March 6, 2025 Story by: Editor
African American women experience the highest burden of cardiovascular disease compared to women of other ethnic backgrounds. Statistics show that 47.3% of African American women are affected by cardiovascular disease, and they also have the highest rates of hypertension, stroke, heart failure, and coronary artery disease among women in the United States.
These disparities persist across various sociodemographic factors and are linked to systemic disadvantages such as discrimination, exclusion from health research, limited access to healthcare resources, and broader social determinants of health. To effectively improve cardiovascular health in this population, interventions must take a comprehensive approach that addresses these social and environmental challenges.
A new study published in the Journal of Women’s Health by White et al. presents an integrative review of interventions aimed at reducing cardiovascular disease among African American women. The researchers analyzed 16 peer-reviewed articles covering 14 interventions designed for African American women under the age of 65.
The interventions focused on improving cardiovascular health literacy and promoting at least two key health measures from the American Heart Association’s “Life’s Simple 7”: tobacco cessation, regular physical activity, healthy eating, and achieving optimal levels of body weight, cholesterol, blood pressure, and fasting blood glucose.
Most of the interventions in the study targeted behavioral risk factors such as physical activity and nutrition—key contributors to racial and ethnic disparities in cardiovascular disease. However, no racial or ethnic group in the U.S. has more than 30% of its population achieving ideal cardiovascular health, and African American women are the least likely to engage in behaviors that lower cardiovascular disease risk, such as maintaining a healthy diet and exercising regularly. Since African American women often have multiple risk factors, the greatest health benefits are observed when interventions address multiple factors at the same time.
Culturally Tailored Interventions and Community Involvement
The review by White et al. found that most behavioral interventions were specifically tailored for African American women using health behavior theories. The most frequently applied theory was social cognitive theory, which promotes behavior change through “observational learning, reinforcement, self-control, and self-efficacy.” This approach integrates personal experience with environmental factors to encourage positive health behaviors.
Every study in the review successfully improved either cardiovascular health literacy or at least one health promotion area. Many interventions leveraged the strengths of African American communities and cultural identity, incorporating elements such as spirituality, self-perception, and traditional foods. Community and academic resources played a key role in shaping these interventions, addressing individual needs such as childcare, transportation, urban versus rural challenges, flexible scheduling for healthcare visits, access to safe exercise spaces, and availability of healthy food options. Importantly, African American communities helped identify barriers to cardiovascular health and proposed solutions to overcome them.
Residential segregation, often tied to economic stratification, also increases African American women’s exposure to harmful environments, further exacerbating health disparities. Regardless of education level, African Americans face a higher risk of poor health outcomes compared to white Americans. Additionally, implicit biases among healthcare providers contribute to worsened health outcomes for African American women.
A Multifaceted Approach to Cardiovascular Disease Prevention
To effectively reduce racial and ethnic disparities in cardiovascular disease, prevention efforts must incorporate culturally tailored strategies that recognize the lived experiences of African American women. Healthcare programs should take into account the social and environmental factors influencing health, ensuring that interventions are both accessible and relevant to the community’s needs.
Conclusion
Addressing cardiovascular disease in African American women requires a multi-pronged approach that tackles multiple coexisting risk factors simultaneously. Healthcare providers must receive education on how to adapt their care practices to better serve vulnerable populations. Additionally, government policies must work toward closing gaps in income, education, and housing while promoting social justice and opportunities for the personal and professional advancement of African American women. Only by addressing these systemic issues can meaningful progress be made in reducing the burden of cardiovascular disease in this population.
Source: NIH
