JP Stroke Foundation

Despite being in the 21^st century with advancements in technology and politics, disparities continue to exist especially between minority and non-minority groups. Unfortunately, as a result, sometimes these disparities also exist in the medical field. As a result, this can affect the health, wellbeing, and lives of certain groups. In addition, people from lower socioeconomic groups still don’t have equal access to medical care when compared to people from higher socioeconomic groups. It is vital for us to look at the trends related to those disparities, especially when they are related to cardiovascular disease. In doing so, we can create change in the healthcare system.

Cardiovascular disease is one of the leading causes of death in the United States and it is very prevalent in other countries as well [8]. Unfortunately, race and ethnicity are factors that can affect someone’s likelihood of developing a cardiovascular disease. Cardiovascular disease can cause early death, and further worsen the existing disparities between black and white people. Data shows that these racial and socioeconomic differences contribute to one-third of the differences between minority and non-minority populations for dying early or experiencing heart related complications [2]. This is where cardiovascular risk prediction models come into play. Cardiovascular risk prediction models are very important for preventing and managing cardiovascular diseases. These models analyze risk factors derived from family history, physical examinations, along with one’s lifestyle [6]. More specifically, these models look at non-modifiable, modifiable, lifestyle, and social risk factors to calculate a score. This score correlates with the level of risk of developing a cardiovascular disease within the next few years [1].

There are more risk factors for cardiovascular disease among ethnic minority populations which in turn results in higher rates of cardiovascular disease as well. These differences can be attributed to greater risk factors or even inadequate medical care [2]. As useful as the risk prediction models may be, there are some variations in the accuracy of the models between different racial and socioeconomic groups. For example, the Framingham risk score model has been shown to underestimate the risk of dying from cardiovascular disease in people from low socioeconomic groups [3]. This leads to less people getting the treatment they need because they’re told that they have a lower risk of death from cardiovascular disease than they actually do [3]. Moreover, according to some studies, there has been an overestimation of the risk of cardiovascular disease among some minority groups as well [4]. There is also evidence that preventive measures for cardiovascular disease have been less effective in reaching women from ethnic minority groups [11]. Additionally, there are several risk prediction models and they each differ which can affect their accuracy and validity [9]. Along with this, not everyone has the same understanding of what these scores mean. For example, some minority groups feel like they can’t trust their health providers completely, which affects their understanding of what the risk score means for them and affects their attitudes towards treatment as well [7]. There may also be a poor understanding of the risk score models because of unconscious racial/ethnic biases, which can be seen when doctors treat minority groups with less care. Some doctors may not explain the cardiovascular risk scores to them as effectively as they would to non-minority groups. Researchers have also observed that Southeast Asians do not recognize symptoms related to cardiovascular disease as promptly as non-minority groups [5]. On top of this, racial/ethnic minority populations usually have less access to regular medical care which can result in an increase in their risk of cardiovascular disease [2].

When looking at research, it may sound surprising, but there are fewer studies that look into cardiovascular risk factors and the understanding of the risk scores of certain minority groups compared to other minority groups [11]. Exploring such differences can help decrease the disparities between minority and non-minority groups. Many experts believe that there should be more research for all ethnic/racial groups to improve our understanding of health and risk of disease. Many studies have also shown that most of the general population gets information about cardiovascular disease from the media rather than from their doctors [10]. However, the media cannot provide specific information about an individual’s risk. Furthermore, it is better for health care professionals to communicate these risks to their patients [10]. A general lack of knowledge leads to people feeling healthy or that their health is not as concerning as it is, when in reality they might be at a very high risk of cardiovascular disease. In addition to this, people with poor education, no education or language barriers have a harder time understanding these concerns and risks on their own [10].

The information discussed within this article highlights the fact that risk assessment models should be adjusted to be more inclusive and accurate so the number of cardiovascular deaths can decrease [3]. Another beneficial adjustment would be to make all the risk prediction models more similar to allow for more accurate scores, or perhaps implement the use of one or two risk models universally. Additionally, scientists and doctors should conduct more research in minority communities to improve health disparities in cardiovascular disease [5]. There should also be more research in the area of communicating cardiovascular disease and cardiovascular risk scores [10]. In the meantime, health care professionals should continue to spread awareness about cardiovascular disease risk factors, as well as cardiovascular risk prediction models, especially to ethnic minority populations and low socioeconomic communities. One way to do this would require the use of Internet-based interventions. There is is evidence that e-Health interventions can reduce the risk of cardiovascular disease in patients on a global scale [8]. It is important to help people gain a better understanding of these topics so that they can prevent and manage cardiovascular diseases. Although cardiovascular disease is preventable, this is only possible if patients have the right information [10]. 

Author: Priya Amin

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