As we near the conclusion of February, American Heart Month, we recognize the importance of preventing heart disease with health-conscious living. The National Heart, Lung, and Blood Institute advises physical activity, a healthy diet, and keeping track of your vitals; and as part of their #OurHearts initiative, this comes with an encouragement to lead healthy lives with others to advance heart health together. However, despite continued efforts from organizations like the National Institutes of Health and the American Heart Association, heart disease remains the leading cause of death in the United States. Further, when viewing heart disease from a community health perspective, research continues to show troubling health disparities across race and ethnicity.
Research from the CDC found non-Hispanic African American residents to have the largest death rates for heart disease in 2017, leading white non-Hispanic and Hispanic populations, and more than doubling non-Hispanic Asian or Pacific Islander rates. Moreover, in notable heart disease risk factors, non-Hispanic African American populations rank at the top for hypertension, while non-Hispanic African American and Hispanic adults lead in obesity and diabetes rates. While most cases of heart disease are among non-Hispanic white populations, the death and risk factor statistics surrounding heart disease for people of color nonetheless depict a sobering health disparity.
A look into the socioeconomic factors, notably geography, preventing people from receiving proper care and treatment may provide key insight into these racial and ethnic health disparities. As Eldrin Lewis, MD, a cardiologist from Brigham and Women’s Hospital remarked, “your ZIP code is more important than your genetic code.” According to our own National Health Survey, African American populations are more likely to experience barriers to healthcare (appointment/physician availability, out-of-pocket costs, language/culture, etc.),14.5% of non-white adults live without health insurance, and both African Americans and Hispanics record greater difficulty in affording prescription medication.
Other analyses consider the effects of racial discrimination on healthcare and disparities. For example, the feeling of discrimination or anticipated discrimination has been measured as a potential stressor for hypertension, with a 2013 study linking race consciousness, that is, “the frequency with which one thinks about his or her own race,” to high blood pressure among African American patients. Further research uncovered concerning inequities in treatment between whites and African Americans across multiple facets of care, including surgery, prescription, and therapy, along with shorter, less patient-centered appointments for African American patients. Whether these inequities and instances of perceived discrimination come from a lack of cultural competence, implicit racial bias, or little diversity among medical staff, these disparities may inspire loss of trust in the patient-caregiver relationship, making the need for diversity in healthcare all the more evident.
With American Heart Month drawing to a close, it’s important to remember that the month’s end doesn’t permit one to abandon heart-healthy living, and it definitely doesn’t mean health professionals should lose sight of the disparities (heart health or otherwise) impacting people of color in their community. The most powerful population health initiatives start with recognizing the unique health needs of their community, and when conducting a Community Health Needs Assessment with PRC, you gain the insights necessary for your institution to provide meaningful community-minded care.
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