Race, Class, and Heart Health | Health Hive – Health Hive

Cardiovascular disease, including heart disease and stroke, remains the number one cause of death for Americans.

The National Center for Health Statistics data shows heart disease-related death rates have fallen in the last 20 years. But underlying factors and healthcare disparities mean the risk factors that can lead to cardiovascular disease, and the risk of deaths from it, are higher for people of color.

We asked Bipul Baibhav, MD, a cardiologist with Rochester Regional Health, about those risk factors and what can be done to help reduce some of the barriers to care experienced by people of color.

There are several factors that can put a person at risk of developing cardiovascular disease. Currently 43 percent of all American adults have at least one of those risk factors.

Age is one of the biggest risk factors that cannot be controlled. The older a person is, the higher their risk of developing cardiovascular disease.

Elements more within an individuals control include:

Over the last three years, health care disparities have been recognized as a major contributor to the health of people of color. The disproportionate effect of the COVID-19 pandemic on this group of people highlight the need for racial justice and health equity.

In the past, research related to race, ethnicity, and heart health was focused on how an individuals biology was connected to their race. However, in more recent years, research is showing that social determinants, driven by race and ethnicity, have a larger impact on heart health than an individuals biology.

Some examples of social determinants include:

Patients who are of a lower socioeconomic status and a lower level of education often do not have access to healthcare and affordable health insurance, Dr. Baibhav said. Frequently, they live in underserved communities where grocery stores, safe places to exercise, and access to healthcare are limited or not available. Those tend to be more among communities of color.

As a result of the systemic inequities previously mentioned, people of color often experience more obstacles to receiving preventative high-quality health care.

Using high blood pressure as an example, Black Americans are more likely to develop high blood pressure as compared to white Americans. Research published in the Journal of the American Heart Association shows approximately 75 percent of Black Americans will develop high blood pressure by the age of 55, compared to 47 percent of white Americans. Cases of cardiovascular disease linked to high blood pressure or stroke are higher in Black Americans as compared to other ethnicities.

For patients seeking a doctor to talk about hypertension, having access to primary care providers is a challenge in some underserved communities; access to cardiovascular specialists is even more of a challenge. Some people may be dealing with a lack of transportation, so they are unable to get to an appointment.

Over the course of the pandemic, many providers expanded their use of telemedicine for patients to offer opportunities to receive healthcare without an in-person visit. Some people may struggle with newer technology or lack access to high-speed Internet. This can prevent the use of telemedicine for screenings which could help identify risk factors such as high blood pressure.

Paying for medical visits can also be a barrier, even with something as simple as checking on high blood pressure. The Affordable Care Act has helped some uninsured individuals obtain insurance through the New York State of Health insurance marketplace, but the cost of care can still be prohibitive for some individuals.

Education also plays a role in healthcare. Health care information can be hard to comprehend. Ensuring that information is clear and accessible helps patients understand how to follow through on recommendations and treatments for high blood pressure.

We want to make sure that patients who have high blood pressure get access to primary care physicians and cardiovascular specialists as needed, so that their blood pressure and other cardiovascular risk factors can be adequately treated, Dr. Baibhav said.

Breaking down the barriers that keep underserved communities from access to providers, high-speed Internet, affordable healthcare, and education will require significant changes. There are several ways to make progress in these areas that could improve heart health.

Making intentional efforts to partner with patients and community organizations to advance cardiovascular health is a good goal. Efforts such as the Barbershop Trial published in the New England Journal of Medicineare examples of providers working with patients and businesses in their own communities to improve the heart health outcomes through mutual trust.

At some Rochester Regional Primary Care offices, trained social workers or health coaches work to identify ways to help lessen the impact of some of these issues when it comes to heart patients. These individuals help find transportation, ensure culturally sensitive dietary changes for cardiovascular patients, and identity other ways of using social determinants of health to create a better patient experience and outcomes.

Given the amount of time and effort researchers have put into studying these disparities, Dr. Baibhav suggests it is time to move from observing to implementing change.

There is an abundance of research examining socioeconomic and ethnic disparities in healthcare, Dr. Baibhav said. It is time to take action and bridge this gap.

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Race, Class, and Heart Health | Health Hive - Health Hive