A big risk factor? Not being aware of your heart health history.
Heart disease affects all Americans, and it's currently the number one cause of death in the country. However, there is a disparity as to how detrimental it is between Black Americans and other demographics. Many Black women either have heart disease or are at a higher risk for heart disease and do not know it.
Risk factors for heart disease include:
- Physical inactivity
- Chronic stress
- A family history of heart disease
- High blood pressure
- High cholesterol
These risk factors are common throughout the country across demographics—so what makes Black women’s risk unique?
Why Are Black Women More at Risk for Heart Disease?
For starters, a lot of research and funding has gone toward studying heart disease in men. More recently, it has become clear that women actually experience heart disease differently, so not all research in male heart disease can be applied to women.
Second, society has lagged in raising awareness among Black women that they need to pay attention to their heart health—and how to look out for warning signs. Heart disease has so long been thought of as something men deal with, yet it’s the leading cause of death in Black women, according to Centers for Disease Control and Prevention. In fact, Black women are more likely to die from heart disease than from breast cancer, even though the latter gets more awareness.
Next, add the increased risk for stroke and other cardiac events that women face stemming from pregnancy, preeclampsia, birth control, and hormone therapy during menopause. Black women endure disadvantages due to both their sex and race.
Socioeconomic Determinants of Health
To be clear, Black women aren’t born with heart health problems. Instead, their risk factors may stem from their environments. “It seems like one of the biggest drivers of [the risk of heart disease] is what we call the socioeconomic determinants of health,” says Dr. David Anstey, a cardiologist at Columbia University’s Irving Medical Center.
Socioeconomic determinants of health can affect “our food choices, our access to information, the stress we experience on a daily basis, and our ability to make the right decisions so that we can start to make lifestyle changes,” says Dr. Anstey.
It’s important to take a look at how those risk factors are magnified by these socioeconomic factors that disproportionately impact Black Americans. It includes:
- Increased consumption of fast food and processed food (due to food deserts [limited access to healthy foods], socioeconomic status, and exploitative marketing, and locations of fast food restaurants).
- Higher rates of obesity, which is a risk factor for heart disease due to the burden on the heart muscle and effect on blood pressure, cholesterol levels, and blood glucose.
- Higher rates of high blood pressure.
- Increased rates of chronic stress due to generational trauma, racial discrimination, and disproportionate rates of incarceration.
- Reduced access to health care, health insurance, or doctors they trust.
- Increased likelihood of living in denser, more polluted, and under-resourced neighborhoods.
In situations where social determinants of health play a role, these factors all may more significantly perpetuate a cycle for Black families and individuals to be trapped in “survival mode.” Among lower-income families, having basic needs for shelter, food, and water met doesn’t foster the ability for Black women to accrue disposable income. This is often needed to dedicate time, funds, and effort to exercise, afford fresh and high-quality food, manage stress levels, and see a doctor regularly for health checkups.
Managing Your Risk of Heart Disease
When it comes to your personal risk for heart disease, there are some factors you have more control over more than others. These controllable risk factors include:
- Know your numbers: Keep track of your blood pressure, cholesterol, blood sugar, and weight/BMI each year.
- Reduce your sodium intake. Just half a teaspoon (or one extra gram) could significantly affect blood pressure, according to the American Heart Association.
- Eat a heart-healthy diet focused on fruits, vegetables, whole grains, legumes, nuts, and seeds. Try to limit intake of added sugars, processed (packaged) food, and fast food.
- Exercise regularly—even if you start at just 10 minutes a day before building up to 30 minutes.
- If you’re smoking, it’s time to think about quitting. Although one in five Black women smoke, limit your temptations to start if you don't already. Research shows that you can cut your risk by as much as half a year after you quit smoking.
Talk to and build a relationship with your primary care doctor. They will know you best, can help determine which tests you might need to take, and provide resources to make lifestyle changes that make a difference.
David Anstey, MD, is a cardiologist at Columbia University Irving Medical Center.
- Leading Causes of Death – Females – Non-Hispanic black – United States, 2017. Washington, DC: Centers for Disease Control and Prevention, 2017. (Accessed on August 10, 2021)
- Heart Disease in African American Women. Dallas, TX: The American Heart Association. (Accessed on August 10, 2021)
- Overview of primary prevention of cardiovascular disease. Waltham, MA: UpToDate, 2021. (Accessed on August 10, 2021)
- Obesity and African Americans. Rockville, MD: U.S. Department of Health and Human Service Office of Minority Health, 2020. (Accessed on August 10, 2021)
- The Heart Truth® For African American Women: An Action Plan. U.S. Department of Health and Human Services National Heart, Lung, and Blood Institute, 2009. (Accessed on August 10, 2021)
- Why Are Young Black Women at High Risk for Cardiovascular Disease? Dallas, TX: American Heart Association, 2019. (Accessed on August 10, 2021)
- Heart Disease In Black Women: The Big Issue You Might Not Know About. Black Women’s Health Imperative, 2021. (Accessed on August 10, 2021)
- Heart Disease in African-American Women: What To Look For. San Diego, CA: Scripps Health, 2021. (Accessed On August 10, 2021)