Jack cardiologists have declared war on heart disease among African- Americans, the leading cause of death in the community. “It’s not justifiable to have a system where the average Black man has a lifespan of sixty-five to sixty-eight years while Caucasian women reach eighty to eighty-five,” declares Ola Akinboboye, M.D.
Dr. Akinboboye, a Nigerian-born heart specialist, was installed as the 14th national president of the Association of Black Cardiologists earlier this year. He is also the medical director of Laurelton Heart Specialist P.C. and Strong Health Medical P.C., located in Rosedale, N.Y., and an associate professor of clinical medicine at the Weill Medical College of Cornell University in New York. The association he now heads is bent on eliminating disparities in cardiac morbidity and mortality between Blacks and whites in the United States. “We have a specific immediate goal: reducing cardiac disparities by 20 percent by 2020. We’re planning to do this through appropriate relationships and community activities,” he says.
While improvements in the treatment and prevention of heart disease have reduced cardiovascular morbidity and mortality in the United States overall, the reductions in the African-American community lag behind the rest of the country. The Black cardiologists group is taking action on three key fronts: cultural competence, exercise and diet. These issues were high on the agenda at the Fourth Annual Cardiovascular Disease in African-Americans Conference, held on April 26 at the Wexner Medical Center at The Ohio State University’s Ross Heart Hospital Auditorium.
“We’re very aggressive in terms of being in the vanguard of action on cultural competence. People need to understand the impact of culture and should be factoring that into the equation when they interact with Black parents. The majority of Black people are treated by non-Black physicians,” Akinboboye says. While improved care will follow an improved understanding of cultural sensitivities, it is also equally important to talk to Black patients more in order to get them to adhere to the recommended therapies.
Exercise is a particularly nettlesome issue among Black women, where the excuse that ‘we can’t exercise because it will mess up my hair,’ is not uncommon. “These are things we have to challenge; things we’re trying to change,” Akinboboye says. “One of the commonest forms of exercise Black women can do is jumping rope. Unfortunately, once they graduate to their twenties they give it up. One reason you hear is, ‘we just do that to play around and when you have children and a family you don’t have time to play around.’ Jumping rope is a good exercise. If you’re good at it you should keep doing it.”
On the diet front, the Black cardiologists are challenging popular notions of “soul food.” “We have to distinguish between soul food and slave food. People tend to associate Black culture with soul food that comprises things like ham hocks and the bottom parts of animals. That’s more slave food. Our forefathers had no choice but to eat like that. Soul food is vegetables from the ground that our great-great- grandfathers ate in Africa,” Akinboboye says.
A landmark 2002 Institutes of Medicine report, titled “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care,” concluded that racial and ethnic minorities experience a lower quality of health-care services and are less likely to receive routine medical procedures compared to their white counterparts. In 2002, according to the American Heart Association, 74 percent of heart transplant patients in the United States were white and 77 percent were male.
Compared to whites, African-Americans — and in some cases, Hispanics — are less likely to receive appropriate cardiac medication, diagnostic procedures and surgery. Moreover, regardless of insurance coverage, African-Americans are less likely than nonminorities to receive many life-saving therapies, such as implantable cardioverter defibrillators or ICDs. When researchers sifted through 64,936 cases of patients treated under Medicare, they found that African-American Medicare patients received ICD devices at one-third the rate of whites. Only 33.4 percent of African-American men received ICDs, compared to 43.6 percent of white men. African-American females had the lowest rates of ICD use of 28.2 percent.