Inequities in Cardiovascular Outcomes, Adherence to Preventive Guidelines, & the Impact of Race-Based Systemic Barriers on Health Management

PURPOSE: The purpose of this study is to describe inequities in cardiovascular outcomes, adherence to preventative health guidelines, and the impact of systemic barriers due to race on health management.

DESIGN: Secondary data analysis.

METHOD: Data from the US Behavioral Risk Factor Surveillance System (BRFSS), a cross-sectional random telephone survey were analyzed to describe the frequency of cardiovascular health conditions, preventative health behaviors, and systemic barriers to health management by race/ethnicity. Analyses were conducted using a QuanCrit lens, which calls on researchers to recognize the centrality of racism in large data and common measures.

RESULTS: Cardiovascular disease affects many Americans. Specifically, 40.6% are diagnosed with hypertension, 36.6% with high cholesterol, 13.7% with diabetes, 5.8% with myocardial infarction, 5.6% with angina, and 4.5% with stroke. Many Americans fail to meet preventative health guidelines. For preventative health guidelines, only 55.8% consume fruit daily, 70.5% consume vegetables daily, 46.5% meet aerobic exercise guidelines, 30.9% meet muscle strengthening guidelines, and 30.3% meet weight guidelines. Across both cardiovascular disease and preventative health behaviors inequities by race/ethnicity were found. Systemic barriers including lack of health care coverage, financial access to physicians, food insecurity, and household incomes below the poverty line were disproportionately experienced by marginalized groups.

CONCLUSION: High cardiovascular disease and poor adherence to preventative health guidelines persists. Occupational therapy practitioners can help people with cardiovascular disease mitigate systemic barriers to engage in preventative health behaviors and reduce their risk. Results suggest that further research to understand these inequities using a QuanCrit lens is needed and that interventions that consider race and racism should be considered.

References

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Piepoli, M. F., Abreu, A., Albus, C., Ambrosetti, M., Brotons, C., Catapano, A. L., ... & Tiberi, M. (2020). Update on cardiovascular prevention in clinical practice: a position paper of the European Association of Preventive Cardiology of the European Society of Cardiology. European journal of preventive cardiology, 27(2), 181–205.

Pizzi, M. A., & Richards, L. G. (2017). Promoting health, well-being, and quality of life in occupational therapy: A commitment to a paradigm shift for the next 100 years. The American Journal of Occupational Therapy, 71(4), 7104170010p1–7104170010p5.