What Hinders Good Heart Health Among African-Americans?

Cardiovascular disease (CVD) is the most common cause of death in America, but the disease rates for African-Americans are especially high.

A recent study used a community-based participatory research method to determine what hinders and facilitates individuals’ heart health.

“We chose to use photovoice because it is an effective tool for engaging communities in identifying public health concerns and potential targets for change as a first step in developing interventions to address them,” the study authors explained.

Because pharmacists have frequent and close contact with patients, they are in a prime position to spread awareness of heart disease and healthy preventive behaviors. Pharmacists can also help patients select appropriate omega-3 fatty acid dietary supplements that can support heart health.

The Heart Healthy Lenoir (HHL) study was conducted in eastern North Carolina, an area known as the “stroke belt,” in 2011 and 2012. The community in Lenoir County is 40% African-American and had a 2010 poverty rate of 23.2%.

Sessions with the 6 adults and 9 adolescents who participated in the study revealed that mental, spiritual, and social health could influence cardiovascular health. Both ecological barriers and personal responsibility factored into whether or not an individual was healthy, as well.

Ecological barriers to heart health may include racial residential segregation, socioeconomic inequalities, and economic disparity, the researchers noted.

Some study participants pointed to difficulties in making healthy choices at supermarkets, though they said personal responsibility can help them make the right choice.

“[W]hen you go into a store, you still have choices, even based on what’s on sale,” one participant said. “...What’s on sale here, $2.99 cake or sales at the fruit/produce section. I still have a choice: in the midst of all these regular ones, there was a low-calorie one.”

One theme that arose from the study was that positive influences on cardiovascular health tended to originate from family and community relationships and spiritual health. Study participants’ articulated that spiritual health helped them understand their body and purpose.

They also emphasized that experience and knowledge could help them make healthier choices.

As part of the study, the participants were given cameras to take pictures of their concerns in the community that could affect their heart health.

They were also instructed on the “showed” technique:

· What do you see here?

· What is really happening here?

· How does this relate to our lives?

· Why does this problem exist?

· How can we be empowered by this?

· What can we do about it?

The photos they took reflected a dearth of healthy available food, lack of access to places where they can exercise, and technology that can promote a more sedentary lifestyle.

In discussions, the group identified heart-healthy factors such as smoking cessation, exercise, healthy diet and weight, and good cholesterol, blood pressure, and fasting blood glucose levels. They also discussed social, spiritual, and mental factors, placing an emphasis on the impact of stress.

The researchers suggested that their findings could help develop and implement interventions to prevent CVD. For example, since stress was pinpointed as a barrier to heart health (and studies have shown evidence of a link between stress and CVD), future interventions could find ways to relieve patients’ stress.

“Future research could build on these and other findings from the HHL study to explore not only how best to target and reduce CVD disparities, but also how to improve community-wide cardiovascular health,” the study authors concluded.

By 2030, about 40.5% of the nation’s population is expected to have some form of CVD, but estimates are even higher for African-Americans, according to the American Heart Association.