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Heart disease mortality rates among black adults decreasing, but slowly
Despite long-term improvements in heart disease mortality, statistics suggest improvement is needed.
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Heart disease mortality rates in black Americans have decreased in recent decades but at a less pronounced rate than that of the general population.
According to a summary of a 2007 National Vital Statistics report, all-cause mortality in 2004 was at a record low, with an average life expectancy at an all time high of 77.8 years. Although the mortality rates among both white and black Americans continue to fall, they are doing so at different rates. The average life expectancy of white adults was 5.2 years longer than that of black adults in 2004, and the age-adjusted total mortality rate was 1.3 times greater among black compared with white adults.
The mortality rates from heart disease follow a similar pattern. According to statistics from the Department of Health and Human Services, death rates from heart disease have continued to decrease markedly between 1950 and 2004. The age-adjusted rate of mortality from heart disease for all subgroups was 586.8 per 100,000 in 1950, and had fallen to 217.0 per 100,000 in 2004.
The statistics also suggest a disparity among racial groups. Age-adjusted heart disease mortality rates for white men were 700.2 in 1950 and 264.6 in 2004. Among black men, the mortality rate in 1950 was lower than in white men (639.4), but decreased more slowly and ended up higher than in white men (342.1) by 2004. The same trend can be seen between white and black women. White women had decreased mortality from heart disease between 1950 (478.0) and 2004 (172.9). Black women had higher heart disease mortality rates than white women in 1950 (536.9), and remained higher with an average of 236.5 in 2004.
Community outreach
The disparities in heart disease burden between white and black Americans have prompted action by some cardiologists.
“Alarmingly, the overall situation is not improving, because if you look at the change in incidents of myocardial infarction or death rates for the entire population of the United States, it has been dropping dramatically during the past 30 years,” Kim A. Williams, MD, professor of medicine and radiology at the University of Chicago Medical Center and chairman of the board of the Association of Black Cardiologists, told Cardiology Today. “If you look at the slope of the decline, there is less of a negative slope among black Americans. So yes, we are improving, but we are improving slower than everybody else. That means that the disparity gap is actually increasing.”
The Association of Black Cardiologists recently offered free health screenings and provided educational talks by prominent black cardiologists to congregation members in 14 churches across the Chicago area during a recent community outreach effort.
“Increasing the awareness of risk factors for heart disease is really the key item for developing strategies to get people to come in to see physicians, to take their medications and to develop healthier lifestyles,” Williams said. “We have been in this setting for a while doing barbershop programs and church screenings intermittently for several years, but this program was much larger. The intent is to do these types of programs on a national basis.”
Persistent problems
In addition to cardiologists, the event also had input from city and county public health officials and members of the American Heart Association. Access to adequate insurance, quality care and healthy food supplies were among the list of logistical problems black Americans face disproportionately. According to Williams, who is also a member of the Noninvasive Imaging section of the Cardiology Today Editorial Board, another lingering problem is a lack of lifestyle guidance taught at home and in physical education programs that are often underfunded or cut altogether.
“If you have inner city latch-key kids and then you take the funding out of physical education in the schools, we are talking about a whole generation of kids who will not have athletic training or an athletic lifestyle,” Williams warned. “The rate of obesity is climbing, and it is the worst in the black community, particularly among black women.”
Many adjustments are required within the black community and within the larger society to improve the response to heart disease and, ultimately, mortality, according to Williams.
“Many fundamental issues need to be addressed,” Williams said. “We can start with a public health approach, but you also have to try a personal approach of having parents teach their children the keys to avoiding obesity: exercise and eating healthy foods. They should not eat high-fat and high-cholesterol foods like there is no tomorrow, because if they do, there will be no tomorrow.” — by Eric Raible
For more information:
- To learn more about the Association of Black Cardiologists, visit www.abcardio.org.
- Miniño AM, Heron MP, Murphy SL, Kochanek KD. Deaths: final data for 2004, National Center for Health Statistics. National Vital Statistics Report. 2007;55(19):2.
- U.S. Department of Health and Human Services. Health, United States: 2007. Washington, DC: U.S. Department of Health and Human Services; 2007: pp. 201-203.