Heart Disease: The Silent Crisis for Black Women

By Darius Spearman (africanelements)

Support African Elements at patreon.com/africanelements and hear recent news in a single playlist. Additionally, you can gain early access to ad-free video content.

Understanding Heart Health

Heart disease is often seen as a condition that primarily affects older men, but for Black women, the reality tells a very different and urgent story. Despite making up a vital and vibrant part of our communities, Black women are disproportionately affected by heart disease. In fact, it is the number one cause of death in the community, according to the American Heart Association (heart.org). This critical health issue demands our attention and understanding.

Heart disease refers to a group of conditions that affect the structure and function of the heart, including coronary artery disease, heart failure, and heart rhythm disorders, according to the Mayo Clinic. These illnesses are serious and can lead to life-threatening complications such as heart attacks and strokes. The American Heart Association annually reports up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors (heart.org). These reports include comprehensive data on core health behaviors such as smoking, physical activity, nutrition, sleep, and obesity. Additionally, they cover crucial health factors like cholesterol, blood pressure, glucose control, and metabolic syndrome that significantly contribute to cardiovascular health (heart.org). The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions, including stroke, coronary heart disease, heart failure, and rhythm disorders (heart.org).

For Black women, these factors carry a particularly heavy burden. Cardiovascular disease is the leading cause of death for Black women in the United States (sciencedirect.com). Black women experience higher mortality rates from coronary artery disease, hypertension, stroke, and congestive heart failure compared to Caucasian women. The mortality rate from coronary artery disease is 69% higher in Black women than in White women (sciencedirect.com). While menopause does not directly cause cardiovascular disease, menopausal changes can impact cardiovascular health. Black women often experience menopause at younger ages, and women who reach menopause before 45 years of age have a higher risk of cardiovascular disease (goredforwomen.org). These elevated risks are not simply the result of individual choices; instead, they are deeply tied to long-standing social and economic inequities that shape health outcomes.

Black Women’s Heart Health Statistics

Black women face disproportionately high rates of heart disease prevalence, mortality, and adverse management outcomes compared to other demographic groups. Alarmingly, nearly 59% of Black women ages 20 and over are living with some form of cardiovascular disease, including heart disease. African American women have greater mortality than Caucasian women from coronary artery disease, hypertension, stroke, and congestive heart failure (sciencedirect.com). The mortality rate from coronary artery disease is 69% higher in Black women than in White women (sciencedirect.com).

Several prevalent risk factors contribute to this alarming reality. Black women have the highest rates of high blood pressure in the United States, yet only 25% have it under control. This condition is one of the strongest predictors of heart disease and cardiac arrest. Chronic high blood pressure can damage the inner walls of blood vessels, leading to plaque formation and reduced blood flow. Additionally, nearly 57% of Black women are obese, representing the highest percentage across all racial and gender groups. Excess weight, especially abdominal fat, puts additional strain on the heart and is closely linked to hypertension, diabetes, and high cholesterol. Black women are also more likely to develop Type 2 diabetes and to go undiagnosed, a condition that damages blood vessels and nerves controlling the heart. The prevalence of stroke in Black women is twice as high as in White women, often stemming from shared risk factors like high blood pressure and atherosclerosis. Furthermore, elevated levels of “bad” LDL cholesterol and low levels of “good” HDL cholesterol are common and often go untreated, contributing to plaque development in the arteries over time. These statistics paint a clear picture of the urgent need for targeted interventions and improved healthcare access for Black women.

Social Determinants of Health

Health disparities in cardiovascular disease among Black women are deeply rooted in social determinants of health. These are 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. These factors create systemic barriers to optimal health and healthcare access. Black, Hispanic, and American Indian and Alaska Native individuals generally experience worse health outcomes compared to White individuals across most health and healthcare measures (kff.org). This disparity is observed across the majority of examined measures of health and health care, as well as social determinants of health (kff.org). While Black people may fare better in some cancer screening and incidence measures, they have higher rates of cancer mortality (kff.org). Despite worse measures of health coverage, access, and social determinants of health, Hispanic people show better outcomes for some health measures, including life expectancy, certain chronic diseases, and most cancer incidence and mortality measures (kff.org).

For example, Black women are less likely to receive revascularization for acute myocardial infarction compared to non-Hispanic White women (sciencedirect.com). There is also a lack of specific data on racial and sex differences in valvular heart disease. However, non-Hispanic Black women and men are less likely to receive transcatheter aortic valve replacement or surgical aortic valve replacement for aortic stenosis (sciencedirect.com). These disparities highlight how systemic issues, rather than individual choices, often dictate health outcomes, creating a profound impact on the cardiovascular health of Black women.

Systemic Barriers to Care

Access to high-quality healthcare and insurance remains a significant barrier for many Black women. A 2024 study by KFF highlighted that as coverage gains began to reverse in 2017, the dramatic effect caused three consecutive years of increased uninsured rates. As of 2021, nonelderly American Indian and Alaska Native individuals (21%) and Hispanic individuals (19%) were more than twice as likely as their White counterparts (7%) to be uninsured (kff.org). As of 2022, nonelderly American Indian and Alaska Native individuals (19%) and Hispanic individuals (18%) had the highest uninsured rates (kff.org). Uninsured rates among nonelderly Native Hawaiian and Pacific Islander individuals (13%) and Black individuals (10%) also exceeded those of their White counterparts (7%) (kff.org). Without insurance, early diagnosis and effective treatment options cannot be distributed, which leaves many Black women undiagnosed or untreated until it is too late.

Black women face a unique intersection of systemic racism and gender bias within the healthcare system. They are less likely to be listened to, believed, or appropriately treated when they report symptoms. Many studies show that Black patients are less likely to receive timely interventions for heart-related symptoms or preventative care. The constant stress of navigating racism, sexism, and socioeconomic barriers, often referred to as “weathering,” has a physiological impact on the body. Chronic stress raises cortisol levels, increases blood pressure, and contributes to inflammation in the arteries, all of which are major risk factors for heart disease. This continuous exposure to stress further exacerbates existing health vulnerabilities.

Addressing the Heart Health Crisis

Addressing the heart disease crisis among Black women requires a multifaceted approach that tackles both individual and systemic factors. First and foremost, healthcare providers must receive comprehensive training in culturally competent care. This means recognizing their own biases and delivering services that are respectful of and responsive to the unique needs of Black women. Building trust through culturally sensitive practices is essential to improving health outcomes and encouraging Black women to seek and adhere to necessary medical care.

At the same time, community empowerment plays a crucial role in fostering health equity. Faith-based organizations, sororities, and grassroots groups are well-positioned to spread awareness, foster meaningful dialogue, and offer emotional and practical support within trusted spaces. These community-based interventions can provide accessible health education, screening events, and support networks that are tailored to the specific needs and cultural contexts of Black women. Policy change is another vital piece of the puzzle. Expanding access to affordable healthcare, investing in community wellness programs, and tackling the social determinants of health, such as housing, education, and employment, are all necessary steps toward achieving health equity. These systemic changes can create environments where healthy choices are easier to make and healthcare is a right, not a privilege.

Empowerment and Prevention

While systemic change is essential, self-advocacy remains an important tool for Black women navigating the healthcare landscape. Black women should feel empowered to ask questions, seek second opinions, and advocate for better care, ensuring their concerns are heard and addressed. However, the burden of navigating inequitable systems should not fall on individuals alone; institutions must also be held accountable for providing equitable and high-quality care. Heart disease remains the number one health threat to Black women, yet many are unaware of this fact. Public health campaigns often fail to reflect the lived experiences of Black women or communicate in ways that resonate with their realities. Without culturally relevant education and outreach, awareness and prevention efforts continue to fall short, perpetuating the cycle of disparity.

Fortunately, there are concrete steps that can significantly lower the risk of heart disease and improve overall well-being. According to the Sarver Heart Center, staying physically active through a mix of cardiovascular exercise, strength training, flexibility, balance, and coordination is essential. Monitoring key health numbers is also critical for early detection and management. Black women should regularly check their cholesterol levels (total, LDL, HDL), triglycerides, fasting glucose, and HbA1c. Blood pressure should ideally be 130/80 or lower, and BMI should target a range of 20-25. Additionally, other relevant indicators like insulin, Vitamin D, and coronary calcium score should be considered where appropriate. Nutrition plays a foundational role as well. Embracing a whole-food, plant-based diet, rich in greens, beans, vibrant fruits and vegetables, whole grains, nuts, and seeds, can dramatically reduce risk. Moving away from the Standard American Diet and exploring different diets, such as the Mediterranean Diet or the MIND diet, can help support this dietary shift. Together, these strategies offer a path toward better heart health and greater overall well-being for Black women. Remember, your heart matters. Your life matters. Let us fight for both.

ABOUT THE AUTHOR

Darius Spearman has been a professor of Black Studies at San Diego City College since 2007. He is the author of several books, including Between The Color Lines: A History of African Americans on the California Frontier Through 1890. You can visit Darius online at africanelements.org.