Cardiovascular disease is the leading cause of death in the U.S. But racial and ethnic minority groups carry a heavier burden. Heart disease risk factors and diagnoses are more common among ethnic minorities. Social factors, known as social determinants of health, drive these health disparities.
Cardiovascular disease is the leading cause of death for all adults. But it hits some people, especially minority groups, harder than others. For example, 47% of Black adults have been diagnosed with cardiovascular disease, compared with 36% of white adults.
When it comes to heart disease risk factors, minority groups also carry a heavier burden. Hispanic women are more than twice as likely as white women to have diabetes, which is a major risk factor for heart disease. And American Indians are three times more likely than whites to have diabetes.
These differences between racial and ethnic groups are called health disparities. Health disparities are a complex and challenging problem in the U.S. and around the world.
Researchers view race and ethnicity as social constructs rather than biological traits. In other words, the health differences between racial and ethnic groups aren’t caused by genetics. Social factors play the biggest role in shaping people’s health.
Many social factors affect a person’s health. Some important factors include a person’s ability to access:
These factors, known as “social determinants of health,” connect with each other. For example, poverty might prevent someone from following a heart-healthy diet. And if that person lives in a “food desert” with no healthy options for food, their choices are even more limited.
Social factors put Black, Hispanic and American Indian people at a disadvantage. These groups often carry a heavier economic and social burden. As a result, their health is also harmed. Other groups also face disadvantages that affect their risks for heart disease.
Social factors impact these numbers. For example, people who lack insurance are more likely to have unmanaged hypertension. And people who face discrimination have higher blood pressure.
Hypertension can lead to complications including:
Type 2 diabetes can harm blood vessels in your heart, brain and kidneys. This condition also causes your triglyceride and LDL cholesterol levels to go up. People who have diabetes are twice as likely as those without it to have a heart attack or stroke.
About 1 in 10 people in the U.S. have some form of diabetes, and the vast majority (90% to 95%) have type 2 diabetes. Diabetes is a major health crisis for all people. But it affects some racial and ethnic groups more often.
Some researchers identify diabetes as an “exemplar health disparities disease.” In other words, differences among racial and ethnic groups are obvious in the data. And social factors cause them. Some racial and ethnic differences in diabetes prevalence include:
Rates of heart disease vary depending on the specific diagnosis. Here are some key research findings from the U.S.
A note from Cleveland Clinic
Cardiovascular disease is the leading cause of death in the U.S. But some people face higher risks than others. If you belong to a racial or ethnic group that faces health disparities, talk with your healthcare provider about your risks. If you don’t have a routine provider, look for community organizations and local resources that can help connect you to one.
It’s important to start young with checkups. Get your blood pressure, cholesterol and blood sugar numbers. Talk with your provider about what these numbers mean. Also talk about any family members who had heart disease risk factors or diagnoses. This information will help you and your provider work together to lower your risks.
People who don’t face health disparities can help improve the situation for those who do. Look for local organizations that support health equity. And work with your provider to identify your own personal risks and find ways to reduce them.
Last reviewed by a Cleveland Clinic medical professional on 05/15/2022.
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