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This blog was written by Asli McCullers, Health Equity Research Associate at MedStar Health. Findings by MedStar Health Research Institute suggest the stress of the pandemic and daily experiences of racism are compounding the health crisis for African Americans as more young adults are diagnosed with high blood pressure.
Heart disease accounts for more than 20% of deaths among African Americans annually. Hypertension, or high blood pressure, is an established risk factor for stroke, kidney disease, and coronary heart disease, and more young Black people than other racial groups are diagnosed with it each year. With social injustice more visible than ever and the compounding mental health effects and disparities of COVID-19, the connection between racism, stress, and high blood pressure is a research imperative.
Even that high blood pressure is often thought of as an “old person problem,” studies suggest it impacts the young too, especially in African Americans. Approximately 33% of African Americans aged 18-44 have been diagnosed with hypertension. The same study found just over 20% of non-Hispanic white people and Mexican Americans with a similar diagnosis. And 75% of African Americans report experiencing racism every day, compounding stress that can contribute to worsening cardiovascular outcomes.
High blood pressure has a reputation as “the silent killer” because it often doesn’t have obvious symptoms. But when the force of the blood flowing through the arteries and veins is consistently too high, patients face serious health consequences such as:
- Heart attack
- Heart failure
- Kidney disease
- Sexual dysfunction
- Stroke
- Vision loss
MedStar Health is committed to identifying opportunities to improve the heart health of Black patients in our communities and throughout the U.S. To that end, I led a review of literature and research published in Public Health Review that revealed several important findings about how daily experiences of racism and the stress of the pandemic have significantly altered the heart-health trajectory of young Black people—as well as opportunities for collaborative initiatives to help slow the trend.
Heart-health impacts of daily traumas.
African Americans live with a long history of race-based trauma. Generational traumas stemming from slavery and segregation continue to impact the health and well-being of young Black adults today, resulting in disparate educational and employment opportunities, restricted socioeconomic mobility, and implicit bias that affects healthcare access and outcomes.
The stress of daily racism can lead to repeated blood pressure elevation and nervous system stimulation, which can produce hormones such as aldosterone and cortisol that increase the risk of adverse cardiovascular outcomes.
The last several years have been uniquely stressful for young Black people. Black people have been three times more likely than whites to contract COVID-19 and twice as likely to die from the virus. As a result, young African Americans are more likely to experience trauma and grief from losing a loved one.
Pandemic-related stress, compounded by increased societal visibility of racial injustice, has contributed to negative mental health impacts for young African Americans, such as anxiety and depression. Moreover, these individuals are less likely to have access to mental health services to help them cope with these challenges.
These findings are grim, but my research has also revealed opportunities to help achieve better outcomes.
Building partnerships for a healthier community.
The most efficient way to make an immediate impact is the implementation of widely accessible, comprehensive education programs targeted to African Americans under age 30 to build skills for health literacy, coping and resilience, and stress management.
Our research suggests collaboration between non-profit organizations, local health departments, hospitals, schools, and other community partners is the most direct route to reach and influence young Black people. In Washington, D.C., organizations such as Black in Mental Health, The Public Health Millennial, and My Sister’s Keeper are already participating in African American health conversations, and young people are listening.
Medical institutions working in cooperation with organizations like these could have an immediate impact. Health collaboratives should explore opportunities to develop tools to help young African Americans advocate for their best interests, navigate their healthcare, and understand the insurance system.
To further address the problem head-on, additional research and policy reform should be prioritized to dismantle the structures of systemic racism.
Black Americans have understood the impact of racism on their health and well-being for generations. Now that science is shedding light on the consequences of these daily traumas, the course is set for action to make a difference in the lives of all patients.
