Researchers are reporting that black Americans have remained at higher risk for heart disease than whites for the past 20 years, despite a significant reduction in the overall burden of this disease in the general U.S. population. The higher risk in this population is likely driven by social determinants of health, such as low income and poor access to health care, they say.
Although the death rate from cardiovascular disease, which includes heart disease and stroke, has declined substantially in the United States since 1950, it remains the leading cause of death nationwide. Researchers have known for some time that blacks are disproportionately affected, but the exact reasons have remained unclear.
To learn more, researchers studied a group of 50,0571 people aged 20 years or older from the 1999-2018 National Health and Nutrition Examination Surveys, a series of cross-section surveys that are representative of the U.S. population. The diverse population differs by race, ethnicity, and socioeconomic status and about half of the participants are women. The researchers examined various factors that contribute to heart disease risk— including obesity, diabetes, and high blood pressure—as well as heart disease death rates in this population.
The researchers found that substantial differences in cardiovascular risk factors persisted between black and white participants during this study period. They showed that these differences are likely influenced by social determinants of health, including socioeconomic status, neighborhood and physical environment, social support networks, and access to health care, they say.
A better understanding of how these socioeconomic factors influence cardiovascular risk factors among blacks and other racial and ethnic groups in the U.S. may help guide the development of improved national public health policies for targeted interventions to eliminate these health disparities, the researchers suggest.
This study, partly funded by the NHLBI, appeared in the Journal of the American Medical Association (JAMA).