The Poorest African Americans at Highest Risk for Heart Disease

By S.C. Rhyne

One in every four deaths in the United States is caused by heart disease, which is the leading cause of death for both men and women, according to the U.S. Centers for Disease Control and Prevention (CDC). 

African Americans at lower socioeconomic levels, particularly women and younger adults, are at greater risk of heart disease and stroke than those in higher socioeconomic positions according to a new study.

Nearly half of all African American adults have some form of cardiovascular disease (CVD), and they are twice as likely as white adults to have a first-ever stroke, according to research was published in the Journal of the American Heart Association on May 27.

Scientists analyzed data from more than 5,300 Black Americans from the Jackson Heart Study, in the Jackson, Mississippi area; participants were followed for up to 10 years.

During this time, 362 new or recurrent CVD events were recorded, including heart attacks, heart disease deaths, strokes and cardiovascular procedures. Of these events, 213 were in women and 149 were in men.

Multiple measures were used to assess participants, including education, income, wealth and public assistance. For each measure, they divided the study population into thirds by defining low, medium and high.

Researchers also adjusted for known behavioral and health risk factors such as smoking, alcohol use, physical activity, body mass index, type 2 diabetes, hypertension and cholesterol.

Participants’ socioeconomic status was assessed in both adulthood and childhood, though family income during childhood wasn’t linked to later-life cardiovascular risks.

“African Americans with low socioeconomic status (SES) are more likely to have higher rates of obesity, hypertension, type 2 diabetes and physical inactivity compared to their counterparts of higher SES,” said lead study author, Samson Y. Gebreab, Ph.D., M.Sc. to Reuters Health. “  

Another possible explanation is that African-American women of low SES experience higher rates of psychosocial stressors such as chronic stress, depression, discrimination and are more likely to live and work in a worse physical and social environment.”

This means that poorer Black women have far fewer resources at their disposal to cope with these stressors and thus creates a recipe for a higher risk of heart attack and stroke. 

Resources could mean access to healthcare, healthy food options or safe streets/place to exercise—including parks or playgrounds.

Here is a rundown of the major findings:

*Women in the lowest socioeconomic group had more than twice the risk of experiencing a CVD event than those in the highest group.

*Men and women 50 years and younger in the lowest socioeconomic group had more than three times the risk of experiencing a CVD event than those in the highest group. 

*Being an African American adult age 50 or younger or an African American woman of any age remained independent predictors of CVD.

By itself, wealth proved to be an independent predictor of CVD in women. Those in the lowest third were 68 percent and those in the middle third were 61 percent more likely to experience a CVD event than those in the top third.