Cardiovascular Disease in

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Oct 23, 2013 (4 years and 16 days ago)

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Cardiovascular Disease

in
Blacks

Compared to
Whites
in
Massachusetts


Abuchi Agu
, Alexander Bogdan,

Mellisa Deandrade,

Haydy George, Jacqueline Tran


Summer Enrichment Program 2013

University of Massachusetts Medical School


What is
Cardiovascular Disease?


Cardiovascular disease is a

class of diseases that
involve the heart and the blood vessels (arteries,
veins, capillaries).



E
xamples include:


Coronary Heart Disease


Cardiac dysrhythmia


Heart Failure


Congenital Heart Defects

2

Health Disparity


Defin
ed as i
nequities in the quality of health care
between
groups as compared to the
general population.

These inequities influence how frequently a disease affects a
certain group within the population .









Black
individuals suffer from a signifcantly higher mortality rate from cardiovascular
disease when compared to the white population.



3

Source:
MassCHIP

Why CVD?


Cardiovascular disease

is the #1

killer in MA
of

black
individuals



Blacks
are
1.5 times

more likely to die from CVD
than their white counterparts in Worcester County
.



Blacks are more likely to develop multiple risk
factors for CVD


4

Source:
www.cdc.gov

Symptoms


Chest pain or discomfort


Shortness of breath


Cold sweat


Abnormal
heart beats


Nausea


Light
-
headedness/
d
izziness


Upper body discomfort
in one or both arms, the
neck, jaw, or stomach.


Unusual
f
atigue


5

Source:
www.nhlbi.nih.gov

Genesis of Maladies



Despite
universal health
care, cost still presents a
barrier to quality care



Many minority patients
with

primary care
providers express
difficulty
communicating

with
doctors

Source: Kaiser Family Foundation

6

Risk Factors

7

Smoking



Blacks are less likely to quit
smoking than whites
.




Smoking prevalence is
higher in individuals at or
below the poverty line

Source:
MassCHIP

8

Physical Inactivity


Black individuals
are 13.4% less active than the general
population

in US
;
7.2% less active in
Massachusetts



Older black adults and those with low education and income levels are
at

greatest
risk for inactive lifestyles


Source: A Profile of Health Among Massachusetts Adults, 2010

9

High Cholesterol



Blacks are less often informed of high cholesterol


D
ue
to cultural, dietary or genetic differences


A 10% decrease in cholesterol can translate to a 25% risk
reduction for CVD


Source:
MassCHIP

10

Hypertension

11




Hypertension increases risk of CVD by nearly 4 times.


Prevalence of hypertension in blacks is highest in the world.


Hypertension leads to about 50% of ischaemic
stroke
s

and significantly
increases risk of hemorrhagic stroke.


Blacks are less likely to have controlled blood pressure than whites.


Source:
MassCHIP

Obesity


Obesity
is an
independent risk factor
for CVD


Blacks have a higher
incidence of obesity than
any

other race/ethnic
group


Proper diet and regular
physical exercise can
reduce this disparity

12

Source:
MassCHIP

Diabetes

13


Incidence of diabetes in
black youths has
increased dramatically
in past 20 years



Adults diagnosed with
diabetes are up to 4
times more likely to die
of CVD



Smoking with diabetes
doubles risk of
developing CVD

Source:
MassCHIP

Diagnosis

As reported by "Determinants of Black
-
White
Differences in the Risk of Cerebral Infarction: The
National Health and Nutrition Examination Survey
Epidemiologic Follow
-
up
Study”



Blacks are less likely to receive major procedures
diagnosing

CVD
,
especially coronary heart disease, than
the white

population.


Specifically, black women are the least likely to have these
procedures recommended.


I
n the past, heart disease was thought to be rare in blacks,
especially since they had low access to medical care
,
contributing to present disparity.

14

Treatment


Common problems for blacks are cost of medication, necessity
of a multiple
-
drug regimen,
and

the

inconvenience of frequent
follow
-
up visits.


15

Source: www.city
-
data.com, Overview of the Uninsured in the United States: A Summary of the 2011 Current Population Survey

Fix graph

Current
Efforts to Reduce CVD
Disparity


HAPPY Hearts
Program


Focus on low
-
income women


Offers screenings and aggressive primary prevention
techniques


Effectively reduces incidence of metabolic syndrome, a
strong predictor of
CVD


Additional s
tudies

conducted

to reduce

disparity:


Control of psychosocial stress


Community education programs


Programs

educating physicians to treat diverse populations




16

Summary of Findings


There are many prevalent risk factors contributing to CVD


Disparities exist between black and white populations in all
risk factors for CVD


Disparities also exist in socioeconomic status and
accessibility to health care


Diagnostic inefficiency may be key to disparity prevalence



17

Conclusion


Research suggests disparities in risk factors reinforce CVD
disparity between blacks and whites


Economic inequality and accessibility of care further
stigmatize CVD disparity


Investigation is needed into existence of diagnostic
disparities and their resolution


Establishment of community
-
based primary prevention
programs have been proven to reduce disparity


18

References




Braveman, P., Cubbin, C., Egerter, S., Williams, D., & Pamuk, E. (2010). Socioeconomic Disparities in Health in the United St
ate
s:
What the Patterns Tell Us.
American Journal of Public Health
,
100
, 186
-
196. Retrieved June 10, 2013, from

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2837459/


Cardiovascular Health (n.d.).
Mass.Gov
. Retrieved June 8, 2013, from http://www.mass.gov/eohhs/researcher/community
-
health/masschip/topics/cardiovascular
-
health.html#state_total


Giles, W., Kittner, S., Hebel, R., Losonczy, K., & Sherwin, R. Determinants of black
-
white differences in t... [Arch Intern Med.

1995]
-

PubMed
-

NCBI.
National Center for Biotechnology Information
. Retrieved June 13, 2013, from

http://www.ncbi.nlm.nih.gov/pubmed/777896
>.


Gilstrap, L., Malhotra, R., Peltier
-
Saxe, D., Slicas, D., Pineda, E., Culhane
-
Hermann, C. e., et al. (2013). Community
-
Based Pri
mary
Prevention Programs Decrease the Rate of Metabolic Syndrome Among Socioeconomically Disadvantaged Women.
Journal Of
Women's Health
,
22
(4), 322
-
329.


Heart disease
-

MayoClinic.com. (2011, August 2).
Mayo Clinic
. Retrieved June 7, 2013, from
http://www.mayoclinic.com/health/heart
-
disease/DS01120


Keppel, K., Pearcy, J., & Heron, M. (2010). Is There Progress Toward Eliminating Racial/Ethnic Disparities in the Leading Cau
ses

of
Death?.
Public Health Reports
,
125
(5), 689
-
697. Retrieved June 5, 2013, from

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2925005/


Lutfey, K. E., Eva, K. W., Gerstenberger, E., Link, C. L., & McKinlay, J. B. (2010). Physician Cognitive Processing As A Sour
ce
Of
Diagnostic And Treatment Disparities In Coronary Heart Disease: Results Of A Factorial Priming Experiment.
Journal of Health and
Social Behavior
,
51
(1), 16
-
29.


Mathieu, R., Powell
-
Wiley, T., Ayers, C., McGuire, D., Khera, A., Das, S., et al. (2012). Physical Activity Participation, Healt
h
Perceptions, and CVD Mortality in a Multi
-
Ethnic Population: The Dallas Heart Study.
American Heart Journal
,
163
(6), 1037
-
1040.
Retrieved June 8, 2013, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3514075/


Schneider, R., Grim, C., Rainforth, M., Kotchen, T., Nidich, S., & Gaylord
-
King, C. (2012). Stress reduction in the secondary
prevention of cardiovascular disease: randomized, controlled trial of transcendental meditation and health education in Black
s.
.
PubMed
,
5
(6), 750
-
758. Retrieved June 11, 2013, from http://www.ncbi.nlm.nih.gov/pubmed/23149426


Why Blood Pressure Matters. (2012, April 4).
American Heart Association
. Retrieved June 14, 2013, from
http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/WhyBloodPressureMatters/Why
-
Blood
-
Pressure
-
Matters_UCM_002051_Article.jsp


Who Is at Risk for High Blood Pressure?
-

NHLBI, NIH. (2012, August 2).
NIH Heart, Lung and Blood Institute
. Retrieved June 14,
2013, from http://www.nhlbi.nih.gov/health/health
-
topics/topics/hbp/atrisk.html


Yancy, C., Wang, T., Ventura, H., Pina, I., Vijayaraghavan, K., Ferdinand, K., et al. (2011). The Coalition to Reduce Racial
and

Ethnic
Disparities in Cardiovascular Disease Outcomes (credo).
Journal of the American College of Cardiology
,
57
(3), 245
-
252. Retrieved
June 11, 2013, from

http://content.onlinejacc.org/article.aspx?articleid=1144069


Yoon, S. S., Burt, V., Louis, T., & Carroll, M. (n.d.). Products
-

Data Briefs
-

Number 107
-

October 2012.
Centers for Disease Control
and Prevention
. Retrieved June 10, 2013, from http://www.cdc.gov/nchs/data/databriefs/db107.htm



Albelda, R., Cadet, F., & Mei, D. (2011, May 1). Poverty in Massachusetts by Race.
ScholarWorks
-

University of Massachusetts
Boston
. Retrieved June 12, 2013, from scholarworks.umb.edu/csp_pubs/56/


CDC
-

Fact Sheet
-

Fast Facts
-

Smoking & Tobacco Use. (2013, June 5).
Centers for Disease Control and Prevention
. Retrieved
June 10, 2013, from

http://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/#use


Carroll, W. (2011, March 1). Hypertension in America: Estimates for the U.S. Civilian Noninstitutionalized Population, Age 18

and Older, 2008.
Statistical Brief #315
. Retrieved June 10, 2013, from
\
http://meps.ahrq.gov/data_files/publications/st315/stat315.pdf


DeNavas
, C., Proctor, B., & Smith, J. (2010, September 1). Income, Poverty, and Health Insurance Coverage in the United
States: 2009.
United States Census Bureau
. Retrieved June 8, 2013, from

www.census.gov/prod/2010pubs/p60
-
238.pdf


Diabetes . (2010, December 7).
Mass.Gov
. Retrieved June 13, 2013, from

http://www.mass.gov/eohhs/researcher/community
-
health/masschip/topics/diabetes.html#state_total


Health Care Access and Screening Indicators . (2010, December 6).
Mass.Gov
. Retrieved June 6, 2013,
from
http
://www.mass.gov/eohhs/researcher/community
-
health/masschip/topics/health
-
care
-
access
-
and
-
screening
-
indicators.html


Holmes
, J., & Madans, J. (2012). Health, United States, 2012: With Special Feature on Emergency Care.
National Center for
Health Statistics
,
1
. Retrieved June 8, 2013, from

http://www.cdc.gov/nchs/data/hus/hus12.pdf#065


McKenna, M., Clifford, C., Gonsalves, D., Hawk, H., & Tinsley, L. (2010). Health Survey Program.
A Profile of Health Among
Massachusetts Adults, 2010
,
1
. Retrieved June 10, 2013, from

http://www.mass.gov/eohhs/docs/dph/behavioral
-
risk/report
-
2010.pdf


Minority Health | The Henry J. Kaiser Family Foundation. (n.d.).
Kaiser Family Foundation
-

Health Policy Research, Analysis,
Polling, Facts, Data and Journalism
. Retrieved June 5, 2013, from

http://kff.org/state
-
category/minority
-
health/?state=MA


Overview of the Uninsured in the United States: A Summary of the 2011 Current Population Survey. (2011, September
1).
ASPE
. Retrieved June 10, 2013, from

http://aspe.hhs.gov/health/reports/2011/cpshealthins2011/ib.shtml


QUICK FACTS on physical inactivity | World Heart Federation. (n.d.).
World Heart Federation | Home
. Retrieved June 9,
2013,
http
://www.world
-
heart
-
federation.org/press/fact
-
sheets/cardiovascular
-
disease
-
risk
-
factors/quick
-
facts
-
on
-
physical
-
inactivity/


Race/Hispanic Ethnicity Report
-

Health Risk Factors . (2010, December 6).
Mass.Gov
. Retrieved June 6, 2013,
from
http
://www.mass.gov/eohhs/researcher/community
-
health/masschip/topics/health
-
risk
-
factors
-
racehispanic
-
ethnicity
-
report.html


Smoking . (2010, December 6).
Mass.Gov
. Retrieved June 7, 2013, from

http://www.mass.gov/eohhs/researcher/community
-
health/masschip/topics/smoking.html


Worcester, Massachusetts (MA) poverty rate data
-

information about poor and low income residents living in this city. (2009,
November 19).
Stats about all US cities
-

real estate, relocation info, crime, house prices, cost of living, races, home value
estimator, recent sales, income, photos, schools, maps, weather, neighborhoods, and more
. Retrieved June 13, 2013, from

http://www.city
-
data.com/poverty/poverty
-
Worcester
-
Massachusetts.html