• Posted August 15, 2023

Heart Disease Targets Black Americans and Poverty, Unemployment Are Big Reasons Why

What researchers call 'social factors' are largely responsible for Black Americans having a greater risk of death from heart disease than whites, according to a new study.

Among the social factors that contribute to this racial disparity are unemployment, low income, lack of regular access to health care and lack of a partner, Tulane University researchers said.

“For so many years we have focused on smoking, diet, physical activity, obesity, [high blood pressure], diabetes and high cholesterol -- and we know those are important" for preventing heart disease, said lead author Dr. Jiang He, chair in epidemiology at Tulane University's School of Public Health and Tropical Medicine in New Orleans. He added he was surprised that the Black-white difference in heart-disease death rates owes mainly to social factors.

Black Americans are 54% more likely to die of heart disease than white Americans, the study found.

This is true even with a substantial overall reduction in heart disease deaths nationwide.

The study used health data from more than 50,000 U.S. adults. The researchers examined links between heart-related deaths and clinical risk factors like obesity, diabetes and high blood pressure as well as lifestyle factors, including smoking, unhealthy diet, lack of exercise and too little or too much sleep.

Researchers also considered social risk factors, such as unemployment, low income, food insecurity, limited education, lack of private health insurance, poor access to health care, and not being married or living with a partner.

Compared to white adults, Black adults had a 54% higher risk of heart-related death, which dropped to 34% after adjusting for clinical factors and 31% after adjusting for lifestyle risk factors.

"However, after adjusting for social risk factors, this racial difference totally disappeared,” He said in a university news release.

This research follows another Tulane study that showed Black Americans are 59% more likely to die prematurely than white Americans. Adjusting for social factors -- referred to as social determinants of health -- reduced that gap to zero.

He said these findings underscore the importance of well-paying jobs, health care access and social support.

He plans to put these findings into practice with a program that aims to address high blood pressure in New Orleans' Black communities. It will partner with local churches to provide health screening training and free medication.

“It is essential to develop novel community-based interventions for reducing cardiovascular disease risk in Black populations,” He said.

Study findings were published Aug. 15 in Annals of Internal Medicine.

More information

The U.S. Department of Health and Human Services has more on the social determinants of health.

SOURCE: Tulane University, news release, Aug. 14, 2023