Heart disease is the leading cause of death in the United States. The risk of having or dying from heart disease varies by race. Black, Indigenous, and People of Color (BIPOC) are more at risk for complications from heart disease than white Americans. This includes a higher death rate and is partly due to the barriers to healthcare BIPOC groups face.
Heart disease accounts for about
The Centers for Disease Control and Prevention (CDC) state that heart disease is the biggest cause of death for most BIPOC living in the U.S., including the following groups:
- African American
- American Indian
- Alaska Native
This article explains how a person’s race affects their risk for cardiovascular disease.
According to the same data from the CDC, heart disease death rates overall have fallen for white Americans since 1999. However, the rate of heart disease has remained consistent among Black, Hispanic, and Asian American groups.
Even though white Americans have the highest rate of heart disease diagnosis, they are less likely than Black Americans to die of the disease.
According to the
|non-Hispanic Black adults||208 per 100,000 persons|
|non-Hispanic white adults||168.9 per 100,000 persons|
|Hispanic adults||114.1 per 100,000 persons|
|non-Hispanic Asian or Pacific Islander adults||85.5 per 100,000 persons|
While anyone can develop heart disease, certain risk factors increase the likelihood. These
- age, with the risk increasing after the age of 35 years
- sex, as males are more likely than females to develop heart disease
- a family history of heart disease
However, BIPOC groups have a higher prevalence of certain conditions that raise their risk for developing cardiovascular diseases. These include:
High blood pressure
Within each group, there were also significant differences. For example, 43% of people from South Asia and 39.9% from East or Southeast Asia had hypertension.
Many factors other than genetics can lead to a higher risk of BIPOC developing high blood pressure, including racism in healthcare and everyday life.
For example, researchers in a
Obesity is a significant heart disease risk factor. It may also signal other risk factors, such as a low-quality diet and an inactive lifestyle.
According to the CDC,
Higher poverty rates and
- 22.1% for Hispanic people
- 20.4% for Black people
- 19.1% for Asian people
- 12.1% for white people
Within groups, there was significant variation. For example, 12.3% of South American Hispanic participants had diabetes compared to 21.7% of Mexican participants.
These disparities happen due to a number of factors, including:
- lack of access to quality healthcare and checkups
- residential segregation
- higher poverty rates among BIPOC groups
- higher stress rates among BIPOC groups
Race is a
Many of the risk factors that can lead to cardiovascular disease or complications from the conditions are preventable and exist because of systemic racism.
A number of modifiable factors could help reduce disparities between groups:
Racism causes chronic stress, which can increase the risk of developing heart disease. This occurs through “weathering,” a term that describes the long-term impact of exposure to racial stress on a person’s overall health.
A 2019 study found that out of 2,694 people, weathering contributed to Black Americans having a biological age that was 2.6 years older than their actual age, while white Americans’ biological age was 3.5 years younger.
Access to resources
It can be more difficult for individuals from BIPOC groups to access healthcare in comparison to white people. This is true for a number of reasons.
For example, residential segregation in the U.S. means that predominantly Black neighborhoods have fewer financial resources and are
Economic inequity also contributes to healthcare being unaffordable for many, making it difficult to access or pay for medical treatment. For undocumented migrants, the fear of deportation
Racism in medicine
Numerous studies have found that individuals from BIPOC groups receive lower-quality healthcare than white people.
For example, in an older
In 2020, the American Heart Association (AHA) emphasized that structural racism is a key driver of disparities in heart disease and heart health outcomes. The organization called for more research on the health effects of racism and urged providers and organizations to examine their role within systemic racism.
One example of an organization that has committed to promoting antiracist policies is The Commonwealth Fund. Measures they call for include:
- Improvements in how doctors help individuals from BIPOC groups with chronic conditions, such as high blood pressure, to control their symptoms. This strategy should address the issues of trust that exist between healthcare professionals and BIPOC.
- More transparency on racial disparities in the treatment of certain conditions by collating and publishing data.
- More information in order to better educate people from all racial groups about factors that could affect their health.
- A better understanding of how structural racism affects the way individuals from BIPOC groups can engage with their treatment and healthcare professionals. This could include an acknowledgment of limited public transport and food deserts.
Systemic and unfair health disparities, or inequities, are something everyone has a responsibility to change. At an individual level, though, there are also things people can do to reduce their risk for heart disease. Where possible, people can try:
- eating a heart-healthy diet that focuses on high-fiber fruits and vegetables, lean proteins, and healthy unsaturated fats, such as olive oil
- exercising regularly
- quitting smoking
- reducing, or stopping, drinking alcohol
- avoiding foods high in saturated fat or added sugar
- monitoring blood pressure to detect early signs of hypertension
- seeking treatment for any chronic conditions or unexplained symptoms
- telling a doctor if a person has a family history of heart disease, so they can monitor them more closely
In the U.S., the mortality rate for cardiovascular disease is higher among certain racial and ethnic groups than it is among white people. Conditions that elevate the risk of cardiovascular diseases, such as hypertension and obesity, are also more prevalent among BIPOC groups.
Evidence shows that the chronic stress, socioeconomic inequity, and discrimination caused by racism all contribute to this disparity.