A long-term U.S. study of more than 48,000 Black women found a 26% higher risk of coronary heart disease for those who reported experiencing racism in employment, housing and interactions with the police, compared to women who did not encounter racism in those areas.
However, self-reported experiences of racism in everyday life — like offensive interactions with a stranger — were not associated with increased risk of heart disease in this study.
“Many Black adults in the U.S. are already at higher risk of developing heart disease due to high blood pressure or Type 2 diabetes,” said Shanshan Sheehy, the study’s lead author, and assistant professor at Boston University’s School of Medicine. “Current evidence shows that racism may act as a chronic stressor in the human body, and chronic stress may lead to high blood pressure, which increases the risk of heart attack and stroke.”
Researchers gathered data from 1997 to 2019. In 1997, participants were between 22 and 72 years old, and by 2019, they were 40 to 90 years old. None had cardiovascular disease in 1997; but in the 22-year follow-up period, 1,947 women developed coronary heart disease.
The findings come as no surprise to cardiologists specializing in population health, said Dr. Sara Tabtabai, regional director of Heart Failure and Population Health at Trinity Health of New England, and director of the Women's Heart program at Saint Francis Hospital in Hartford.
“[Those of] us that have been following the literature in this space, we know that Black patients, Black women in particular, do have worse outcomes when it comes to heart disease,” Tabtabai said. “And we are starting, through some of this research, to put together why that may be.”
Saint Francis Hospital has a long-standing women's heart program that conducts heart health research in the community, including screening for heart disease, and providing education at churches and other community spaces.
Tabtabai said the hospital did not have hard data on outcomes, but that could soon change.
“We're discussing here that that would be something that would be very beneficial for us to focus our efforts on," she said. "[It's] looking at those heart outcomes and understanding within our community how a program like ours can improve health. We do have some grants from the community, and I think that that is something that we can really put our effort towards.”
Community interventions for population groups affected by systemic racism help mitigate health risks, physicians said.
At the Southwest Community Health Center in Bridgeport, care coordinators work with patients to help with social needs, in addition to navigating care.
“This assistance does result in better outcomes,” said Dr. Dara Richards, chief medical officer. “More patients are connected to care and receiving needed screenings and services.”
