Despite recent medical advances, African-Americans remain disproportionately affected by cardiovascular disease. What’s responsible?
Genetics, socioeconomic status and lifestyle all play a role, yet the problem remains “mind-bogglingly complex,” says David Schlundt, Ph.D., associate professor of Psychology at Vanderbilt University.
Schlundt has been a member of the evaluation team for the Nashville REACH 2010 project (Racial and Ethnic Approaches to Community Health), part of a national initiative aimed at eliminating health disparities in more than 30 urban and rural communities.
During the past several years, REACH volunteers have worked with hospitals and community groups to sponsor free medical screenings aimed at reducing the number of individuals with undiagnosed diabetes, hypertension and high cholesterol. When left untreated, these factors increase heart disease risk and mortality.
“Invariably, individuals are identified that have problems such as diabetes that they weren’t aware of, and in particular, blood pressure and cholesterol are elevated,” says James L. Potts, M.D., professor of internal medicine at Meharry Medical College who has participated in Project REACH.
Potts says that one of his favorite discussions with patients is to “know your numbers—blood pressure, cholesterol level, weight, and blood glucose.” These are what physicians call “modifiable cardiovascular risk factors” because they can be changed to reduce risk.
“We can’t ignore genetics, patient attitudes and historical issues (of access),” Potts says, but significant decreases in risk, mortality and disparities would occur if everyone followed this simple advice: “Focus on changing the things that we can change.”
Schlundt agrees. Due to cutbacks in federal funding, continuation of the Nashville REACH project next year is not assured. However, it has begun to see positive results, including a decline in smoking rates among young African American women and improved access to medical care through the establishment of night and weekend hours at free clinics.
Community programs, in partnership with physicians, can begin to narrow heart disease disparities, Potts says, if patients will do their part to educate themselves, live healthier lifestyles, and commit to change.