Friday, May 19, 2017

Heart Disease Crisis in Black America

by Kenny Anderson

Heart disease disproportionately affects Blacks in America, a 2009 study published in the New England Journal of Medicine revealed that one in 100 Black men and women between 18 and 30 develops heart failure before age 50, a rate that is 20 times higher than whites in the same age group. 

According to 2013 data from the American Heart Association 48% of Black males age 20 and older have heart disease, while 44% of Black males age 20 and older have heart disease. 

Heart disease is the number one killer of Black women and men in America. Black women’s death rate from heart disease is 31% and Black men’s death rate from heart disease is 34%. Black men are 30% more likely to die from heart disease than white men; Black men account for over 100,000 more heart disease deaths than white men.

Black men and women are more likely to die of a heart attack or heart failure than whites in the United States. A study (2003 – 2007) at the University of Alabama at Birmingham shows that every year during the study, 4 in 1,000 Black men died from heart disease, on average compared to 1.9 of 1,000 white men, the researchers found. Among women, 2 in 1,000 Blacks died of heart disease each year, compared to 1 in 1,000 whites.
Though Blacks suffer from much higher rates of heart disease they receive less heart catheterizations. A study that appeared in the March issue of Journal of the National Medical Association, researchers compared the rates of cardiac catheterization in about 585,000 white, 51,000 black, and 32,000 Hispanic people treated for heart attack in U.S. hospitals from 1995-2001. Researchers found cardiac catheterization rates were higher for whites than Blacks for all years examined, while rates among Hispanics approached that of whites during the study period.
  

Slavery Connection and Black Heart Disease


One enduring critical issue that has negatively impacted Blacks from past to present is the stress of racism. The American Journal of Human Biology contains details of two studies that contend that poor nutrition and stress stemming back to the days of slavery could help explain Black-white differences in cardiovascular health in the United States.

In one study, researchers from Northwestern University explain how nutrients and hormones present in the womb can profoundly shape a fetus's development, in part by silencing certain genes. These influences, say the research team, can persist into later life to impact adult health, a process known as 'fetal programming'. The researchers argue that such inter-generational impacts of environmental factors could help explain racial health differences.

Christopher Kuzawa and Elizabeth Sweet who co-authored the research article says a pregnant African American mother's experience of well documented stressors including social forces such as discrimination and racism could have lingering effects on diseases like hypertension, diabetes, and heart attacks in her children.

By synthesizing this new evidence, they argue that the socioeconomic stress forces, rather than genes, may underlie the problem of racial inequity in heart attacks and strokes. Indeed the social force strain of racist socioeconomic deprivation and stress wreaks havoc on the minds and bodies of Black men that causes greater emotional distress and heart disease. Tupac Shakur once rapped that every day too many Black men “got to try to make a dollar out of 15 cents.”

Stress and High Rates of Black Heart Disease

One enduring critical issue that has negatively impacted Blacks from past to present is the emotional distress of racism. In her book, ‘Environmental Stress and African-Americans’, author Grace Carroll states that race is brought to the consciousness of African Americans every day through interaction with employers, service providers, landlords, the police, and the media. 

Carroll says the stress experienced by Blacks merely as a result of being African American causes micro-aggressions that include experiences such as being denied jobs, being targeted, being falsely accused, being negatively portrayed and singled out on account of one's race.

Carroll labels the stress resulting from such micro-aggressions as Mundane Extreme Environmental Stress (MEES) that has a daily significant negative impact on one's psychological well-being, physical health, and world view; it is environmentally induced, frustrating, detracting, energy consuming, immune draining, and overwhelming. 

Racism induced emotional distress whether in the form of stress, worry, depression, or anger can increase the risk of heart disease, heart attack, and stroke a growing body of research studies have found.

A research team led by Carnegie Mellon University's Sheldon Cohen has found that chronic psychological stress is associated with the body losing its ability to regulate the inflammatory response. Published in the Proceedings of the National Academy of Sciences, the research shows for the first time that the effects of psychological stress on the body's ability to regulate inflammation can promote the development and progression of disease.

Cohen argued that prolonged stress alters the effectiveness of cortisol to regulate the inflammatory response because it decreases tissue sensitivity to the hormone. Specifically, immune cells become insensitive to cortisol's regulatory effect. In turn, runaway inflammation is thought to promote the development and progression of many diseases.

Another study provides a better understanding of why chronic stress leads to high levels of inflammation in the body. Researchers found that chronic stress changes gene activity of immune cells before they enter the bloodstream so that they're ready to fight infection or trauma even when there is no infection or trauma to fight. This then leads to increased inflammation.

The University of California, Los Angeles researchers looked at blood samples from both the stressed mice, as well as humans who came from differing socioeconomic statuses. Just like in the mouse part of the experiment, 387 genes were identified that had differences in activity between the people who came from low socioeconomic backgrounds and those who came from high socioeconomic backgrounds. 

And just like in the mice, the up-regulated genes in those who came from low socioeconomic backgrounds were pro-inflammatory. 

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