Findings from a new Northwestern Medicine study rebut the idea that Black individuals’ higher risk of cardiovascular disease is because of biological differences.
“The key take-home message is that racial differences in cardiovascular disease are not due to race itself, which is a social concept that is not related to biology.”
Black adults are at significantly higher risk (1.6-2.4 times) for cardiovascular disease than white adults. The new study found these large differences can be explained by differences in social determinants of health (like education or neighborhood-level poverty), clinical factors (like blood pressure) and lifestyle behaviors (like dietary quality).
“The key take-home message is that racial differences in cardiovascular disease are not due to race itself, which is a social concept that is not related to biology,” said corresponding author Dr. Nilay Shah, assistant professor of cardiology and epidemiology at Northwestern University Feinberg School of Medicine and a Northwestern Medicine physician. “Rather, these differences in cardiovascular disease can be explained by differences in social and clinical factors. Clinicians should be evaluating the social determinants that may be influencing the health of their patients.
“The data from this study starts to identify what contributes to the higher burden of heart disease experienced by Black adults, and how much each factor matters.”
Black women had a 2.4-times higher risk for cardiovascular disease compared with white women. The study found that clinical factors, neighborhood-level factors and socioeconomic factors explained the largest components of the higher risk experienced by Black women.
Black men had a 1.6-times higher risk for cardiovascular disease compared with white men. The study found that clinical factors, socioeconomic factors and lifestyle behaviors explained the largest components of the higher risk experienced by Black men.
“The findings of significantly higher risk in non-Hispanic Black adults compared with non-Hispanic white adults is not surprising—this is well-known,” said senior author Dr. Sadiya Khan, assistant professor of cardiology and epidemiology at Feinberg and a Northwestern Medicine physician. “But it was surprising that the risk for cardiovascular disease was the same once social and clinical factors were considered over time. This finding is really important to rebut that there is an unexplained or genetic reason that Black individuals have higher risk.”
The study’s findings are important because they show that disparities in heart disease experienced by Black adults could be reduced by improving preventive care of heart disease risk factors and addressing social determinants, Shah said. The data provide a guide to identify strategies that may be particularly effective at reducing the persistent differences and disparities in heart disease that exist in the U.S.
“It is important to note that clinical risk factors, lifestyle and depression are not independent of socioeconomic status and neighborhood segregation,” Khan said. “Future research needs to go upstream to target social determinants of cardiovascular health. Our study lays groundwork to help inform community-engaged interventions that ensure equal opportunities for all people to have access to high-quality foods, environments and health care.”
The study evaluated data from about 5,100 Black and white adults who participated in the CARDIA (Coronary Artery Risk Development in Young Adults) Study at four locations in the U.S. (Chicago; Minneapolis, Minn.; Oakland, Calif.; and Birmingham, Ala.). The participants enrolled around 1985 and have been followed for over 30 years. The scientists evaluated the information participants provided starting from the time of their enrollment to determine the role of social and clinical factors in the differences in cardiovascular disease experienced by Black compared with white adults over the course of 30 years of follow-up.
Other Northwestern co-authors include Norrina Allen, Dr. Donald Lloyd-Jones, Mercedes Carnethon, Kiarri Kershaw, Lucia Petito and Hongyan Ning.
Funding for the study was provided by the National Heart, Lung, and Blood Institute (NHLBI) (grant K23HL157766); the National Institutes of Health (grants P30AG059988 and P30DK092939); and the American Heart Association (grant 19TPA34890060). The CARDIA study is conducted and supported by the NHLBI in collaboration with the University of Alabama at Birmingham (grants HHSN268201800005I and HHSN268201800007I), Northwestern University (grant HHSN268201800003I), University of Minnesota (grant HHSN268201800006I) and Kaiser Foundation Research Institute (grant HHSN268201800004I).
So, you are thinking about completing your Master’s degree. You may be just graduating with your bachelor’s, established in your career, seeking career advancement, or an overall career change. You should commend yourself wherever you currently are in your professional journey. Graduate school is essential for career progression and as daunting as the challenge may be it is feasible and worthwhile. However, there are certain things that I wish I had known previously to enrolling in my first graduate courses that would have saved me a ton of grief on this grad school journey.
Learn the APA Manual
Do you briefly remember being introduced to this in your undergraduate English and Research classes? You know, the blue book that you couldn’t wait to toss as soon as you completed those courses! Well, don’t get too excited and toss that manual out just yet. The APA manual will be your bible at the graduate level. It is best to not only familiarize yourself with it but read it cover to cover. In all seriousness, there will be no mercy for APA formatting issues at the graduate level, and failure to comply will hinder your ability to graduate. Let’s be honest; graduate school is very expensive so do not lose points over APA errors and get your bang for your bucks when it’s time to cash in on that top G.P.A.
Proofread
Grad school will push your writing capabilities to the maximum. When I first started, I went in under the false pretenses that I was a decent writer. After all, my highest scores were always in English and Language Arts. However, never underestimate the power of proofreading your document, or having someone else review it. It is important to remember that you are not supposed to be writing as if you are talking in scholarly writing. Read every single thing you submit out loud at least two times before turning it in. You will be surprised at some errors you will find in your documents once you hear it out loud. I swear by Owlet Purdue, Grammarly, and PERRLA to assist with the completion of my papers.
Don’t Break
One of the biggest mistakes that I made during my Grad school journey was “taking a break”. Apparently, life happens to everybody, but if you can help it, you should stay on the course to graduate on time. While taking a leave of absence is certainly an option, there are some universities have a time limit on the amount of time you can spend on the completion of your master’s degree. Taking a leave of absence sounds a nice break until you return and you are under even more pressure to complete your degree. Stay on track and graduate on time. Put yourself out of grad school misery. Try not to prolong it.
Find Balance
My zodiac sign of a Libra makes finding balance very high on my priority list. Regardless of your sign, it is essential to find a way to balance everything you have going on in life. Many of us are career focused, have spouses or partners, children, and community obligations. There are going to be some times that you will simply have to say no to others as well as avoid taking on too many additional duties. You have to be able to take care of yourself before you can take care of others. Do not feel guilty about taking a step back or going on a much need hiatus to keep everything together. Remember that this is temporary, and there will always be opportunities to restock your plate once you have graduated.
Cost vs. Reputation
This has been an ongoing debate for such a long time. I will give you my honest opinion and say that it is best to go for value in regards to selecting a school to attend. There is absolutely nothing wrong with investing yourself, but please do not break the bank along the way. Try your very best to avoid debt, save up, and develop a reasonable budget that you can use to finance your educational goals. If you are shelling out a ton of money, ensure that the institution has a reputation that fits your tuition bill. Student loan debt is a serious problem. Remember that you will need to pay that money back, and if this degree does not make a high paying job seem promising to you it may be necessary to scale back. Remember, grad school isn’t cheap!
Wrapping it All Up
I hope that you avoid the pitfalls that I incurred during my grad school journey and that these tips will help ease you in your transition and prepare you for entry into grad school. A graduate degree is totally obtainable; it’s just a different academic dynamic. I’ll see you on the other side!
Vision boards are an excellent way to visualize your best life, goals, and dreams. Vision boards are a creative way to generate a visual of the things that you want to see manifested in your life, and a way to provide yourself a daily reminder of why you work so hard, and what your outcome will be. Creating a vision board does not have to be a tedious process. This can be a fun opportunity for a girls night, wine, and some creativity
Here is what you need to host your vision board party:
-Poster boards/Paper or Cork Board
-Magazines
-Scissors
-Glue
-Snacks
-Most Importantly Some Good Wine/Vino
Have a Method to Your Board
There is no right or wrong way to do this. I tend to divide my poster board into sections by category. Divide you vision board into 9 different sections. The top three sections of the board (from left to right) should be prosperity, reputation, partnerships/love. The second row should be family, health, and unity. The third row should be self-improvement, career, and travel. You can see a visual example of several options on Pinterest.
It is important to remember that you can change or update your vision board as much as you deem it necessary. I typically opt for the cork board version of the vision board because it is easier to modify. If you are hosting the vision board party and would like to utilize the cork board, it may be more cost-effective to collect those funds from your guests in advance, or request that they bring their own if they would like to use that.
Get Digital
Don’t have the time or resources to buy supplies for everyone? Get digital with your vision boards. There are several different ways that you can complete a vision board digitally by downloading simple apps from App Store from Apple or the Android Market. I particularly like the Success Vision Board Application by Jack Canfield, the creator for chicken soup for the soul. You can also create one online at www.dreamitaliave.com.
Remember the law of attraction! Hang your vision board somewhere you will see it daily. Use it to inspire you and generate positive energy at the beginning of your day. Live and work towards your dreams every day.
Health is defined as the state of being free from illness or injury. Health is what keeps all individuals in a state of harmony and balance because when our health is good, we are good. However, the state of being free from illness or injury is not equal across all spectrums of the human species. Some of you may deal with health related issues on a daily basis, occasionally, or rarely. Despite your frequency, it’s doubtful time allows you to look up interesting facts and figures on this topic. For instance, did you know that black women have a shorter life expectancy than White women by 5 years, 50% higher all-cause mortality rates, and death rates from major causes such as heart disease, cerebrovascular diseases, and diabetes that are often 2 to 3 times higher than those for Caucasian women? Knowledge is power, so here are a few interesting facts and figures about the health of minority women that make you go hmmm.
Caucasian women are more likely to develop breast cancer than African American women. But African Ameri- can women are more likely to die of this cancer because their cancers are often diagnosed later and at an advanced stage when they are harder to treat and cure. There is also some question about whether African American women have more aggressive tumors.
African American women between the ages of 35-44, have an increased breast cancer death rate of more than twice the rate of White women in the same age group—20.02 deaths per 100,000 com- pared to 10.2 deaths per 100,000.
Black women develop high blood pressure earlier in life and have higher average blood pressures compared with white women. About 37 percent of black women have high blood pressure.
About 5.8% of all white women, 7.6% of black women, and 5.6% of Mexican American women have coronary heart disease.
A 2011 Journal of Women’s study indicated that 57 percent of Latina women, 40 percent of African American women, and 32 percent of white women had three or more risk factors for having a heart attack.
According to the article published by the Diabetes Sisters, the prevalence of diabetes is at least 2-4 times higher among African American, Hispanic/Latino, American Indian, and Asian/Pacific Islander women than among white women.
One in four African American women over 55 years of age has diabetes.
In the United States, race once defined an individual’s level of freedom, including where they could enter, sit, and eat. Today, with African Americans at a higher risk than White Americans for obesity, high blood pressure, stroke, and heart disease, race also defines the quality of healthcare, making health disparities in African Americans the true silent killer.
Statistics from the American Heart Association and Center for Disease Control and Prevention acknowledges the prevalence of cardiovascular diseases in African Americans. However, the link between race and health are obscured, and there is not much conversation dedicated to eliminating the socioeconomic and cultural barriers that make African Americans a target for death by disease.
So the question is what should we as healthcare professionals implement to address socioeconomic and cultural barriers that contribute to the healthcare disparities in African Americans and other minority populations? Should we continue to research different treatment regimens that can improve the overall health of African Americans and other minority groups? Or should we continue to educate these populations through traditional patient education? The Answer is No! In order for us to get something that we have never had, that means we have to do something that we have never done. The solution to this issue must extend beyond medicine, and instead be addressed by community leaders, community health providers, and minority healthcare professionals so race can be a category and not a barrier to quality healthcare.
There is undoubtedly a necessity to increase the level of cultural sensitivity among physicians, nurses, & other healthcare personnel; recognize unfavorable socioeconomic and cultural barriers as a preexisting condition; improve the community surrounding African Americans & other minority patients; and increase the number of minority healthcare workers. Implementing these actions will begin the process of closing the gap of socioeconomic and cultural barriers that contribute to the healthcare disparities in African Americans and other minority populations.
