This analytical literature review (ALR) analyzes the prevalence of cardiovascular disease in African-American women by comparing it with Caucasians. The hypothesis holds that the prevalence of CVD is higher in African American women as compared to Caucasian women. There is a major burden of disease that exists among the African Americans, especially women, in comparison to their Caucasian counterparts. Research conducted in 2007 showed that the age-dependent death rate was up to 1.3 times greater among African Americans than in the Caucasians. Besides, the average lifespan of African Americans was 4.8 years less than that of Caucasians (Frieden, 2011).
CVD accounted for 46.9 percent deaths in African American women in 2006. Data collected from the Centers for Disease Control and Prevention (CDC) further portrays ethnic/racial health disparities with a 32.3 percent higher mortality rate as a result of strokes among the African Americans in comparison with Caucasians. Besides CVD, African Americans are also greatly exposed to various CVD risk factors such as physical inactivity, diabetes mellitus, obesity, and hypertension. For instance, 48 percent of African-American women portray multiple CVD risk factors in comparison with the 37 percent remainder of the population. The race is an aspect that is continually studied while observing health disparities. However, the meaning and relationship of race to health are issues that still need some further clarification to shed some light on these studies (Helms, 1994).
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The meaning of race is something that has continually varied over the decades to define the phenotypical features, physical traits, or social-political construct that result in the racial hierarchy, where some races are considered better than others. However, there still lacks varied assessment methods, the operational explanation of race across disciplines also remains unclear, which has continually pressed for the need of methodological literature that will further clarify the influences, meaning, and factors related to race. For example, the ethnicity construct, which is not similar to race could be used to replace race in the research of health disparities because this term is broader, referring to customs, behaviors, values, and traditions (Sambamoorthi & McAlpine, 2003).
The ethnicity construct could also be incorporated into a study having an acculturation measure. The influence of the environment and genes on health and race outcomes is a subject that has evolved with the rise in genetic research, quantitative methodologies, and technology. Besides, theory-driven constructs that are related to race, e.g., discrimination, while not encouraging stereotypes can be a better option when delineating the relationship between race and the way people perceive it. However, race is confused with low SES to a point where it is no longer clear if race and low SES contribute to certain poor health outcomes ( Lloyd-Jones, Adan1s & Brown, 2010).
SES is used to refer to employment, income, insurance status, and occupation. All these indicators of SES are expected to be incorporated in health research. However, factors like the privacy of the participant, survey design, and report bias could prevent a valid or actual assessment of the indices. Race does not explain these factors, which leaves the need for clearly defined outcomes in health research. Factors resulting in racial group differences include discrimination at both the personal and health care level, limitations in the environmental protection, limited access to quality healthcare, and medical mistrust. Other critical elements that greatly affect medical care among ethnic/racial minorities include access to proper healthcare or inadequate health insurance (Helms, 1994).
Studies prove that there is a strong relationship between these psychosocial and sociodemographic factors and the increased CVD mortality in African-American women. However, the investigation of the same on ethnic/racial minorities with higher SES in comparison with Caucasians that receive medication is limited. It is, therefore, not clear if the ethnic/racial minorities when compared with Caucasians, both with high levels of SES, will result in better or poorer findings on the case of the African Americans. Thus, there is a lack of a comprehensive understanding of factors that cause health and disease disparities among the racial and non-racial minorities. The paper thus warrants studies that will further look into higher SES ( Lloyd-Jones, Adan1s & Brown, 2010).
Method
For this study, I made use of a database that provided the perfect opportunity to compare two racial groups : African-Americans women and Caucasians. Besides the physical examination of the sample, peer-reviewed articles were also very helpful for me because they helped me get more information regarding CVD and also develop my study. The articles also helped me determine the validity of my paper, where I made an explicit assessment of the knowledge delivered based on the description of questions and key concepts. I have used a wide range of peer-reviewed articles and journals, all talking about African-American and Caucasian women. I aimed at getting as much information as possible regarding the prevalence of CVD in the two ethnic groups, and then compare them to see where the group in which the disease is more prevalent.
Results
Seven out of 10 of the peer-reviewed articles that I used were in support of my two-variable hypothesis that the prevalence of CVD is higher in African-American women as compared to Caucasian women. A comparison of the occurrence of cardiovascular diseases between African Americans and Caucasians by sex showed a higher prevalence in African Americans. A larger section of African American women exhibited all of the three risk factors of CVD in comparison to the Caucasians. According to the recorded demographic baseline characteristics, women portrayed significant racial differences in education, age, personal perception of their well-being, and employment. African-American women were younger, more employed, but with lesser marriages in comparison to Caucasian women (Frieden, 2011).
Discussion
(Sambamoorthi & McAlpine, 1997) analyzed 762 African American adults, of which 39 percent were women, and 40,051 Caucasians, of which 32 percent were women. The patients at Cooper Clinic had a higher SES, which was defined by the level of educational attainment. This study was completed, and the database used provided the perfect opportunity to compare two racial groups, both from similar SES backgrounds. The study revealed a higher occurrence of self-reported hypertension among African-Americans, 26.30/0 vs. 15.5% for women [ X 2 = 47.2, P ≤.0003]) and (37.4% vs. 20.5% for men [ X 2 = 21.3, P ≤.00015]; and diabetes 6.4% vs. 2.0% for women [ X = 10.27, P =.0012]) and (4.4% vs. 3.0% for men [ X 2 = 24.0, P ≤.000105].
(Lloyd-Jones, Adam & Brown, 2010) found out in their study on the occurrence of chronic diseases in Caucasian and African-American women that t he latter had a higher occurrence of self-reported hypertension; 27.10/0 vs. 13.5% for women [ X 2 = 45.3, P ≤.000l]) and (27.4% vs. 17.5% for men [ X 2 = 31.3, P ≤.0001]; and diabetes 4.4% vs. 1.9% for women [ X = 9.27, P =.002]) and (5.4% vs. 2.0% for men [ X 2 = 26.0, P ≤.0001]. African American adults also recorded a higher prevalence of systolic blood pressure and obesity but lower chronic renal failure (CRF) compared to their Caucasian counterparts.
(Xu, Kochanek, Murphy & Tejada-Vera, 2007) made a comparison of the occurrence of CVD among African American adults and Caucasians. It showed a higher prevalence in the African Americans, with the statistics for men being: (20.5% vs. 15.8% in African Americans, P =.012), and that for women being: (Caucasian [39.9%] vs. African-American [29.1%], P <.001). A larger section of African American men (4.6% vs. 2.4%, P =.00l) exhibited all of the three risk factors, which are high blood pressure, obesity, and diabetes . Statistical analysis of the data for the African American men revealed greater odds for hypertension (OR= 1.35, 95% CI, 1.11, 1.64, P =.002) and diabetes (OR= 1.94, 95% CI, 1.37, 2.75, P =.002). As for the African American woman, the odds of prevalent hypertension was higher (OR=2.20, 95% CI, 1.74, 2.78, P <.001) and that of diabetes was also higher (OR=2.19, 95% CI, 1.33, 3.62, P =.002). However, adjustments for obesity left the odds for the African American women greater than the Caucasians but statistically insignificant (OR= 1.58, 95% CI, .094, 2.66, P = .087).
(Pollock, Bohannon & Cooper, 1976) further supported my two-variable hypothesis that the prevalence of cardiovascular diseases (CVD) is higher in African American women as compared to Caucasian women. It explored the relationship between various sociodemographic factors on the risk burden of CVD in African American adults and Caucasians. Through this study, it was possible to analyze the effects of CVD on African American women. The prevalence of self-reported chronic diseases was highly prevalent in African Americans, who recorded greater odds of prevalent diabetes mellitus and hypertension compared to Caucasians. It showed a higher prevalence in African Americans, with the statistics for women being: (Caucasian [49.9%] vs. African-American [39.1%], P <.001) and that for men being: (19.5% vs. 16.8% in African Americans, P =.0152). A larger section of African American men (4.6% vs. 3.4%, P =.0050l) exhibited all of the three risk factors, which are high blood pressure, obesity, and diabetes . Statistical analysis of the data for the African American men revealed greater odds for hypertension (OR= 1.45, 85% CI, 1.101, 1.604, P =.0025) and diabetes (OR= 1.945, 97% CI, 1.375, 2.175, P =.00125). As for the African American woman, the odds of prevalent hypertension was higher (OR=2.205, 98% CI, 1.745, 2.758, P <.0011) and that of diabetes was (OR=2.195, 95% CI, 1.353, 3.672, P =.0027). However, adjustments for obesity left the odds for the African American women greater than the Caucasians but statistically insignificant (OR= 1.508, 98% CI, .0945, 2.66, P = .0867).
Conclusion
Several factors such as race, SES, gender, among others affect the health disparities between Caucasians and African Americans. After narrowing down to prove that the prevalence of CVD is greater in African Americans compared to Caucasian, the results of this ALR also showed that the risk factors are more dominant in women compared to men. This study has used SES as a predictor of ethnic/racial minority health. The high prevalence of CVD in African American women in comparison to the Caucasians can be explained by diminishing return hypothesis, which suggests that higher education among the African Americans is not helpful towards positive health outcomes as compared to Caucasians. This occurrence is due to an unequal relationship between the daily experiences of the people and their economic status, and this resulted in stress and conflict. The high incidence of cardiovascular disease in the African American women has resulted in disadvantages due to lower SES and race, embattled recruitment of lower SES, and a lower enrollment of a range of SES within the African-American samples.
References
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