‘Race Gap’ in Heart Health Has Changed Little in 20 Years

By Denise Mann
HealthDay reporter

MONDAY, March 15, 2021 (HealthDay News) – Black Americans who live in rural areas are two to three times more likely to die from diabetes and high blood pressure than rural whites, and that gap hasn’t changed much in the past. over the past 20 years, new research shows.

The study ran from 1999 to 2018 and will be published as a research letter in the March 23 issue of Journal of the American College of Cardiology.

Experts not involved in the research fear this racial divide has increased due to the restrictions COVID-19 places on daily life.

“The new findings are likely related to the lack of access to primary and specialist care and even hospitals in rural areas,” said Dr Sadiya Khan, assistant professor of cardiology and preventive medicine at the Feinberg School of Medicine. ‘Northwestern University in Chicago. Widespread lockdowns during COVID-19 likely further hampered access to care and may also have increased behaviors known to increase the risk of heart disease, including eating an unhealthy diet, not exercising and consuming more alcohol. “


For the study, researchers analyzed racial breakdowns on death rates for Americans aged 25 and older from the U.S. Centers for Disease Control and Prevention. They wanted to know if racial differences in death rates from diabetes, hypertension, heart disease and stroke had changed in rural and urban areas.

And overall, they didn’t change much in rural areas from 1999 to 2018. They’ve consistently been highest among black adults in those areas, according to the study.

Overall, black adults did worse than white adults, but death rates from heart disease improved in urban areas, according to the study.

And black adults in rural areas were at greater risk of death from diabetes and hypertension, while the racial gap narrowed faster in urban areas.

Study author Dr. Rahul Aggarwal, of Beth Israel Deaconess Medical Center and Harvard Medical School in Boston, cited several reasons for this “striking” fracture.

“Black communities face system inequalities that lead to worse health outcomes, including a higher burden of poverty, residence in disadvantaged areas, less access to health services such as primary care and preventive measures and structural racism, ”Aggarwal said. “These problems are magnified in rural areas of the United States”


Structural racism refers to the policies and practices that can make it more difficult for black Americans to advance.

Lead author Dr Rishi Wadhera, cardiologist at Beth Israel Deaconess Medical Center, said that public health and policy initiatives are needed to tackle these issues, “which are inextricably linked to health and are in need of the origin of racial inequalities in health “.

Khan agreed. “We need the stability of housing for people in these areas who are homeless or struggling to find stable housing, as well as the expansion of Medicaid so that a younger person has access to care before they are. eligible for Medicare, ”she said.

She also noted that black people in rural areas often did not have access to computers and / or the Internet. Online visits were among the top ways people viewed their doctors in the early months of the pandemic. Lack of access to technology has likely increased disparities in care and death rates from heart disease, Khan said.

Dr Keith Ferdinand, president of preventive cardiology at Tulane University School of Medicine in New Orleans, also reviewed the results.


He said that much of the problem is that black people in rural areas may not have adequate health insurance – or not at all.

“With modern medicine, you can control blood sugar, cholesterol, and hypertension and reduce deaths from heart attacks and strokes, but the benefits are lost when people don’t have adequate insurance and ‘have no access to care,’ Ferdinand said.

He said some of the trends can be reversed through basic education in these communities that focuses on a healthier lifestyle and understanding the risks of heart disease.

More information

Learn more about the risk factors for heart disease, diabetes, and stroke that you can control at the American College of Cardiology.

SOURCES: Sadiya Khan, MD, MSc, assistant professor, cardiology and preventive medicine, Northwestern University Feinberg School of Medicine, Chicago; Rishi Wadhera, MD, MPP, MPhil, cardiologist and assistant professor, medicine, Beth Israel Deaconess Medical Center, Boston; Rahu Aggarwal, MD, clinical researcher, medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston; Keith Ferdinand, MD, president, preventive cardiology, Tulane University School of Medicine, New Orleans; Journal of the American College of Cardiology, March 23, 2021

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