Health disparities between Black and white Americans are everywhere, from pregnancy to overall shorter life spans; heart disease is no different.
According to the U.S. Department of Health and Human Services, Black Americans are 30% more likely to die from heart disease than white Americans. While this can be linked to how Black Americans experience higher rates of obesity, diabetes, high blood pressure and high cholesterol — all of which are
"When we think about the disparate healthcare that African Americans receive, so many things come into play," says Dr. Jayne Morgan, cardiologist and clinical director of the COVID task force at Piedmont Hospital in Atlanta, Georgia. "Whether you're in a food or pharmacy desert, whether you're in a multigenerational household or an essential worker, which really means you're in a low-paying job."
Read more:
Dr. Morgan underlines the importance of social determinants of health, or the economic and social conditions that influence one's health. She notes that education and wealth gaps between Black and white Americans also point to what type of communities and what level of healthcare Black Americans are more likely to have access to. Unfortunately, racism is rooted in the U.S. education and professional worlds, explains Dr. Morgan.
Black Americans have the lowest college graduation rate, with financial barriers playing a large role. According to the United Negro College Fund, 65% of African American college students pursue a degree alongside a full-time job to care not only for themselves, but their families. Notably, Black Americans' net worths are 70% lower than that of non-Black households, according to research from Wells Fargo. Financial services company Mercer highlights how Black professionals are less likely to receive highly rated performance reviews and promotions, hinting at rampant discrimination in the workplace.
"In many ways, the education you receive translates into the type of job you receive," says Dr. Morgan. "But once you get the job, you will have a very hard time getting promotions, and the point of promotions is higher incomes. Higher incomes mean you can move into better neighborhoods, have parks where you can exercise, buy better insurance and have access to better foods."
Read more:
Fruits, vegetables, walkable communities, gym memberships and quality health insurance do not come cheap, emphasizes Dr. Morgan. However, even great health plans won't eliminate the racism Black Americans face within the healthcare system itself. A study published in "JACC Heart Fail" found that Black Americans are less likely to receive primary care from a cardiologist during an intensive care unit admission for heart failure.
"Our symptoms are not heard, and we are not taken seriously," says Dr. Morgan. "We are more likely to be labeled as non-compliant. Those labels create judgment."
Black women, who face the highest maternal mortality rate in the U.S., are also less likely to be referred to a cardiologist following pregnancy complications, notes Dr. Morgan. Black women experience worse menopause symptoms than white women as well, but are less likely to receive hormone therapy, which can decrease the risk of heart disease.
Read more:
Ultimately, heart disease is likely to become an even more prominent health issue since COVID-19 has been proven to increase cardiovascular problems after infection. Research from the United States Department of Veterans Affairs revealed that those recovering from COVID were 52% more likely to have a stroke than those who weren't infected. Dr. Morgan highlights that the COVID death rate was highest for Black Americans until the end of 2021, when the mortality rate of white Americans overshadowed other groups.
"During the first half of the pandemic, the African American community bore the brunt of it," says Dr. Morgan. "Now we are seeing higher rates in the white community, with certainly the older white community becoming entrenched in an ideology that is [against] getting vaccinated."
Still, given Black Americans' lack of access to quality healthcare, COVID is yet another factor that could lead to poor heart health — and should be on employers' and employees' radars. Dr. Morgan advises employers to evaluate whether they are promoting and building health benefits with
"The main thing is awareness," says Dr. Morgan. "Where are you applying judgments?"
