Eliminating Disparities in Cardiovascular Disease for Black Women: JACC Review Topic of the Week

Abstract

Black women are disproportionately affected by cardiovascular disease with an excess burden of cardiovascular morbidity and mortality. In addition, the racialized structure of the United States shapes cardiovascular disease research and health care delivery for Black women. Given the indisputable evidence of the disparities in health care delivery, research, and cardiovascular outcomes, there is an urgent need to develop and implement effective and sustainable solutions to advance cardiovascular health equity for Black women while considering their ethnic diversity, regions of origin, and acculturation. Innovative and culturally tailored strategies that consider the differential impact of social determinants of health and the unique challenges that shape their health-seeking behaviors should be implemented. A patient-centered framework that involves collaboration among clinicians, health care systems, professional societies, and government agencies is required to improve cardiovascular outcomes for Black women. The time is "now" to achieve health equity for all Black women.

Keywords: Black women; cardiovascular disease; disparities; health equity; heterogeneity; race/ethnicity; social determinants of health.

CENTRAL ILLUSTRATION. Achieving Cardiovascular Health Equity While Recognizing the Heterogeneity of Black Women

Cardiovascular research rarely acknowledges the heterogeneity of Black women in the United States, which includes those born in the United States (African American), Africa (African), and the Caribbean (Afro-Caribbean), as illustrated by the geographic maps. Each of these groups of Black women experiences unique and differential effects of social determinants of health, such as racism, discrimination, acculturative stress, residual psychological effects from prior exposure to geopolitical conflict or violence, xenophobia, immigration, and disruption of prior social networks. These must be considered in addressing cardiovascular health disparities. The roles of individual clinicians, health care systems, professional societies, and government agencies in achieving health equity for Black women are summarized.