RACiAL AND ETHNiC CONSiDERATiONS

The U. S. population has become increasingly diverse, with an increase in Hispanics, African Americans, Native Americans, and Asian/Pacific Islanders. The prevalence and incidence of CVD varies among these ethnic and racial groups in the United States. These variations are important in developing strategies for prevention and treatment as these minority populations increase in number. CVD mortality rate varies significantly by U. S. region, with a greater than twofold difference between states with the lowest and the highest rates. Factors influencing these differences are complex. As an example, in the southern United States, more than 25% of individuals are obese. This in turn puts the population at a higher risk for diabetes mellitus and CVD. The key to reducing CVD in these populations lies in education and intervention. Many, however, do not have health insurance and do not see a doctor regularly. Improved access to health care coupled with education and modification of risk factors can reduce cardiovascular events. The highest mortality rates from CVD are seen in the Mississippi Delta, Appalachia, and the Ohio River Valley, where the numbers of people in the lower socioeconomic category are highest.

African Americans have the highest mortality rates in the United States for CHD and stroke. In 2004, the overall death rate from CHD in the United States was 288/100,000, while the death rate for African Americans was 454/100,000 for men and 333.6/100,000 for women. The mortality rate from CHD is lower among the Hispanic, Asian, and Native American populations. Among Asians, probably because of the high prevalence of hypertension, the mortality rate from stroke is higher. A high mortality rate from stroke continues to exist in the southeastern United States, especially among the African American population, but stroke rates have increased in the northwestern United States, possibly because of an increase in the Asian population of those states. The areas with the highest CVD mortality in the United States are frequently poor and rural.

Racial differences in health care outcomes are well documented in the United States. Members of minority populations, especially African American individuals, are less likely to receive invasive cardiovascular procedures shown to improve outcomes, are less likely to see doctors and other health care providers, and tend to smoke more than nonminority members. As the ethnic populations increase, more attention must be directed toward identifying those at risk and intervening with recommended therapies.

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  • Category: Heart and vessels