FORT LAUDERDALE, FLA. -- In a media round table today at Broward Health Medical Center, Broward Health Physician Group physicians met with members of the media to discuss heart health disparities in African-Americans and Hispanics.
Recent data from the CDC, United States Census Bureau and Florida Department of Health indicates that 56 percent of African-Americans and 64.5 percent of Hispanics in Miami-Dade County, as well as 57.3 percent of African American and 61.8 percent of Hispanics in Broward County, suffer from heart disease. This rate is significantly higher than for Caucasians.
Violet McCormack, M.D., medical director of interventional cardiology, Broward Health Medical Center; Aldo Calvo, D.O., medical director of ambulatory care, Broward Health Community Health Services; and Arnoux Blanchard, M.D., director of the cardiology fellowship program, Broward Health Medical Center, gave their reasoning as to why we are seeing these discrepancies.
"When we look at the higher death rate for Hispanics living within counties with more of their ethnic peers, we have to consider that those counties and areas also have a higher poverty rate, which impacts access to proper treatment," said Calvo, who is a primary care physician. "From a cultural perspective, Hispanic diets in some countries have a higher concentration of complex carbohydrates that are associated with a higher risk for diabetes, which is a risk factor for developing heart disease."
While some causes can be linked back to a combination of genetic and cultural characteristics, the panel also felt that socioeconomic and environmental issues can be keys in recognizing risk factors in minorities and creating a map to manage existing health disparities.
"In the black community, one of the reasons the outcomes are so bad is because they don't take their medicine," said Blanchard, who is a cardiologist. "Yes, the medicine is expensive, but we can work it out. They often don't understand why a doctor is giving them 10 medications. There's an issue of mistrust. They are suspicious. The doctor/patient relationship is critical."
"In these populations, their first encounter with a doctor is often in the ER with a heart attack," McCormack said. "We save their lives, but it's sad that because of their circumstances the attack wasn't prevented or the onset delayed."
"I've seen people who have been unknowingly walking around with heart disease for decades," added Blanchard. "This sheds light on the importance of timely checkups and promoting the physician/patient relationship."
The panel also agreed that education is critical to not only create necessary lifestyle changes, but also to overcome patient mistrust.
"The patient/physician relationship is key," said Blanchard. "Part of the disparity is obtaining access and maintaining compliance with treatment. Physicians need to sit down with a patient with socio-economic distress and be sensitive to their cultural nuances."
"To be more effective, you have to understand the cultural norms that make Broward, Miami-Dade and Palm Beach counties this beautiful melting pot," said Calvo. "The most important person is the patient. For an hour of their time, we can go over nutrition and the side effects of medication. We'd rather know their complications now so we can prevent a heart attack later. We are just trying to get them healthy, happy and with access to what they need."