Heart disease is the number one cause of death in the United States; heart disease kills over 375,000 people a year.4 Cardiovascular disease comprises of illnesses that result in narrowing or blockage of blood vessels which can lead to angina (chest pain), stroke, or heart attack.9 There is a high prevalence of cardiovascular disease within the African American community. According to the Center for Disease Control, nearly 44% of African American men and 48% of African American women have some form of cardiovascular disease.5 In fact, heart disease represents about one-third of the disparity in potential life-years lost between black and white patients.6 Racial and ethnic minority populations experience more barriers to heart disease diagnosis and care, lower quality treatment, and have overall poorer health outcomes than their white counterparts. African Americans have a higher prevalence of high blood pressure, which increases their risk for heart disease and stroke.6,8 Also, research suggests that black patients may be genetically predisposed to having high blood pressure, because of a gene that is linked to salt-sensitivity and high blood pressure.14 African Americans are greatly impacted by obesity, which can be attributed to poor health behaviors.13 These poor health behaviors include high-fat and high-sodium diets, lack of exercise, and smoking.8 These risk factors contribute to the high prevalence of heart disease within the African-American community. Many racial and ethnic minority groups have significantly higher rates of cardiovascular disease and it’s risk factors.13,15
Health literacy and education are critical for the early detection of diseases and treatment compliance. Patients with low health literacy rates are less likely to understand the underlying risk factors and symptoms for their disease. Lack of awareness about the risk factors, symptoms, and diagnosis of heart disease is a potential contributing factor to the high prevalence and mortality among black patients. Recent literature suggests that Haitians make up the second largest black immigrant population and are disproportionately impacted by hypertension.11,12 . Sociocultural and behavioral factors that contribute to the chronic disease management of hypertension. Currently, there are very few initiatives to address the growing prevalence of hypertensive patients in the Haitian-American community.10
Angelíca Gousse, who is a Master of Public Health candidate at the Dartmouth Institute, under the guidance of Dr. Michel Dodard (Center for Haitian Studies) are developing an educational resource to address this gap. This resource called “Haitian Healthy Heart” will increase health literacy, education promotion, and awareness of cardiovascular disease in the Haitian community. This resource consists of a multilingual brochure in English and Haitian Creole and a web-component that is accessible on computer and mobile platforms. The goal of this initiative is to develop and implement of a multilingual educational resource that will raise awareness of heart disease risk factors. Health literacy and lack of education play a role in lack of awareness of heart disease risk factors and symptoms, which contributes to poorer health outcomes among minority patients. The implementation of this tool will increase patient knowledge, raise awareness of heart disease risk factors, and potentially encourage clinician-patient discussion of hypertension management and heart health.
References
1. Adler N, Newman K. Socioeconomic Disparities In Health: Pathways And Policies. Health Affairs. 2002;21(2):60-76. doi:10.1377/hlthaff.21.2.60
2. Allen J, Mars D, Tom L et al. Health Beliefs, Attitudes and Service Utilization among Haitians. J Health Care Poor Underserved. 2013;24(1):106-119. doi:10.1353/hpu.2013.0015
3. Apa.org. https://www.apa.org/pi/ses/resources/publications/minorities.aspx. Published 2018. Accessed November 9, 2018.
4. Apa.org. https://www.apa.org/pi/ses/resources/publications/education.aspx Published 2018. Accessed November 9, 2018.
5. CDC. https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_women_heart. Published 2018. Accessed November 9, 2018.
6. Heart.org. https://www.heart.org/idc/groups/heart-public/@wcm/@hcm/@ml/documents/downloadable/ucm_429240.pdf. Published 2018. Accessed November 9, 2018.
7. Heart Disease – The Office of Minority Health. Minorityhealth.hhs.gov. https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=19. Published 2018. Accessed November 9, 2018.
8. Heart Disease Risk Factors | cdc.gov. Cdc.gov. https://www.cdc.gov/heartdisease/risk_factors.htm. Published 2019. Accessed February 26, 2019.
9. Heart disease – Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/heart-disease/symptoms-causes/syc-20353118. Published 2018. Accessed November 9, 2018.
10. Kwan G, Mayosi B, Mocumbi A et al. Endemic Cardiovascular Diseases of the Poorest Billion. Circulation. 2016;133(24):2561-2575. doi:10.1161/circulationaha.116.008731
11. Sanon M, Mohammed S, McCullagh M. Definition and Management of Hypertension among Haitian Immigrants: A Qualitative Study. J Health Care Poor Underserved. 2014;25(3):1067-1078. doi:10.1353/hpu.2014.0147
12. Sanon M, Spigner C, McCullagh M. Transnationalism and Hypertension Self-Management Among Haitian Immigrants. Journal of Transcultural Nursing. 2014;27(2):147-156. doi:10.1177/1043659614543476
13. Solomon A, Christian B, Norton G, Woodiwiss A, DEessein P. Risk Factor Profiles for Atherosclerotic Cardiovascular Disease in Black and Other Africans with Established Rheumatoid Arthritis. J Rheumatol. 2010;37(5):953-960. doi:10.3899/jrheum.091032
14. Svetkey L, McKeown S, Wilson A. Heritability of Salt Sensitivity in Black Americans. Hypertension. 1996;28(5):854-858. doi:10.1161/01.hyp.28.5.854
15. Vital Signs: Avoidable Deaths from Heart Disease, Stroke, and Hypertensive Disease — United States, 2001–2010. Cdc.gov. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6235a4.htm. Published 2018. Accessed November 9, 2018.
Source: https://angiegousse.wixsite.com/healthyhaitianhear-1
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Angelo E. Gousse, MD
Memorial Hospital Miramar,South Broward Hospital District 1951 SW 172 Avenue, Suite 305, Miramar,
FL, 33029 Tel: 954-362-2720 | Fax: 954-362-2761
www.bladder-health.net
