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Other heart failure risk factors include being over 65 years old; having diabetes, sleep apnea, and/or kidney disease, among other chronic conditions; having a high BMI (many experts acknowledge that this measure of health is flawed and rooted in racism—but we want you to know it’s likely to come up in your care at some point); not eating enough fruits, vegetables, and whole grains; smoking and heavily using or consuming other substances like alcohol; and not getting enough exercise, according to the National Heart, Lung, and Blood Institute. These factors can help your doctor evaluate whether you’re at an increased risk of heart problems in general, Dr. Khan says, and nearly all of them disproportionately affect communities of color in some way, per the AHA.
Of course, there isn’t a simple explanation as to why high blood pressure and diabetes, for example, are so prevalent in Black communities. Does it come back to genetics? Societal factors? “It’s very hard to separate the reasons out because they are very interconnected,” Dr. Khan says.
Social determinants of health are also a big deal.
The term ”social determinants of health” refers to “the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks,” per the US Department of Health and Human Services.
This includes things like a person’s financial stability, their access to and quality of health care, their ability to find nutritious food and exercise opportunities in their community, as well as the likelihood of facing racism, discrimination, and violence in their everyday life. In a 2022 paper coauthored by Dr. Khan and published in Clinical Cardiology, Northwestern University researchers note that a variety of social determinants of health have been associated with heart failure risk, including things like a lack of quality education, living in a low-income household or community, living in a region with a poor public health infrastructure, and a lack of health insurance, among others.6
These aren’t factors that individuals have much, if any, control over, and Black people face these detrimental social determinants in large numbers, due in part to the impacts of structural racism.6
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