Reducing Health Disparities in African Americans Through Culturally Competent Church-Based Interventions to Increase Physical Activity
November 21, 2013
PHE 576: Physical Activity, Health, and Disease
Background & Statistics
The Centers for Disease Control (CDC) states that there are 67 million Americans adults with hypertension (HTN). The highest rates are among African Americans, 42.5% of whom have HTN (CDC, 2012a). Over one-third of U.S. adults are obese, with Non-Hispanic Blacks having the highest age-adjusted rate, at 49.5% (CDC, 2012b). Strokes kill nearly 130,000 Americans every year (CDC, 2012c) and approximately 600,000 Americans die from heart disease annually, more than from any other cause (CDC, 2013a). Compared with the same age men and women, African Americans aged 45-74 had the highest death rates from heart disease and stroke in 2006 of all ethnicities (CDC 2013b). More than 25 million Americans are affected by diabetes, with Non-Hispanic Blacks again having the highest rate of all ethnicities (CDC, 2011). Age-adjusted death rates by race and Hispanic origin are also highest for Blacks (CDC, 2012a). The fact that African Americans are disproportionately affected by these conditions plays a major role in the health disparities experienced by this population (Deuster, Kim-Dorner, Remaley, & Poth, 2011). Healthy People 2020 defines a health disparity as, “a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage” and which, “adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group” (Healthy People, 2010). Achievement of health equity for all Americans is an over-arching goal of Healthy People 2020 (Healthy People, 2010). Scholars, advocates, and researchers agree that this is a public health priority (Banks-Wallace, Enyart, & Johnson, 2004; DeHaven et al., 2011). It is a major concern for society, as well, that African American men, women, and children have increased incidence of cardiovascular disease and are at higher risk for premature death or disability (Butler-Ajibade, Booth, W. & Burwell, C., 2012). Disparities in Cardiovascular Disease (CVD) are largely due to hypertension that is uncontrolled. Hypertension is a risk factor for a variety of negative conditions including Cerebral Vascular Accident (Stroke), Myocardial Infarction, Heart Failure and Kidney Disease (Fernandez, Scales, Pineiro, Schoenthaler, & Ogedegebe, 2008). Among African Americans, there is a 35% excess overall mortality rate which is due to CVD (Cooper et al., 2013). Hypertension in African Americans not only is more prevalent but they also have higher rates of uncontrolled hypertension, more cases of severe stages of hypertension, manifest it at earlier ages, and have diminished responses to some medications as compared to Whites (Banks-Wallace, 2007; Paschal, Lewis, Martin, Shipp, & Simpson, 2006; Savoca, Oakley, Austin, Wideman, Martinek, et al., 2013). The rate of hospitalizations for treatment of severe hypertension among African Americans is nearly six times the rate Whites experience (Holmes, Arispe, & Moy, 2005). These characteristics associated with hypertension play a significant role in the disproportionate rates of CVD among this population. It also is a factor in the lower life expectancy that African Americans have; in some areas of the U.S. this is greatly pronounced. There is a 20 year difference in life expectancy among those in the highest and lowest socioeconomic status (SES) groups in Baltimore, with African Americans predominantly living in the poorer areas (Cooper et al., 2013). African Americans in Oregon also have higher cardiovascular disease death rates than all other races, (Oregon.gov, 2007). Possible Explanations for Disparities
There are many reasons, both known and yet undiscovered, as to why African...
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