Understanding Racial Disparities in Heart Health

Black Americans are far more likely to live with heart and cardiovascular diseases than any other demographic in the U.S.

Fact checked by Nick Blackmer

Heart disease is the top cause of death for all adults in the United States. For the Black community, the risk of heart disease—a term that refers to several different conditions—is higher than any other racial or ethnic group.

Not only are Black Americans more likely to be diagnosed with heart disease and die from it, but they’re also disproportionately affected by chronic conditions, such as high blood pressure, diabetes, and obesity, that increase the likelihood of developing heart disease.

Genetics is only one piece of the puzzle when it comes to who will develop heart disease: the communities we’re part of, the environments in which we live, and the resources available to us also make a difference.

These factors are called social determinants of health (SDOH), and they play a large role in the health inequities people of color often face. Facing racism, living in neighborhoods with high rates of pollution, and having limited access to healthcare and nutritious food—situations disproportionally experienced by people of color—place consistent stress on the body, making cardiovascular or heart disease more likely.

Take for example, peripheral artery disease (PAD), a common cardiovascular disease that affects more than 12 million Americans. Black Americans are twice as likely to develop PAD as their white peers, in part, because of SDOH that increase the odds of developing risk factors like high blood pressure, smoking or tobacco use, and diabetes. Despite having higher rates of PAD, most people in the Black community (and the U.S. in general) have never heard of the condition.

Below, we explore the intersection of racial inequity and cardiovascular disease risk. From the ways in which lifestyles and environments affect risk factors and disease outcomes, to deeper dives on heart diseases and the populations they most affect.

Omar’s Story: Cardiac Arrest Survivor Turned Heart Health Educator

In the past year, disparities in heart health have played out in professional athletics. Two high-level players—Buffalo Bills safety Damar Hamlin and USC Trojans guard Bronny James—had cardiac arrests while playing their respective sports. These events are part of a larger issue: Black male athletes and their increased risk of cardiac arrest.

Sudden cardiac arrest is the leading cause of sudden death among young athletes in the U.S., and young, Black male athletes carry the majority of that burden. At the Division 1 college level, the incidence rate of sudden cardiac arrest or death is 21 times higher in Black male basketball players than the average among high school male athletes of all races.

Omar Carter, 36, knows this first-hand. At 25 years old, Carter had a cardiac arrest on the basketball court. His heart stopped for 13 minutes, and it took three shocks from an automated external defibrillator (AED) to get it beating again. Now, more than a decade later, Carter teaches others the importance of bystander CPR and AED use through his nonprofit, the Omar Carter Foundation.

Health reporter Julia Landwehr spoke to Carter about what happened on the day of his cardiac arrest, and the mental and physical recovery that followed. Read his story below to learn more about his foundation, how he’s doing now, and what we know about the heightened risk of cardiac arrest for young, Black male athletes.

Heart-Healthy Diets Are a Good Start, But Not Enough to Extinguish Disparities

The ability to access healthy, nutritious food is another social determinant of health directly related to heart disease risk. Eating a filled with fresh, whole foods; being physically active each week, and maintaining a healthy weight can drastically lower your chances of having a heart attack or stroke.

However, research from 2021 shows that one in every five Black families lives in a food desert, with an abundance of convenience stores but little to no access to fresh food options. Meanwhile, a diet that consists of foods high in sodium—like many of the options you’d find in a convenience store —is a leading risk factor for heart disease.

It can be difficult to follow a “healthy” diet if you don’t have the tools or resources to do so. If you feel overwhelmed or unsure of where to start, following a specific heart-healthy diet can provide guidelines and structure.

In the article below, Health writer and nutritionist Johna Burdeos, RD, outlines three types of diets that have been scientifically proven to promote good heart health. All three diets limit foods high in sodium and saturated fats, highly processed foods, and added sugars, and emphasize fruits and vegetables, whole grains, nuts, and legumes. Following these diets can be a great starting point for improving blood pressure, low-density lipoprotein (LDL) cholesterol, and excess weight.

Frequently Asked Questions

Is cardiovascular disease the same as heart disease?

The two are often used interchangeably, but cardiovascular disease (CVD) and heart disease are not the same thing. CVD is an umbrella term for all types of diseases that affect the heart and blood vessels. Heart disease is a type of cardiovascular disease made up of conditions that affect the heart only.

How can you prevent heart disease?

There are certain heart disease risk factors you cannot change, like getting older and your genetics, but a handful of lifestyle changes can offer protection, including:

• Managing blood pressure

• Keeping cholesterol under control

• Maintaining a healthy weight

• Eating a nutritious, balanced diet

• Exercising regularly

• Keeping stress levels low

• Managing diabetes

• Getting enough sleep

Is heart disease hereditary?

It’s possible that genetic factors play a role in heart disease or the conditions that increase a person’s risk of heart disease, but a family history of heart disease may also be attributed to a shared environment between family members. Any potential increase in risk due to genetics could be increased by an unhealthy lifestyle.

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