WHEP Scholar Temi Adegoke
Drexel University College of Medicine, Class of 2021

The existence of racial disparities and worse cardiovascular health outcomes among black Americans in comparison to whites is a well-known phenomenon. Blacks are two to three times as likely to die of preventable heart disease and stroke compared to their white counterparts. However, the typical explanation given for these disparities has focused on risk factors such as obesity, dietary habits and delays in seeking health care. While these factors are important, they do not account for the persistent difference in cardiovascular outcomes among black patients after controlling for these components.

 There is an alternate source of these racial discrepancies: racial discrimination. Stereotyping, whether intentional or unintentional, often results in a physician failing to recommend cardiac rehabilitation or cardiac catheterization when required. Discrimination can also inhibit the development of a strong physician-patient relationship, resulting in discontinuous care, mistrust of the provider and ultimately medication nonadherence leading to worse cardiac outcomes. Furthermore, the ever-looming threat of discrimination produces perpetual state of hypervigilance among black Americans, activating the sympathetic nervous system, culminating in higher systolic and diastolic blood pressures.

Physicians from racial minority backgrounds may possess greater cultural competence, skills and experience in dealing with diverse populations; but does that actually manifest in reduced cardiovascular mortality for their patients of color? This is an unanswered question. However, it is important that all providers be educated on the reality of their own biases and the racial disparities in health outcomes that exist in their own practice. Health institutes can work on tackling these issues by initiating training programs for physicians on cultural competence, disarming stereotypes and false beliefs about black bodies, and having open dialogues about the intersectionality of race and medicine.