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The Heart of the Matter

As Americans are expressing interest in bettering their health, the African American community remains stagnant on health improvements, says Dr. Christopher J.W.B. Leggett, director of cardiology at Medical Associates of North Georgia.  In addition, a study done by the American Heart Association indicates that African Americans remain at greater risk for cardiovascular disease and stroke than white Americans, which may partially be a result of how blacks receive treatment for such ailments.

The difference between the cardiovascular treatment received by whites and minorities is increasing. To combat the problem, some of the country’s leading physicians have joined forces to develop an initiative called Close the Gap, which raises awareness of the issue and ensures that eligible candidates receive the medical attention they deserve, regardless of background.

“These disparities exist even when we adjust for insurance, age, or income. Minorities continue to fall short in terms of less access,” says Leggett who serves as a member of the Close the Gap steering committee.

A collaborative effort between the medical company Boston Scientific and its partners, including the Association of Black Cardiologists and Black Coaches and Administrators, Close the Gap was launched in February with the goal of defining the disparity problem on a national level while simultaneously developing the necessary tools to provide local solutions.  “If you eliminated the disparities and brought the standard of healthcare in African American populations up to the standard of the Caucasian population, you would essentially save 900,000 lives,” says Dr. Charles Noble, an Ohio-based electrophysiologist who also serves on the steering committee.

With pilot projects in 10major cities, including, New York City; Atlanta; and St. Paul, Minnesota, the focus is on community education. Through seminars and brochures, Close the Gap reaches out to both patients and physicians, addressing the issues of healthcare awareness and cultural sensitivity.

Citing patient culture as one of the hurdles to be conquered, Leggett says it is necessary for minorities to not only familiarize themselves with diseases that plague their communities, but

also to be open to and educated about the various treatment options available. “Sometimes the appropriate treatment could be recommended by the physician but refused by the patient,” says Leggett.

On the other hand, doctors cannot avoid the role physician bias plays in widening the gap that divides minority cardiovascular care from that of the white population. “We as doctors have to own up to being participants in this disparity,” says Leggett, who accepts that the bias may not be intentional on the part of most physicians, but a side effect of socialization that should not be ignored.

The doctors anticipate that soon there will be visible evidence of progress. Both Leggett and Noble are looking forward to a decline in the number of cardiovascular-related deaths among minorities and an increase in the number of patients receiving adequate treatment. In the end, they hope to completely eliminate all disparities in cardiovascular healthcare and reduce the number of minorities being affected by such diseases to the same level as white Americans.

“If we can achieve that goal, Close the Gap will not only be successful,” Leggett says, “but the country will be healthier, and people will get the treatment they deserve.” For more information on the initiative, visit www.heart-healthdisparities.
com.

THE FACTS ON BLACK AMERICANS AND HEART DISEASE

Based on data from the Census Bureau and Centers for Disease Control and Prevention, it is estimated that there are approximately 700,000 black Americans with heart failure in the United States, and this number is expected to grow to 900,000 by 2010.

Black Americans between the ages of 45 and 64 are 2.5 times more likely to die from heart failure than white Americans in the same age range.

Black Americans have almost twice the risk of first-ever stroke compared with whites.

Black Americans are 2 times more likely than white Americans to be diagnosed with diabetes and 1.5 times more likely to be diagnosed with hypertension–important risk factors for heart disease.

The prevalence for Peripheral Artery Disease (PAD) increases dramatically with age and disproportionately affects black Americans.

Black Americans are at greater risk for cardiovascular disease and stroke than white Americans.

The prevalence of hypertension in black Americans in the United States is among the highest in the world.

The annual rate of first heart attacks is higher for black Americans than for white Americans.

SOURCE: BOSTON SCIENTIFIC

GENERAL HEART DISEASE STATISTICS

More women than men die of heart disease, although more men have heart attacks.

As you age, your risk for heart disease increases.

At age 40, the lifetime risk for developing heart disease is 2 in 3 for men and more than 1 in 2 for women.

Heart disease causes more deaths in Americans of both genders and all racial and ethnic groups than any other disease.

Black Americans, American Indians, Alaskan Natives, Asian/Pacific Islanders, and Latino Americans die at earlier ages from heart disease.

This story originally appeared in the July 2008 issue of Black Enterprise magazine.

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