Every time I ride the Metro, I see them -- by now, they've almost become friends: a group of 11 middle-aged women who smile at me from a giant PSA poster in the Farragut North station. All of them are dressed in in-your-face red. Forget wearing black because it makes a person look thinner. Large, small and in between, these women are fashion-rule-breakers. They want to get noticed.
They are the new front line in the government's public health campaign to raise awareness of heart disease in women. The initiative by the National Heart, Lung, and Blood Institute (NHLBI) is targeted at women ages 40 to 60 -- when the risk of heart disease begins to rise. The poster women all have heart disease, and they have a message for women of all ages and the people who love them. Virgie Harris-Bovelle, 70, of the District's Shepherd Park, who is standing in the back row, put it this way in an interview: "A heart attack today does not have to be the end of life."
The poster women appear very different from the female faces that launched the campaign two years ago in partnership with the fashion industry. Back then the only poster ladies in red were 19 breastless, bony plastic mannequins sporting designer dresses. I remember being appalled at the display. It was hard to see any connection between these emaciated store dummies in their high-end gowns and the average middle-aged women at risk of heart disease. With such red dresses available only to the very rich and very thin, the campaign seemed like public health for the country club set.
This is the problem when the culture of excess is superimposed over the ethos of public health. The red dress is an advertising gimmick to brand heart disease. We're used to Madison Avenue slickness in the selling of political candidates. But is the selling of the presidency the model for selling public health? Celebrities are used by disease associations to raise money, but usually these high-profile patients have the medical condition and can speak with some personal authority. (Example: the late Christopher Reeve and spinal cord injuries.)
Advocates of the red dress project say the Seventh Avenue-NHLBI collaboration has been very successful. A diorama of the original 19 mannequins in designer dresses has been displayed in airports across the country. It's an attention-getter. And pushing the disease-prevention campaign at the Mercedes-Benz Fashion Week in New York, as is done each year now, is a way to get buzz.
But press coverage at such events is mainly buzz about the rich, thin and famous. What about the rest of us? We're left out.
That's why the newer poster of real women in ordinary red dresses is so successful. We're like the women in the poster in the Metro station. We're lawyers and psychotherapists, mothers and mentors. We're African American and Caucasian. Some of us are overweight; some are not. We buy our clothes off the rack. We depend on public transportation.
Without these real women with heart disease, the red dress project would collapse. They are the ones who speak from the heart about the toll of this leading killer of women (and men).
Harris-Bovelle had a heart attack about 20 years ago. "It was devastating," she said. "I was so lost. I was so alone." Initially, her diagnosis was missed when she went to the hospital with chest pain. She was told to go home, rest and drink plenty of fluids. Back then, the myth persisted that only a man of her age could have a heart attack.
Breaking down that myth is what the public health campaign is about. Harris-Bovelle, an African American, finally got to a cardiologist who treated her properly. Today she takes many medications to prevent blood clots, control blood pressure, lower cholesterol and manage her congestive heart failure and arrhythmia. She has an implantable defibrillator. "Same as Dick Cheney," she quips.
She wants women to know how full life can be with heart disease. The mother of two grown children, she works as a psychotherapist. She became a red dress poster child through WomenHeart, the national patient advocacy organization for women with heart disease. Since posing for the PSA, she has turned her whole wardrobe into red.
"I just feel so empowered. Life is good for me," she said. Helping women with heart disease is a new chapter in her life.
Public health is about people, ordinary people. There's not a lot of disagreement over the mass destruction caused by heart disease. It's the stories of the women in the poster that matter -- not what they wear. Even in the world of the PSA, there's value in the old-fashioned approach of the country's founders -- government programs of real people, by real people, for real people.
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