Cardiovascular deaths are on the decline—but there is still a lot of work to do
Three recent studies, all published in Circulation, shed light on disparities in cardiovascular health outcomes for Black Americans. While the studies are separate, they draw similar conclusions regarding long standing equity gaps, and, in some cases, suggest potential areas for improvement.
All three studies were partially funded by the National Heart, Lung, and Blood Institute, which is part of the National Institutes of Health.
Below are highlights and takeaways from each analysis:
Study 1: Disparities in Cardiovascular Mortality Between Black and White Adults in the United States, 1999 to 2019
To better understand racial disparities in cardiovascular mortality, this study calculated and compared annual age-adjusted mortality rates for Black and White women and men.[1]
While mortality rates dropped significantly over time for each of the four groups, researchers still observed higher mortality for Black women and men than their white counterparts across the board.
“The persistent disparities observed in our study likely reflect the fact that Black adults disproportionately experience social, economic, and environmental barriers to optimal health due to systemic inequities and structural racism,” Rishi K. Wadhera, MD, a section head of Health Policy and Equity at the Smith Center for Outcomes Research at Beth Israel Deaconess Medical Center and an assistant professor of medicine at Harvard Medical School, said in an NIH statement.
The study’s authors also noted that disparities were especially pronounced in rural areas.
Study 2: Racial and Ethnic Differences in All-Cause and Cardiovascular Disease Mortality: The MESA Study
A team of Multi-Ethnic Study of Atherosclerosis (MESA) researchers reached similar conclusions in its own analysis.[2] Despite advances in population health since starting their research in 2000, the group found that racial and ethnic disparities in cardiovascular disease (CVD) mortality are prevalent.
Specifically, over 15 years of follow-up, Black adults had a 34% higher risk of death overall than White adults. Other social determinants of health that served as independent predictors of risk included the socioeconomic status of a person’s neighborhood, access to health care, income, and education.
Even when adjusting for these factors, however, Black adults still had 16% higher risk of death compared to White adults.
“In addition to assessing traditional risk factors for heart disease, such as diabetes, family history, blood pressure, cholesterol, and smoking, this research shows the importance of identifying and accounting for social determinants of health when calculating risk,” Wendy S. Post, MD, MS, a study author and director of cardiovascular research at Johns Hopkins University School of Medicine, said in the same statement.
Study 3:. Association of Extreme Heat and Cardiovascular Mortality in the United States: A County-Level Longitudinal Analysis From 2008 to 2017
This third study, examining increased CVD mortality during the summer heat, found that certain groups—Black adults, older adults, and men—were indeed more likely to die of heart-related causes when the heat index was 90 degrees or above.[3]
In exploring potential solutions, the authors discussed multiple possibilities, including increasing access to shade or cooling centers where needed.