Introduction: Cardiovascular (CV) disease (CVD) is the leading cause of mortality in Chicago according to the most recent data gathered by the Chicago Department of Public Health (DPH). This is also true at the state and national level. The unique distribution of the population in Chicago along racial/ethnic lines promotes disparity in CVD prevalence and, consequently, higher mortality in certain racial minorities and neighborhoods. We sought to identify the factors contributing to racial disparities in CV health, interventions that have been initiated to address these risk factors and lastly, solutions to decrease this gap in Chicago.
Hypothesis: We hypothesize that unique risk factors put certain racial minorities, especially African Americans (AAs), at greater risk for CVD and mortality.
Methods: An extensive literature search was performed using PubMed, Scopus and the Chicago DPH Epidemiological database with the search terms/phrases health disparities, CVD, mortality, longevity, life expectancy and Chicago in order to identify contributing factors to racial disparities in CV health and outcomes in Chicago.
Results: Many CV risk factors identified at the national level held true for Chicago. Race and socioeconomic status (SES) were repeatedly found to be significantly associated with increased prevalence of CV risk factors with one study finding no association between residence in a primary care health provider-deprived area and increased prevalence of CV risk factors after adjusting for SES and race. AAs, persisting into old age, had poorer control of hypertension (45% vs 51%, p <0.001) relative to their Non-Hispanic White counterparts regardless of their Medicare eligibility status and after adjusting for potential confounders such as SES and obesity. Life expectancy for AA Chicagoans was the lowest at 71.7 with Hispanics having the highest life expectancy at 84.6, and Non-Hispanic Whites at 78.8 years. CVD claims the most lives in Chicago with AAs at greatest risk for CV mortality greatly contributing to longevity being the lowest in this racial subgroup. Interventions identified include city-level efforts such as the Healthy Chicago 2.0 initiative and partnerships involving public, community and healthcare organizations striving to narrow the health disparities gap. Recognition that race and SES are strongly associated with adverse CV health outcomes to a greater extent in certain racial subgroups is a huge step in increasing effective strategies to combat the disproportionate burden of CVD in this subgroup.
Conclusion: African Americans in Chicago suffer the greatest burden of CVD and mortality with studies strongly suggesting that race, itself, and SES are leading culprits in this racial disparity.