally regulated by the food and drug administration. the products have also been found to exhibit estrogenic properties that could increase the risk of cancer for the consumer. similarly, breast cancer prevention partners recently reported personal care products marketed to children of color and endorsed by celebrities or deemed “green” or good for the environment actually contain more hazardous chemicals than the cleaning products they tested [24]. the concern about the potential risks of hair and personal care products extends beyond the academy [9 11] to communities of color, wherein black men and women’s concerns initiated this collaborative study. however, all behavior change is complicated and subject to many influences, even in light of emergent scientific insights. as we seek to better understand cultural influences that perpetuate breast cancer disparities, the impact of hair on identity for black women should also be recognized. hair is a fundamental component of one’s cultural identity. our black identity, hair product use, and breast cancer scale may provide important insights into the social and behavioral patterns as well as the growing perceptions about risk of black women in relation to breast cancer prevention and hair product risk. considering both of these perspectives of women across the african diaspora may yield culturally appropriate strategies that inform interventions about identity, hair product use, and breast cancer risk. this work was supported by the california breast cancer research grants program [grant number 19ab 2100]. thank you to our faith based organization partners, stylists, salon owners, women and men of san bernardino and riverside county for their participation in this project. for more information about plos subject areas, click here. is the subject area "breast cancer" applicable to this article? yes no thanks for your feedback. is the subject area "cancer risk factors" applicable to this article? yes no thanks for your feedback. is the subject area "culture" applicable to this article? yes no thanks for your feedback. is the subject area "women's health" applicable to this article? yes no thanks for your feedback. is the subject area "african american people" applicable to this article? yes no thanks for your feedback. is the subject area "cancer detection and diagnosis" applicable to this article? yes no thanks for your feedback. is the subject area "principal component analysis" applicable to this article? yes no thanks for your feedback. is the subject area "personality" applicable to this article? yes no thanks for your feedback. plos is a nonprofit 501(c)(3) corporation, #c2354500, based in california, us

for most older adults, good health and financial wellness ensures independence, security, and the ability to afford a longer life. discover tools and resources to improve quality of life and tips to make the most of your money. improving the lives of older adults, especially those who are struggling, is not just your job it’s at your core. gain your inspiration here and find ncoa tools, tips, and resources to help improve your delivery and service. we believe every person deserves to age well, regardless of their background. learn more about the work we do, the people we serve, and why aging well matters now more than ever. help us build a more just and caring society in which each of us, as we age, lives with dignity, purpose, and security. explore how to support our mission, partner with us, and advocate on behalf of older adults. for most older adults, good health and financial wellness ensures independence, security, and the ability to afford a longer life. discover tools and resources to improve quality of life and tips to make the most of your money. improving the lives of older adults, especially those who are struggling, is not just your job it’s at your core. gain your inspiration here and find ncoa tools, tips, and resources to help improve your delivery and service. we believe every person deserves to age well, regardless of their background. learn more about the work we do, the people we serve, and why aging well matters now more than ever. help us build a more just and caring society in which each of us, as we age, lives with dignity, purpose, and security. explore how to support our mission, partner with us, and advocate on behalf of older adults. we use cookies to give you the best experience on our website. for more information on what this means and how we use your data, please see our privacy policy. 6 min read as we grow older, diminished bone density can lead to osteoporosis a potentially debilitating disease that increases the risk of fractures. while black women have a lower prevalence of osteoporosis overall, they experience worse outcomes after fractures caused by osteoporosis. preventing osteoporosis starts with knowing your risk factors and creating a plan of action with your healthcare provider. having strong, healthy bones is important at any age. but as we grow older, the health of our bones requires more attention. this is because our bodies begin to absorb calcium and phosphate from our bones over time, making them weaker and more porous. bone loss affects postmenopausal women in particular and can lead to osteoporosis. there’s a common belief that osteoporosis only affects white women. however, this is a dangerous misperception that can prevent older black women from getting the information, screening, and treatment they need to prevent and manage this debilitating condition. osteoporosis is a bone disease in which bones lose their density, becoming thinner and weaker and more prone to breaking. this condition can cause pain and disability and make it challenging to perform everyday activities. osteoporosis shouldn’t be confused with osteoarthritis, a degenerative joint disease characterized by pain and inflammation. osteoporosis is often a “silent” disease that produces no symptoms. it may progress for many years undetected, until a broken bone, or fracture occurs. these fractures can compromise an individual’s ability to walk, cause deformities and loss of height, and dramatically lower quality of life. osteoporosis may even indirectly lead to death, since fractures and related complications can cause an older person’s health to quickly deteriorate. risk factors for osteoporotic fractures include: breaking a bone as an older adult is another osteoporosis risk factor. in a 2021 study, postmenopausal women who sustained an initial fracture from minimal trauma a sign of weakened bones were 52% more likely to suffer another fracture compared to women with no initial fracture. black women tend to have higher bone mineral density throughout their life and a lower prevalence of osteoporosis overall. however, they face health disparities and other issues that put them at high risk for developing and suffering complications from this disease: women in the black community also tend to have less awareness about osteoporosis than white women, which can delay prevention and treatment. it’s never too late to start taking care of your bones. here are some smart habits you can adopt to improve your bone health: 1. eat a balanced diet: one of the primary ways to build bones and reduce osteoporosis risk is to eat a varied, nourishing diet that's rich in calcium and vitamin d. the bone health & osteoporosis foundationrecommends that women age 51 and older get 1,200mg of calcium daily, while most adults age 50 and older need 800 1,000 iu daily of vitamin d. if you’re not getting a sufficient amount of these nutrients from food or diet alone, you may need to support your diet by taking a multivitamin or supplements. 2. make exercise part of your daily routine. exercising regularly can help boost your muscle strength, improve your balance and posture, and relieve pain. it can also lower your risk of falls and fractures. focus on weight bearing activities such as walking, jogging, dancing, and weight training. if you have osteoporosis or a condition that affects your ability to exercise, check with your doctor before beginning an exercise regimen. 3. get a bone density test. a bone density test is a fast, painless, and inexpensive way to determine your risk for fractures due to osteoporosis. it's performed using a dxa scan, which stands for dual energy x ray absorptiometry. the dxa scan uses low levels of x rays to measure the mineral content of your bones. the bone health & osteoporosis foundation (bhof) recommends a bone density test of the hip and spine for women who: a bone density test is also advised if you break a bone after the age of 50 following a minor fall or injury. 4. take medication for osteoporosis. if your dxa scan shows osteoporosis or if you had a fracture after age 50 or have a high risk for breaking a bone you may be prescribed medication to strengthen your bones along with counseling on diet and exercise. there are safe and effective drugs available that are approved for osteoporosis prevention and treatment. for older black women, the first step in preventing osteoporosis is education. arm yourself with information about osteoporosis in the black community, and then be your own bone health advocate. you can take action by: there is no cure for osteoporosis. however, prevention and treatment can help you stop further bone loss, reduce your risk of fractures, and keep living your best life possible. 1. national institute of arthritis and musculoskeletal and skin diseases (niams). osteoporosis. found on the internet at https://www.niams.nih.gov/health topics/osteoporosis 2. office of dietary supplements, national institutes of health. vitamin k: fact sheet for health professionals. found on the internet at https://ods.od.nih.gov/factsheets/vitamink healthprofessional/ 3. healthline. 20 foods that are high in vitamin k. found on the internet at https://www.healthline.com/nutrition/foods high in vitamin k get information on prevention and how to manage ongoing health conditions focused on physical and mental health. from exercise tips to diet and nutrition, this is your one stop shop for caring for yourself and loved ones. choose where we'll send you resources to support your health and financial well being. select an option(s) below that best describes you to get communication that matches your interests. © 2025 national council on aging, inc.

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supported by a growing body of evidence shows a link between these products and a number of health disorders in black women. by linda villarosa linda villarosa is a contributing writer for the magazine. straightened hair has long been the dominant societal standard of beauty for black women, from the working class to those in government and corporate america to celebrities and even someone in the white house. michelle obama said in 2022 that she felt she had to straighten her hair while serving as first lady rather than wear a natural style. “nope,” she said. “they’re not ready for it.” hair can be straightened with heat, but a vast majority of black women   an estimated 89 percent   have used chemical relaxers, which are easier and more affordable, at some point in their lives, often beginning in childhood. yet there is a growing body of evidence, much of which hasn’t reached the public, that shows a link between these products, directly marketed to black women and girls, and a number of health disorders in women. here’s what to know about relaxers and your health. scientists have struggled for decades to explain why black girls show signs of early puberty   developing breasts and pubic hair   more than twice as frequently as white girls and also earlier than girls of other ethnicities. the early onset of puberty and menstruation is associated with a cascade of reproductive health disorders. many of these hormone health related problems are more common in black women than in other women, including an aggressive form of breast cancer that contributes to a death rate from the disease that is 28 percent higher than the rate for white women. the ingredients in chemical relaxers include a number that are known disruptors of the endocrine system. burns and abrasions, often caused when the products are applied to the scalp, give the endocrine disrupting chemicals an efficient entry into the body, and research done over the last several years now shows that frequent use is linked to an elevated risk for both breast and uterine cancer. chemical relaxers line shelves of beauty supply stores and drugstores in black communities, with packages targeted to kids featuring brightly colored boxes and adorable little girls with swingy straight hair. and the labeling can’t be trusted: a 2018 report found dozens of chemicals that can disrupt hormones in hair products used by black women, but a majority of the toxic ingredients weren’t listed on the packaging.

 by staff writer june 15, 2023   a growing body of evidence suggests that chemicals in hair relaxers products aimed at straightening hair and other hair products marketed to black girls and women contain endocrine disrupting substances linked with early menstruation, reproductive health issues, and cancer. but these remain largely unregulated in the u.s. a june 13 article in the new york times detailed how black women and girls in the u.s., feeling pressure to conform to societal norms about having “neat” or “professional” hair, have for many years used a variety of methods to calm their hair, including chemical relaxers containing substances such as formaldehyde and phthalates. black women quoted in the article  including harvard t.h. chan school of public health’s tamarra james todd talked about how their scalps would burn when their hair was being treated, and how their hair would fall out in clumps afterwards. over the past 20 hears, james todd, mark and catherine winkler associate professor of environmental reproductive epidemiology, has conducted or co authored nearly 70 studies aimed at showing the link between chemicals in hair products and serious health problems that disproportionately impact black women and girls.