Heart disease is the number one cause of death for women in the United States. Though this is true for women of all races and ethnicities, women of color are especially at risk. Heart disease, also called cardiovascular disease, is a group of health conditions that affect the heart and the blood vessels. Having heart disease increases the risk of a cardiac event, such as a heart attack or stroke.
In the U.S., non-Hispanic Black women, Latina and Hispanic women, and Asian women have higher rates of heart disease than non-Hispanic white women. African American women also have higher rates of stroke and are more likely to die from heart disease than other women.
Risk Factors for Heart Disease
A family history of heart disease is one factor in developing the condition. But the higher rates of heart disease in women of color are due to much more than genetics.
Other risk factors include:
- Experiences of personal and structural racism and discrimination
- External factors called social determinants of health
- Lifestyle factors, such as diet, exercise and sleep
Other health conditions also raise the risk for heart disease, including:
- Anxiety, chronic stress or depression
- Being overweight or having obesity
- Diabetes
- High blood pressure, or hypertension
- High cholesterol, or hyperlipidemia
Non-Hispanic Black women in the U.S. have higher rates of diabetes, hypertension and obesity than other women. Still, these differences involve more than genetics or lifestyle factors. They’re often rooted in external factors.
Heart Disease in Women of Color and External Factors
The external factors referred to as social determinants of health are a group of nonmedical factors that can have a big impact on health, such as:
- Access to healthy food
- Availability of affordable, quality health care
- Dual child and elder caregiver roles
- Educational opportunities
- Employment opportunities
- Housing and the condition of housing
- Pollution levels or exposure to chemicals
- Neighborhood elements, such as parks, safety and sidewalks
- Social connections
- Transportation
Many of these factors directly affect the risk of developing heart disease. For example, if a person lives in a food desert without access to healthy foods and doesn’t have access to transportation, it can be challenging to eat a healthy diet. Similarly, air pollution, the risk of violence or a lack of green space can prevent people from getting enough exercise.
Such factors may be equally or more important to a person’s health than lifestyle choices and the quality of health care a person receives. In fact, these social factors may be responsible for 30–55% of health outcomes. Because of racism and discrimination, these factors are more common for women of color than white women.
Reproductive Health and Heart Health
Social factors can significantly impact mothers and babies during and after pregnancy. Women of color are more likely to experience adverse pregnancy outcomes, including:
- Eclampsia or preeclampsia, a condition that affects blood pressure during pregnancy
- Gestational diabetes, or diabetes that starts during pregnancy
- Infant and maternal mortality
- Preterm birth
Challenging pregnancies increase the risk of developing heart disease for mothers and their babies. African American women have the highest risk of difficult pregnancies.
Women who get their first period before age 12 or start menopause before age 40 may also have a higher risk of developing heart disease. African American women are more likely than white women to experience early puberty or early menopause. This may add to disparities in heart health.
What to Do About an Increased Risk of Heart Disease
While social factors are difficult to change, there are simple ways to lower the risk of heart disease. If you are a woman of color, talk with your health care provider about your risk factors and how to be healthier. For example, if it’s difficult to get fresh food, your doctor may be able to connect you with helpful resources in your area.
Your provider can also order blood work or imaging tests to learn more about your current heart health. This information allows you and your care team to make better choices about your care and what you need to stay healthy. Make sure to discuss your mental health too. Learning healthy ways to manage stress can have a significant positive effect on your heart health.
More to Read
- Women and Heart Health: How to Reduce Your Heart Disease Risk
- Women’s Heart Attack Symptoms: Do You Know the Signs?
- Understanding Health Risks for Black Women
- Women and Clinical Trials: Closing the Gaps
Medically reviewed by Manjula G. Ananthram, MBBS.
