The Impact of Health Disparities in African-American Women

Article excerpt

Introduction

Over the past two decades the overall health of the nation has improved significantly. However, research shows that wide disparities in health and healthcare continue to persist throughout the United States. Particularly striking are disparities in the occurrence of illness and death experienced by African Americans1 caused by higher rates of cardiovascular disease (CVD), cancer, stroke, diabetes, AIDS, and a shorter life expectancy. Possible explanations for these disparities are the complex interaction of biological factors, environment, ethnicity, insurance, and certain health behaviors or lifestyle choices. Equally important are the effects of socioeconomic factors (SES), education and income in creating health disparities. For AA women, poverty, race and ethnicity play a significant role in lower health quality and health outcomes.

The leading causes of death for all women in the U.S. are heart disease, cancer, AIDS, stroke, and diabetes.2 The number of new cases (incidence) and death rates for these diseases among AA women continues to rise despite declining rates for whites. AA women have the highest cancer death rates for breast colorectal, and pancreatic cancers.3 Overcoming persistent health disparities and promoting healthy behaviors for AAs is a formidable health challenge.

Heart Disease, Hypertension, and Stroke

Data from 2001 indicates that coronary heart disease (CHD) is the leading cause of death (498,863) for women in the U.S. followed by lung cancer (65,632) and breast cancer (41,394).4 Over the past decade the number of deaths from cardiovascular (CVD) has declined. However, the rate of decline is smaller for women and for African Americans. For example, 38 % of women the within the first year after diagnosis compared to 25 % of men.

Coronary heart disease (CHD), which is a sub-set of cardiovascular disease, occurs when plaque builds up in the arteries. The death rate for African American women is 377 per 100,000 compared to 274 per 100,000 in white women. One in five women has some type of heart disease; the death rate is 20% higher for African Americans than whites. The incidence rate of stroke is disproportionately higher in African Americans, and the death rate is nearly 28% higher than in whites.5

Major risk factors for developing heart disease are: unhealthy cholesterol level; high blood pressure (greater than 130/85 for an extended time period); smoking- which leads to damaged blood vessels and blocked oxygen delivery to the body's tissue; insulin resistance-inability of the body to utilize insulin appropriately; diabetes; obesity; metabolic syndrome-a group of factors related to excess weight and obesity that leads to heart disease, stroke and diabetes; no physical activity; increasing age; and family history of early heart disease (before age 55 for men and 65 for women). Having a family history of early heart disease and aging are uncontrollable risk factors, which if present, do not necessarily mean that developing heart disease is imminent, but that the risk is elevated. It is important, particularly as we get older, to make healthy lifestyle changes that minimize other risk factors.

Nearly 1 in 3 adult Americans has high blood pressure is defined as blood pressure at or above 140/90. A normal blood pressure is 120/80 mmHg or lower. Once high blood pressure develops it usually lasts a lifetime. Nevertheless, it is treatable and in many cases can be controlled with diet, exercise and medications. When the blood pressure is elevated and left untreated it can cause an enlarged heart, leading to heart attack, heart failure, kidney failure, and stroke. Often, blood pressure problems are undetected and untreated until there is heart, brain, or kidney trouble; hence, hypertension has been called the 'silent killer'. High blood pressure accounts for 18% of the overall death rate. However, it accounts for 41% of deaths in AA women and 50% in AA men. …