Particular person psychological well-being could guard coronary heart well being in Black adults
Credit: Unsplash / CC0 Public Domain
Being optimistic that you have a purpose in life and in control of your surroundings – traits of psychosocial resilience – is linked to better cardiovascular health in black adults regardless of the neighborhood context, according to a study published today in Circulation: Cardiovascular Quality and Outcomes, a journal from the American Heart Association.
This study sheds light on a relatively under-explored area of research and shows that psychosocial well-being or resilience can positively affect black people’s cardiovascular health. A well-known factor negatively affecting health in the Black Community is the neighborhood itself, as people who live in areas with more socioeconomic disadvantages are more likely to suffer from heart attacks, strokes, and deaths due to these factors. Living in a neighborhood with fewer or limited socio-economic resources is viewed as one of several social determinants of health that can affect the risk of cardiovascular disease.
“Differences in cardiovascular health between black and white Americans have been documented for decades. However, individual factors within black Americans that could contribute to better cardiovascular health are not well understood,” said Tené T. Lewis, Ph.D., FAHA, a clinical psychologist and adjunct professor of epidemiology in the Rollins School of Public Health at Emory University in Atlanta and a key researcher on the study. “Almost everything we know about black Americans and their health is focused on deficits, but we really need to start identifying strengths. If we understand which strengths are most important to black Americans – and in what contexts – we can the most appropriate and applicable public will develop health interventions for this group.
Using the American Heart Association’s Simple 7 metrics, the study examined whether individualized psychosocial resilience and neighborhood-level cardiovascular resilience were associated with better cardiovascular health in black adults. Life’s Simple 7 are seven individual metrics that quantify heart health: smoking status, physical activity, diet, weight, and blood sugar, cholesterol and blood pressure values.
The researchers recruited 389 adult volunteers with no history of CVD (30-70 years old, 39% men) who identified themselves as Black or African-American in a sub-study funded by the American Heart Association in the greater Atlanta area, Morehouse-Emory Cardiovascular (MECA) study. -Center for Health Justice. The MECA study of 1,500 black adults, conducted from 2016 to 2019, examined socio-ecological and individual behavioral measures that promote cardiovascular disease resistance in black adults by assessing biological, functional and molecular mechanisms in the greater Atlanta metropolitan area.
Participants completed several standard questionnaires in face-to-face interviews that measured their psychosocial health. The questionnaires focused on their perception of control over their own environment; whether they feel they have a purpose in life; their level of optimism; and assessment of coping skills and depressive symptoms. Participants also received physical exams and blood tests. Individuals with previous cardiovascular events, human immunodeficiency virus, lupus, cancer, substance abuse, psychiatric illness, or pregnant or breastfeeding individuals were excluded from the study.
Participants’ psychosocial and physical data were compared with their neighborhood data on heart and stroke diseases and death rates from the 2010 US Census Tract.
Among the results, black adults with higher psychosocial resilience scores who lived in areas with high rates of heart disease and stroke had a 12.5% lower incidence of cardiovascular disease than those with lower psychosocial resilience in the same neighborhoods.
“It was somewhat of a surprise that our psychosocial resilience interventions were more closely related to cardiovascular health than the neighborhood resilience effort. We believed that both high psychosocial resilience and living in a resilient neighborhood are most beneficial for cardiovascular health What we found was that psychosocial resilience has the most robust association regardless of neighborhood resilience measure, “said Lewis.
One of the limitations of the study is that the small number of participants came from a single city. Therefore, the results may not apply to black adults in the US or other countries. The study also did not assess the structural features of the neighborhoods, such as
as walkability or access to food or environmental factors such as air pollution. More research is needed to examine the factors within a community and how they, along with and compared to other social determinants of health, affect the psychosocial well-being and general health of Black Americans.
“Given the heartbreaking aftermath of COVID-19 and the inhumanity of George Floyd’s death, we are having a national conversation on how structural and interpersonal racism has shaped the lives and deaths of black Americans,” added Lewis. “More studies like this are needed to fully understand the factors promoting better health for Black Americans, who, according to current numbers, are at greatest risk for COVID-19 and cardiovascular disease. With this information, we can create new ones Support and care systems that can lead to improved psychosocial resilience, which in turn could improve health outcomes. “
An editorial by Amber E. Johnson, MD, MS, MBA, and Jared W. Magnani, MD, MS, Assistant Professors of Medicine in Cardiology at the University of Pittsburgh Medical School, appears concurrently with Lewis et. as the article.
They note that the study “… supplements the existing data describing LS7 [Life’s Simple 7] among black individuals by adding the association of resilience with health outcomes. Few studies on resilience have focused on black people. “While they noted some limitations in the study, they support these results.” … underline the importance of psychosocial support and empowerment for black patients who are at risk of developing CVD. However, the factors that mitigate the relationship between exercise capacity and cardiovascular health remain to be defined. “
In particular, Johnson and Magnani comment: “While resilience techniques can be taught, they require the deliberate recognition of the conditions and experiences from which adversity arose. The community context in which resilience thrives is not just about psychosocial well-being. Economic well-being and accessibility Health care is also needed. To address disparities in cardiovascular health, community partnerships based on common goals are needed to ensure care and rebuild health systems, unnecessarily strengthening resilience. ”
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Circulation: Cardiovascular Quality and Results (2020). DOI: 10.1161 / CIRCOUTCOMES.120.006638 Provided by the American Heart Association
Quote: Individual Psychological Wellbeing Can Protect Heart Health in Black Adults (2020, October 7th), released October 7th, 2020 from https://medicalxpress.com/news/2020-10-individual-psychological-well-being-heart- health. html
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