While heart disease is the leading cause of death for all men and women in the U.S., the risk of heart disease and stroke is even higher for Black Americans.
One recent study, published in the Journal of the American Medical Association, found that Black Americans were at higher risk for high blood pressure, diabetes and obesity: all of which are risk factors for heart and blood vessel disease.
“When we look at the research, we see that people in the Black community are at higher risk of developing the risk factors that can lead to heart disease,” says Dr. Merije Chukumerije, a cardiologist at Cedars-Sinai.
Dr. Chukumerije says that there are several reasons why heart disease can be more prevalent in the Black community, including socioeconomic status, access to care and disparities in health equity.
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In order to combat this complex issue, Dr. Chukumerije says there needs to be more of a focus on prevention and intervention.
“I definitely see a higher proportion of older patients who have a chronic disease, like coronary heart disease,” Dr. Chukumerije says. “These health conditions don’t just suddenly develop.”
If doctors and healthcare professionals can identify these conditions in Black Americans and intervene sooner, the lower their risk of heart disease will be.
“For example, if a Black man or woman in their 20s or 30s appears to have high cholesterol or high blood pressure, then we should address these health risks from the start,” Dr. Chukumerije says. “If we don’t first detect and then address them, they can go untreated for decades. It’s more common for patients to see a cardiologist when they’re older, but by that time, the damage to the heart and cardiovascular system has been done.”
In addition to prevention and intervention, lowering the risk of heart disease in the Black community involves a fair amount of cultural competency.
“As a healthcare provider, you have to understand what those in certain communities go through when they leave your medical office or clinic,” Dr. Chukumerije says.
Some neighborhoods that are primarily populated by Black Americans may lack outdoor parks, have limited access to gyms and feel unsafe. Black Americans might also be more likely to live in “food deserts,” geographic areas where residents have few options for affordable and healthy foods.
“When you tell a patient to exercise more and change their diet, you need to first address the barriers they might face to this and figure out how to help them overcome these barriers,” Dr. Chukumerije says.
Cultural competency can also come into play when looking at gender roles in the Black community and how they affect health.
“Particularly in the Black community, Black women are viewed as the pillar of the family,” Dr. Chukumerije says. “Black women can often be head of the household, dictating what the family eats and their lifestyle.”
Dr. Chukumerije says that while there should be a greater emphasis on healthy living in the Black community, there should also be an acknowledgment of the limitations in doing so.
“In Black families with a sole provider or head of household who has to work multiple jobs, it can be harder to get the entire family to eat healthier or exercise more,” Dr. Chukumerije says.
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Those in the Black community face specific challenges when it comes to improving heart health, but there are steps Black Americans can take to prevent or lower their risk of heart disease.
“I tell my patients all the time, ‘I don’t need you to go out and train for a marathon tomorrow, but I would love for you to take that first step today,'” Dr. Chukumerije says.
As a Black physician, Dr. Chukumerije says it’s important to not only address the barriers his Black patients face, but also hold them accountable for their health.
“I often hear patients say that their health condition or chronic disease is hereditary, implying that they were predetermined or destined to inherit this disease,” Dr. Chukumerije says. “Some diseases are hereditary, but lifestyle habits, both good and bad, can play a larger role in a person’s overall health. As their doctor, I try to be their accountability partner as well.”
For Black Americans, finding a doctor you trust and having the cultural competency to understand your barriers to health is essential.
“Sometimes it’s not bad news,” Dr. Chukumerije says. “Sometimes you go to the doctor to hear that you’re doing a good job. When it comes to your health, consider yourself a luxury vehicle. Even luxury vehicles need to go get routine maintenance checks.”
For more health tips, read the Cedars-Sinai blog.
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