| Identify the population of interest and health condition/event to your practice. Specify how you define the population (e.g., age, gender, health status, etc.). | The selected health condition for this assignment is coronary heart disease, medically identified as coronary artery disease (CAD) or ischemic heart disease (IHD). It is the most common type of heart disease in the United States, caused by plaque buildup in artery walls, limiting blood flow to the heart and eventually leading to heart failure among other risk factors and symptoms affecting the heart muscle which can cause severe illness or death (Centers for Disease Control and Prevention, 2015). Certain races and ethnicities are disproportionally affected by CAD, with the African American population being one of the most affected. The selected population for this assignment is African American males, aged 20 and older. Health status should be healthy or moderately healthy individuals without other contributing illnesses to the condition. |
| Summarize your search process. Specify what sources, organizations, and agencies for health statistics were searched to find relevant health statistics. Be specific and thorough in your search. | After selecting a population, a search engine inquiry was conducted in Google as well as Google Scholar. Keywords were used such as “coronary artery disease,” “African Americans,” and “statistics.” Out of the search results, the websites which are either government-run or legitimate medical organizations were selected. These sources include the CDC and the American Heart Association. Furthermore, journal articles were examined to find information regarding statistics on risk factors and epidemiology. The U.S. National Library of Medicine National Institute of Health database was also searched. As a result, articles were selected based on the criteria of relevance to the topic and being published within the last 5 years. The scholarship of the journal was considered as well. |
| Provide the health information obtained in the search. Include any significant statistics and information on risk factors and trends in epidemiology data on your topic. | Nationally, the rate of coronary heart disease among non-Hispanic blacks is at 7.2% for males aged 20 and older. The fatality rate for CHD events is at 5.9% for black males, leading to approximately 20,693 deaths. Within a year of experiencing a first CHD event, 22% of black males will have a repeating episode and 14% will die (American Heart Association, 2015). The statistics for the state of Florida indicate that 3.3% of African Americans have been diagnosed with CAD. Although there is no breakdown by both race and age, the overall statistics for age in the state suggests that CAD affects mostly people aged 45 and older (America’s Health Rankings, 2018). Local statistics were also incomplete. However, there is an indicator that heart disease is a leading cause of death for African Americans in Miami-Dade, at approximately 185.1 deaths per 100,000 population. It disproportionately affects males and rises gradually with age (LiveStories, 2016). In the modern day, African Americans are significantly more at risk for cardiovascular disease than other races. Africans represent approximately 14% of the United States population, and therefore a minority. However, African Americans have a higher prevalence of hypertension which leads to higher rates of CAD, stroke, and congestive heart failure. There are also higher rates of diabetes and obesity in this population, disproportionately more so than other races. Despite greater instances of CAD in the population, African Americans tend to smoke less and have a lesser frequency of atherosclerosis which are primary risks for CAD incidence (Saab et al., 2015). African Americans have poorer cardiovascular health than non-Hispanic whites, with little change occurring since 2005. Cardiovascular disparities and mortality are a leading health concern for African Americans. Coronary heart disease rates have been declining in recent years among the general US population. However, the decline in CHD incidence among African American men was half that of non-Hispanic whites, 3.2% in comparison to 6.0% per year. African Americans have a 6.5% diagnosis rate for CHD and a substantially higher fatality than other races (Carnethon et al., 2017). |
| Interpret your findings and determine if there is any evidence of health disparities based on the population examined. Address multicultural factors that influence the health issue. Provide several examples and include interventions that would improve health disparities. | As mentioned earlier, the rates for CHD and CAD for African Americans, particularly males, are much higher than other races and ethnicities in the United States. Various data from national to state to local levels indicate that there are noticeable and statistical differences among incidence and fatality rates. This suggests that there are disparities present. Some of these stem from risk factors such as obesity, cholesterol issues, and hypertension. However, these are partially genetic but also affected by cultural and societal factors. For example, African Americans have much greater barriers to access in healthcare, facing instances of discrimination or financial burden. A much lower percentage of African Americans engages in preventive care, critical for managing heart conditions. Other cultural factors such as diet and negative health habits have an impact as well. Social aspects such as lack of health education and a greater percentage of the population being impoverished can contribute in combination with other factors to cause a greater prevalence of CHD. A variety of interventions are possible to address risk factors for CHD in African Americans. Traditional public health interventions focus on the promotion of health and education through social aspects such as community centers, schools, workplaces, and churches. Interventions targeting hypertension management, diet, and physical activity are most effective in achieving results. Public health programs should attempt to target lower-income communities where rates are higher. Meanwhile, on a personal level, physicians should work with African American patients to provide greater insight into the seriousness of the issue. Finally, it is important to go beyond traditional interventions and focus research, policy, and public health strategies on addressing upstream social determinants of health (Thornton et al., 2017). |
References
American Heart Association. (2015). African Americans & cardiovascular disease. Web.
America’s Health Rankings. (2018). Annual report.
Centers for Disease Control and Prevention. (2015). Coronary artery disease (CAD).
LiveStories. (2016). Miami-Dade country heart disease statistics.
Saab, K. R., Kendrick, J., Yracheta, J. M., Lanaspa, M. A., Pollard, M., & Johnson, R. J. (2014). New insights on the risk for cardiovascular disease in African Americans: The role of added sugars. Journal of the American Society of Nephrology, 26(2), 247-257. Web.
Thornton, R. L., Glover, C. M., Cené, C. W., Glik, D. C., Henderson, J. A., & Williams, D. R. (2016). evaluating strategies for reducing health disparities by addressing the social determinants of health. Health Affairs, 35(8), 1416-1423. Web.