Why are black adults at greater risk of death from heart disease? New study suggests social factors are responsible


heart disease concept

Black Americans face a 54% higher heart disease mortality rate than white Americans, with a recent study attributing this disparity to social factors rather than traditional clinical factors. The research underlines the importance of social determinants of health, highlighting the need for social and community interventions to address these disparities.

African Americans have a 54% higher risk of becoming a victim cardiovascular disease Compared to their white counterparts, however, heart disease-related deaths have declined significantly across the country.

A recent study from Tulane University, published in History of Internal Medicinefound that these racial disparities are linked more to social determinants such as unemployment, limited income and partner absence, rather than previously identified factors such as high blood pressure and obesity.

“For years we have focused on smoking, diet, physical activity, obesity, high blood pressure, diabetes and high cholesterol – and we know these are important for heart disease prevention – but I was surprised that blacks-whites “Differences in mortality from cardiovascular disease are largely due to social factors,” said Dr. Jiang He, lead author and the Joseph S. Copps Chair in Epidemiology at the Tulane School of Public Health and Tropical Medicine.

Using health data from more than 50,000 adults, the study examined clinical risk factors (obesity, diabetes, high blood pressure and high cholesterol), lifestyle risk factors (smoking, unhealthy diet, lack of exercise and too little or examined the relationship between excess sleep). ), and social risk factors associated with cardiovascular mortality (unemployment, low family income, food insecurity, low education, no regular access to health care, no private health insurance, not owning a home, and neither married nor living with a partner only).

When the study was adjusted for age and sex, the death rate from heart disease was 54% higher among black adults than among white adults. This dropped to 34% and 31%, respectively, after adjustment for clinical and lifestyle risk factors. However, racial differences in cardiovascular mortality were completely eliminated after adjustment for social risk factors.

“When we adjusted for lifestyle and clinical risk factors, the black-white disparity in heart disease mortality decreased but still persisted.” He said. “However, after adjusting for social risk factors, this racial difference completely disappeared.”

The study follows another recent Tulane study that similarly found that Black Americans are 59% more likely to die prematurely than white Americans. That disparity dropped to zero after adjusting for these social factors, also known as social determinants of health.

Social determinants of health, while a relatively new framework, was developed by CDC’s Healthy People 2030 initiative emphasizing eight areas of life important for health and well-being.

For them, the findings emphasize the importance of good-paying jobs, health care access and the social support that can come from a family or close-knit community.

Moving forward, he is putting these findings into practice with a program that aims to address high blood pressure in New Orleans’ black communities by partnering with local churches to provide health screening training and free medication.

“Developing innovative community-based interventions to reduce cardiovascular disease risk in black populations is essential,” he said.

Reference: “Social, behavioral, and metabolic risk factors and racial disparities in cardiovascular disease mortality in US adults” by Jiang He, Joshua D. Bundy, Siyi Geng, Ling Tian, ​​Hua He, Jingyan Li, Keith C. Ferdinand, Amanda H. “. Anderson, Kirsten S. Dorans, Ramachandran S. Wasson, Katherine T. Mills and Jing Chen, September 2023, History of Internal Medicine,
DOI: 10.7326/m23-0507

The study was funded by the National Heart, Lung, and Blood Institute, the National Institute of General Medical Sciences, and the National Institute on Minority Health and Health Disparities.



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