African American Disease

Heart Disease amongst African Americans

When asked what was the main cause of death for the people within the United States is, most people think diseases like cancer or even diabetes, but statistically speaking the number one killer of Americans is heart disease. “Heart disease is the leading cause of death in the United States, and African Americans disproportionately experience more cardiovascular disease, including coronary heart disease (CHD), hypertension, and diabetes”(Schwandt, Coresh, Hindin, 2010, p. 9). What is even more alarming is the fact that in many cases the disease is considered preventable when it comes down to focusing on minimizing an individual’s risk factors. Another shocking revelation is that while the disease can

affect people of all ages and races, it seems to afflict the African American community at a higher rate than others. The African American people make up one the biggest of the many cultural groups within the United States and they are primarily of African descent, but many have nonblack ancestors as well. The African Americans people are the progenies of slaves; their descendants were brought from their African homelands, sold and force to work in the New World. They had very little rights, if any at all and they were denied an equitable share in the financial, social, and civil progress of the United States. The African Americans people have made many lasting contributions to our history and culture. Since heart disease coupled with other diseases is killing a large percentage of the population, why is it more prevalent in the black community? This important issue needs to be addressed, so that heart disease as a whole can be treated more effectively and even prevented when possible.
Heart disease refers to an array of conditions that affects your heart. According to the Mayo Clinic (2014) “the diseases which fall under the heart disease umbrella includes such conditions as blood vessel diseases, coronary artery disease; arrhythmias, or heart rhythm problems; and congenital heart deficiencies”, which are present at birth. Heart disease and cardiovascular terms are often used interchangeably, although when it comes to the cardiovascular disease it generally states to conditions that consist of constrict or obstructed blood vessels that can hint to a heart attack, chest pain or a stroke (Mayo Clinic 2014). There are several other heart conditions, such as those that affect your heart's muscle, valves or rhythm, also are considered forms of heart disease. Most medical experts agree that the many types of heart disease can be stopped or treated with healthy and better lifestyle choices. When analyzing the demographics of those affected by heart disease, the Center for Disease Control (CDC) found that “African Americans are nearly twice as likely as Caucasians to die from preventable cardiovascular disease”(CDC 2013). Those living in Southern states also had the highest rates of preventable deaths from heart disease and stroke.
To gain a deeper understanding of why African Americans are more likely to die from heart disease, one must first examine the way African Americans view healthcare from a cultural standpoint.

“Many scholars have written about the historical underpinnings and likely consequences of African Americans distrust in health care, yet little research has been done to understand if and how this distrust affects African Americans' current views of the trustworthiness of physicians” (Jacobs, Rolle, Ferrans, Whitaker, and Warnecke, 2006, 643). As shown by the increasing number of preventable heart disease related deaths, this distrust of physicians could possibly be a mindset that continues to pass on from one generation to the next. Participants in a study done by Jacobs et al., (2006) point out that trust is determined by the social and technical ability of physicians. There are many factors when it comes to distrust in physicians, such as privation of social and technical ability, the quest for revenue and anticipations of racism and experimentation during routine provision of health care. Trust seems to facilitate care-seeking behavior and encourages patient trustworthiness and adherence. When you have no trust in your physician it can constrain the care-seeking and can/or will result in a change in physician and may lead to non-adherence. If African Americans do not believe that the healthcare system in place looks out for their best interests (Gamble, 1997), they are definitely

less likely to have regular health checkups or heed the advice of physicians in order to prevent or treat heart disease.
Another topic that must be considered is the affordability of healthcare in America. Statistically, 17.8% of African Americans under the age of 65 are without health insurance. There are programs such as Medicaid that provide low to no-cost medical care, but a large percentage of the population fall just above the maximum household income and are still not able to afford private medical insurance (CDC, 2012). The bottom line: money has a lot to do with quality and availability of healthcare for the African American community. Among the African American population there was sixty-one percent of adults uninsured during a specific year whom acquired medical bills or debt problems, 5% higher amongst the uninsured white adults and 26% higher than of the uninsured Hispanic adults. The Minority Americans face indomitable disparities when it comes to rates of health care coverage, as well as cost and access barriers to care even when they do have health insurance.` “Despite remarkable improvements in the overall health of the nation during the past two decades, compelling evidence suggests that the nation's racial and ethnic minority Americans suffer increasing disparities in the incidence, prevalence, mortality, and burden of diseases and adverse health outcomes compared with white Americans” (Copeland, V, 2005, p.3).
Though economic status contributes to heart diseases’ rampant run, it was found that African American adults still have greater rates of health difficulties among both the lower and higher income groups.

Sixty-three percent of African American adults below the poverty line described having one out of the four chronic diseases (hypertension, heart disease, diabetes or asthma) or a disability, compared to half of low-income whites and 39 percent of low-income Hispanic adults. Forty-five percent of African American adults whom are considered below the poverty line reported health problems, compared to 32 percent of whites and 23 percent of Hispanics in the higher income group (CDC

2013).
One common question that arises when looking at the prevalence of heart disease in African Americans is whether they are genetically predisposed to certain diseases. Scientists have been working diligently to find the basis for the discrepancies between race and the predisposition for development of diseases such as type II diabetes and cardiovascular disease. Could the factors such as differences in standard of living or access to health care play a role, or is there something else in play? Latest findings propose inherited genetic distinctions exist between whites and blacks living in the U.S., leading to less efficient metabolism of glucose and predisposition to diabetes, which can contribute to cardiovascular issues in African Americans. What is the implication of this difference between how whites and blacks metabolize sugars? Why do these dissimilarities exist? The answer may lie far back in history, in a time when these races were not living in the same country or environment. The researchers suggest that the obvious inhibition of glucose metabolism in blacks may be a likeness of an environment where food was scarce or that the diet was considerably different to that consumed by whites. Even though the finding may be debatable, it wasn’t the first time researchers have found that geographic descent predicts genetic variations. As another example, G6PD deficiency, a genetic disorder that affects red blood cells and is most common in African-American males, is believed to have developed in some populations as a defense against malaria. These studies raise the question, are there other examples of groups of gene changes that might be protective under some environments or nutritional scenarios, and maladaptive under others according researchers at (UNC, 2009)?
Another reason that heart disease may be affecting African Americans at a higher rate is cultural influences like diet and exercise. Cardiovascular disease has five major risk factors, high blood pressure, high blood cholesterol, cigarette smoking, excessive body weight, and physical inactivity. These are problems in any community and probably more so in the African American community in part because of the large number of African Americans who live in lower socioeconomic settings. If you are economically at a disadvantaged, you have a tendency to eat the low-cost, most unhealthy food and your health takes a back seat to basic nourishment.