Heart disease is a problem that many people in the world are facing right now. But did you know that some ethnic groups are at a higher risk of developing this heart disease than others? What is the real reason for this? Is it genes? Or is it the society we live in? Let's talk about this in a little more detail .
What is heart disease? Why does it affect some people more?
Cardiovascular disease is not just one disease. It is a term used to describe a group of diseases that affect the heart and blood vessels. It is the leading cause of death among adults. However, some people, especially minorities, are more susceptible to it. For example, 47% of black adults have been diagnosed with heart disease, compared to 36% of white adults.
When it comes to risk factors for heart disease, some groups of people are at higher risk. For example, diabetes is a major risk factor for heart disease. Hispanic women are twice as likely to develop diabetes as white women. American Indians are three times more likely to develop diabetes than whites.
What are "Health Disparities"? Are genetic or social factors important?
This is how we define health disparities (`) for the differences in health between different races and ethnic groups. This is called Health Disparities . This is actually a complex problem that exists all over the world.
Researchers often argue that race and ethnicity are ``social constructs`` rather than ``biological`` traits. That is, the main cause of these health differences is not genes, but various factors in the society we live in.
What are these social factors? There are many social factors that affect a person's health. We also call these ``Social Determinants of Health`` . Some of the main ones are:
- Money and assets to meet the basic needs of life.
- The opportunity to get a good education.
- The ability to receive quality health care.
- A safe living environment with clean air and clean water.
- Resources for obtaining nutritious food, fresh fruits, and vegetables.
- Supportive human relationships, free from discrimination and violence.
These factors are interconnected. For example, poverty may prevent a person from eating heart-healthy foods. If that person lives in a "food desert" with no good restaurants or grocery stores, their choices are even more limited.
These social factors put black, Hispanic, and American Indian populations at a disadvantage. They often carry a greater economic and social burden. As a result, their health suffers. Other ethnic groups may also face various disadvantages that affect their risk of heart disease.
Hypertension and heart disease - how they affect different populations
Certain races and ethnicities in the United States are more likely to have high blood pressure and type 2 diabetes, both of which are major risk factors for heart disease.
Let's look at high blood pressure (Hypertension).
- 59% of black adults have high blood pressure , the highest rate of any ethnic group.
- Four out of five Asian adults seeking treatment still have uncontrolled high blood pressure. This number is slightly lower among Hispanic and black adults (three out of four).
- Black women are twice as likely as white women to develop chronic high blood pressure (`chronic hypertension` ) during pregnancy. This condition increases the risk of developing heart disease later in life.
- Black adults are more likely than white adults to have internal organ damage from high blood pressure. As a result, they are four times more likely to develop end-stage kidney disease.
- Black adults are also more likely to die from high blood pressure and related diseases than white adults.
These statistics are also influenced by social factors. For example, those without insurance are more likely to have uncontrolled high blood pressure. And those who face discrimination have higher blood pressure .
High blood pressure can cause complications such as:
- Coronary artery disease
- Heart failure
- Stroke
- Peripheral artery disease
- Abdominal aortic aneurysm
- Chronic and end-stage kidney (renal) disease
- Dementia
How Diabetes (Type 2 Diabetes) Leads to Heart Disease - How It Affects Different Populations
Type 2 diabetes can damage the blood vessels in your heart, brain, and kidneys. This condition can cause your triglyceride and LDL cholesterol levels to rise. People with diabetes are twice as likely to have a heart attack or stroke than people without diabetes.
About one in ten Americans has some form of diabetes, the majority (90% - 95%) of whom have type 2 diabetes. Diabetes is a major health crisis that affects everyone. However, it affects certain races and ethnicities more than others.
Some researchers call diabetes an "exemplar health disparities disease." That is, the data clearly shows differences between different races and ethnicities. This is due to social factors. Here are some national and ethnic differences in the prevalence of diabetes:
- Among American Indians, one in four adults has diabetes, compared to only one in twelve among whites.
- Hispanic/Latinx, black, and Asian American adults are more likely to develop diabetes than white adults.
- Black people are diagnosed with diabetes at a younger age than white people, which means their life expectancy is lower.
- Hispanic/Latino people are twice as likely to have undiagnosed diabetes as white people. This is because they do not always have access to health insurance and regular health care.
- Hispanic women are twice as likely to develop diabetes as white women.
- Although type 2 diabetes usually affects people over the age of 45, research shows that it is now becoming more common in young people and children .
- The diagnosis of this disease has increased rapidly among Hispanic/Latino and black children from 2002 to 2015.
- Obesity increases the risk of developing type 2 diabetes. Diabetes is more common among Asian Americans, blacks, and Hispanics/Latinos. Severe obesity (BMI of 40 or higher) is more common among black adults.
Which ethnic group has the most heart disease?
The rate of heart disease depends on the diagnosis. Here are some key findings from American research:
Heart Failure
- Black men are 70% more likely to develop heart failure than white men.
- Black women are 50% more likely to develop this condition than white women.
- Black adults are twice as likely to be hospitalized for heart attacks as white adults. They spend more time in the hospital and are more likely to be readmitted within 90 days.
- Hispanic adults are also more likely to develop heart disease than white adults.
Coronary Artery Disease and Heart Attack
- Black women are more likely to have a heart attack than white women.
- Black adults are more likely to die from heart disease than white adults.
- Asian adults are less likely to develop coronary artery disease than other ethnic groups. However, there are some differences by ethnicity. Asian Indian men, Filipino men, and Filipino women are at higher risk than whites.
- Young Hispanic women who have a heart attack are at a higher risk of dying than young Hispanic men, and are also at a higher risk of dying than young black and white adults.
Stroke
- Compared to other races and ethnicities , black adults are more likely to have a stroke. They also tend to be younger when they have it.
- Black adults are more likely to die from stroke than white adults.
- Mexican American adults are more likely to develop paralysis than white adults.
- One study showed that Filipino women are twice as likely to develop stroke as white women.
- Vietnamese men and Korean women are more likely to have hemorrhagic stroke than white people.
- Filipino adults, Japanese men, and Vietnamese men are more likely to die from stroke than white adults.
It's very sad that there are such differences, isn't it? But it's very important to be aware of these things.
What can you do about this? (Take-Home Message)
Heart disease is the leading cause of death in the United States. But some people are at higher risk than others. If you are part of a group that faces disparities in access to health care and quality of care, talk to your doctor about your risks. If you don't have a regular doctor, look for community organizations and local resources that can connect you with one.
It's important to start getting health checkups at a young age. Get your blood pressure, cholesterol, and blood sugar levels checked. Talk to your doctor about what these values mean. Also, tell your doctor if anyone in your family has risk factors for heart disease or has been diagnosed with heart disease. This information can help you and your doctor reduce your risk.
Those who do not face barriers to accessing health services can help improve the situation for those who do. Look for local organizations that help ensure equal access to health services. Also, work with your doctor to identify your personal risks and find ways to reduce them. The most important thing is to take care of our own health.
` Heart disease, race, ethnicity, health disparities, high blood pressure, diabetes, social factors
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