April is National Minority Health Month. Introduced in 2002 by the 107th Congress, and tracing its origins back to 1914 when Booker T. Washington initiated Negro Health Improvement Week, this is an opportunity to highlight the importance of improving the health of racial and ethnic minority communities, and reducing health disparities.
The theme for National Minority Health Month in 2023 is: “Better Health through Understanding.” The vision is to improve health outcomes for racial and ethnic minorities by providing culturally and linguistically competent healthcare services, information, and resources. And while there are many issues and conditions on which to focus and remedy, one in particular requires far more attention than it has historically received: racial and ethnic disparities in heart disease.
Heart Disease Disproportionately Impacts Certain Groups
In the U.S., the ugly truth is that certain racial and ethnic groups are disproportionately affected by high blood pressure (hypertension) and type 2 diabetes — both of which are major risk factors for heart disease, and can subsequently lead to stroke and heart attack. For example, research has found that relative to white adults, Black adults are:
- 30% more likely to die from heart disease.
- Twice as likely to have a stroke.
- Have a higher rate of myocardial infarction (MI).
- Have a higher rate of heart failure.
- Experience higher functional impairment from Acute Coronary Syndrome (ACS).
- Have a higher death rate from ACS.
In addition, Black women are twice as likely as white women to develop chronic hypertension during pregnancy. This condition raises the risk for cardiovascular disease later in life.
Other minority groups are also disproportionately impacted by heart disease. Native American individuals are 1.5x as likely to be diagnosed with coronary heart disease compared with the white population. And coronary artery disease among Asian Indians occurs earlier in life and in a higher percentage than in other ethnic groups.
Overall, minorities have an elevated risk of morbidity and mortality due to coronary artery disease, and have not benefited to the same extent from the general decline in deaths caused by heart disease in the U.S. over the last few decades. And the situation worsened during the pandemic. For both heart disease and cerebrovascular disease deaths that occurred during March to August 2020, Black, Asian, and Hispanic populations experienced a larger relative increase in deaths than the non-Hispanic White population.
What Employers Can Do
There are several ways that employers can be part of the solution across the workforce, and set an example for others to follow:
- Start by clearly understanding your employee population, and recognize that members of some racial and ethnic groups are at greater risk of heart disease, heart attack, and stroke.
- Provide education and resources to help employees understand heart disease, and learn about lifestyle changes that can significantly reduce their risk.
- Consider establishing an employee resource group (ERGs) that focuses on addressing racial and ethnic disparities in heart disease specifically, and overall health and well-being generally.
- Add digital self-management interventions to your roster of benefits. According to a peer-reviewed clinical study published in JAMA Network Open, these interventions are associated with blood pressure reduction.1 A separate study published in the American Heart Association's journal Hypertension found that the positive results were consistent across populations, and not affected by race, language, gender, or age.2
The Final Word
Heart disease is the number one killer in the U.S., and affects people across all demographic categories. However, as discussed above, members of some racial and ethnic groups — Blacks (especially Black Women), Native Americans, and Asian Indians — are disproportionately affected.
Employers have an opportunity — and in the bigger picture, an obligation — to take action. Use the occasion of Minority Health Month to start making a positive difference!
1 Kim B, Lee J. Smart Devices for Older Adults Managing Chronic Disease: A Scoping Review. JMIR Mhealth Uhealth 2017;5(5):e69. https://mhealth.jmir.org/2017/5/e69. Accessed April 25, 2023.
2Gazit T, Gutman M, Beatty AL. Assessment of Hypertension Control Among Adults Participating in a Mobile Technology Blood Pressure Self-management Program. JAMA Netw Open. 2021;4(10):e2127008, https://doi.org/10.1001/ jamanetworkopen.2021.27008. (Some study authors are employed by Hello Heart. Because of the observational nature of the study, causal conclusions cannot be made. See additional important study limitations in the publication.)
Hello Heart is not a substitute for professional medical advice, diagnosis, and treatment. You should always consult with your doctor about your individual care.
1. Gazit T, Gutman M, Beatty AL. Assessment of Hypertension Control Among Adults Participating in a Mobile Technology Blood Pressure Self-management Program. JAMA Netw Open. 2021;4(10):e2127008, https://doi.org/10.1001/jamanetworkopen.2021.27008. Accessed October 19, 2022. (Some study authors are employed by Hello Heart. Because of the observational nature of the study, causal conclusions cannot be made. See additional important study limitations in the publication. This study showed that 108 participants with baseline blood pressure over 140/90 who had been enrolled in the program for 3 years and had application activity during weeks 148-163 were able to reduce their blood pressure by 21 mmHg using the Hello Heart program.) (2) Livongo Health, Inc. Form S-1 Registration Statement. https:/www.sec.gov/Archives/edgar/data/1639225/000119312519185159/d731249ds1.htm. Published June 28, 2019. Accessed October 19, 2022. (In a pilot study that lasted six weeks, individuals starting with a blood pressure of greater than 140/90 mmHg, on average, had a 10 mmHG reduction.) NOTE: This comparison is not based on a head-to-head study, and the difference in results may be due in part to different study protocols.
2. Validation Institute. 2021 Validation Report (Valid Through October 2022). https://validationinstitute.com/wp-content/uploads/2021/10/Hello_Heart-Savings-2021- Final.pdf. Published October 2021. Accessed October 19, 2022. (This analysis was commissioned by Hello Heart, which provided a summary report of self-fundedemployer client medical claims data for 203 Hello Heart users and 200 non-users from 2017-2020. Findings have not been subjected to peer review.)