Realities of heart disease in Black and Hispanic women

More than one in three women in the United States are living with some form of cardiovascular disease, with heart disease being the leading cause of death for many.

But cardiovascular disease doesn't affect all women alike. Forty-nine percent of Black women ages 20 and older experience heart disease and are more likely to endure heart disease-related deaths at earlier ages. On average, Hispanic women are more likely to develop heart disease 10 years earlier than non-Hispanics. Heart disease is also the second leading cause of death among Latinos after cancer

So, how do you make sense of Black and Hispanic women being disproportionately affected by cardiovascular disease? A few areas to think about:

Issues with making lifestyle changes

The reality is that lifestyle changes, things like food, exercise and self-care practices that decrease your risk of cardiovascular disease, are greatly connected to your access to a social and physical environment that promotes good heart health. For many minority communities, however, access to these necessities has been historically complicated by systematic and institutional discrimination. The result? Social determinants of health, or conditions in which people live, that have negatively impacted quality of life, health risk and outcomes for entire communities.

With the added variables of sex and gender, women of color are especially vulnerable to health inequities, as reflected in the extreme rates of cardiovascular disease and risk factors in Black and Hispanic women. For example, more than 80% of mid-life Black women and 77% of Hispanic women are overweight or obese, compared with 63% of whites.

When living in a food desert, which is the case for many of these communities, managing weight can be difficult without access to nutritious food. The options available in some neighborhoods promote an unhealthy eating pattern, with fast food restaurants and convenience stores carrying foods high in saturated, trans fats, and sugar - things that raise cholesterol levels and increase the risk for high blood pressure. Consequently, 46% of Black women and 31% of Hispanic women end up having high blood pressure.

Hurdles getting in physical activity

Physical activity could offer some recourse against extra calories and risk factors. However, it's middle-class neighborhoods, which are more likely to be predominately white, that have more facilities, organized programs, and safe, green, walkable space available for physical activity. Without these types of recreational spaces for diverse communities, nearly 14% of Black women and 13% of Hispanic women develop diabetes from the lack of physical activity and a poor diet, compared with about 7% of whites.

Unsupported self-care

The idea of self-care is a culturally taboo one for Black and Hispanic women. In both Black and Hispanic cultures, women are often called upon to be the caregivers for children, partners, parents, and extended families, sometimes on their own, while also working and maintaining relationships, leaving little to no time to prioritize routine care, diet and exercise. This amount of responsibility can also create a greater exposure to chronic stress that further exacerbates risk factors for cardiovascular disease.

Access to health care problems

To add to these circumstances, people from some racial and ethnic minority groups face difficulties accessing health care services in general. Compared to non-Hispanic whites, Blacks and Hispanic people have persistently lower insurance rates at all ages, and don't get access to the care and medications they need. For Black and Hispanic women, factors such as access to transportation, childcare or ability to take time off work can make it even more challenging to get to the doctor and are therefore less likely to have a primary care provider. For Hispanic communities specifically, with language barriers and no one to translate, the patient provider interaction is affected and so is the quality of care they receive.

It's also important to note that people in minority groups may be distrustful of the healthcare system as a result of history filled with examples of exploitation at the hands of doctors and medical researchers, and therefore, they just don't go. With challenges accessing health care, in comparison to 65% of white women, only 36% of Black women and 34% of Hispanic women are aware of cardiovascular disease being among of their most significant health risks.

Understanding how social determinants of health impact access to health care and creating culturally sensitive approaches to raise awareness in these communities is of supreme importance in addressing the disparity in the rates of cardiovascular disease these populations face.