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Heart Disease and Stroke in African American Adults


The purpose for this review is to highlight the need for the for using a health communication

intervention in the Riverside county area. This health communication intervention will target

African American adults between the ages of 25 and 50 years old in an effort to share the

benefits that certain lifestyle modifications can have on minimizing their risks of developing

heart disease and stroke later in their lives. To explain why this topic was chosen, some data

must be shared to shed light on this topic.

The majority of the population who are not involved in healthcare may not be aware that heart

disease and stroke are the number one and number 5 leading causes of death in America.1 The

CDC reports that every minute, someone will die from a heart-related event such as a myocardial

infarction or heart failure.2 Every minute. More interesting however, is that African Americans

only make up 13% of the entire population of the Unites States (approximately 41 million),3 yet

this population have a significantly higher risk of developing heart disease and suffering from

stroke (s) later in life.

To address this health problem, one has to look at the research-based evidence that posits reasons

for the health disparity and identify how to overcome barriers in an effort to achieve an

improvement in cardiovascular outcomes in African American adults. The proposed intervention

will be a communication intervention using social media to target members of ten African

American communities within Riverside county, California. A Facebook page will be created

with information about the intervention, sharing facts and statistics about heart disease and stroke
events in African Americans. This page will also feature testimonials from stroke survivors, as

well as survivors of cardiovascular events such as hearts attacks. Preventive measures such as

using the DASH diet, exercising 3 times per week for thirty minutes, not smoking, knowing

blood cholesterol levels, and controlling blood pressure levels etc. will be posted on the page.

Participants will be invited to a central community center on a set Saturday morning for more

information, a weigh in, and links to resources to support a healthy lifestyle. A weight loss

challenge will be set in place thereafter and participants will be encouraged to form work out

groups and share recipes and video posts of dishes they have been trying. The aim is to keep this

intervention engaging and fun for all participants. The winner of the weight loss challenge will

be given a Fit Bit. This intervention will run for one year with the aim of fostering change in

lifestyle behaviors such as diet, exercise, and smoking within that time frame. A survey will be

taken from participants to identify how much weight was lost at different time increments, with a

weigh in at the end of the program. Also, they will be asked how exactly they modified their

lifestyles throughout the life of the program based on the information and engagement over the

one-year period.

This review consists of the introductory section, which presents the purpose of the review and a

synopsis of the health communication intervention. The body of evidence section follows, which

will consist of scientific based research components highlighting the need for health intervention

for heart disease and stroke in the African American community. Finally, a summary and

conclusion section will synthesize all the major tenets of this review.
Body of Evidence

Carnethan et. al reports that in 2012, life expectancy was 3.4 years shorter for African Americans

than that of Caucasians, i.e. 75.5 years versus 78.9 years respectively. Cardiovascular risk

factors were among the twenty-five leading causes of death (6/10 diseases) substantially

contributing to the millions of years of life lost to these diseases.4 The same authors report that

heart diseases explain approximately 32% and 43% of the mortality difference between African

American and Caucasian men and African American and Caucasian men respectively. Other

research aiming to identify the impact that heart disease and stroke have on African American

adults have share similar findings.

One thing that was salient in the research is that most researchers agree on a few things:

1). There is a disparity for cardiovascular health status between African American adults and

their Caucasian counterparts.1,3, 4,5

2) . Reasons can be linked to social determinants of health, access to care, early life origins etc.1,

3). Lifestyle has a bearing on the cardiovascular and stroke outcomes in the future1,2,3,4

4). More research is needed to see what other reasons exist outside of what current research has

found for the significantly higher risk for African Americans for heart disease and stroke.

Another author has posited that African Americans have been identified with higher risk of

obesity and being overweight than their Caucasian counterparts at different ages.5 Obesity in

and of itself is a leading cause of heart diseases, due to fatty deposits being built up in the

arteries. To take things further, another research aims to explain why African Americans are

more likely to be obese than Caucasians-making reference to the soul food diet. The soul food
diet, though consisting of vegetables such as collard greens, okra, and corn, also consists of a lot

of deep frying and the consumption of fatty meats. Yet, other researchers blame the geographic

disparity that exist in many poor African American communities, stating that these communities

have food deserts- lacking enough places where people can find fresh and healthy food options,

and that they do not consist of safe infrastructure or environments that promote regular physical


With all of the above being said, one thing that is agreed on is that intervention is needed in

vulnerable populations such as the African American communities.6 One research study done

on a web-based intervention for patients who had heart disease reported that patients engaged

actively and willingly in a participatory design process.7 Arena et al. in their examination of a

multifaceted approach to improving health stated that “technologies can facilitate health

education and delivery process.” This supports the notion that human behavior has changed,

and people spend so much time with technology now that it only makes sense to use that

technology to meet them through this medium their health needs. Hours are spent browsing

Facebook, Instagram and other social media to see “what’s going on?”, therefore engaging the

target population through this medium is a feasible approach.

Even though technology has infiltrated our lives so much, and heart disease and stroke are such

huge burdens on the population’s health, the scientific literature lacks much evidence of the use

of mobile technologies targeting heart diseases and stroke prevention. The American Heart

Association reports that mobile technologies, (which is what is most heavily used today for

digital communications), does offer tremendous promise for improving the health of the

population.8 On the flip side however, another report states that interventions targeting the

African American community and cardiovascular health prevention are usually modestly
successful, after the interventions end, changes achieved are not sustained.7 This statement

offers a glimmer of hope for the use of the social media communication campaign. The fact that

Facebook is personal, participants are free to continue engaging with each other even after the

intervention has ended and continue to challenge each other into better health outcomes.

Summary and Conclusion

The internet has over 3 billion users worldwide. That is Just under half of the world’s

population. Using social media to reach vulnerable populations is becoming a moderately

successful approach in healthcare and technology. This article review identified the problem of

heart disease and stroke in the African American population and discussed the feasibility of

developing a communications program using social media (Facebook) to reach African

American community members in Riverside county. The main tenets of the research articles

show the irony that even though technology has become so widely used in American

communities, there is no significant improvement in health outcomes as it relates to African

Americans and their cardiovascular health. With this being said both implicitly and explicitly,

there is a need to use social media and other forms of mobile technology to infiltrate the gap and

reach target communities for health status improvement. Arenas et. al states that social media

and other online platforms fosters social support which have proven to translate into the

adherence to maintaining healthy lifestyle behaviors.

Online presence often allows one to become a part of a “community.” Often times it is difficult

to get participants to continuously attend health and wellness classes in person. Reaching them

through social media posts, video uploads, hosting live video presentations and encouraging

them to challenge each other through healthy recipe sharing and fitness goals can bring

awareness to the great risk that African Americans have developing heart disease and stroke
events. Though these forums are engaging, the quality will not be compromised as only science-

based research material will be shared with the participants. Many things have advanced in

America, but unfortunately, the health of minority populations have not improved. Let us use the

advanced tools that we have become accustomed to help bridge the gap to meet the health needs

of our fellow Americans. Heart disease and stroke are largely preventable.10

1. Heart Disease and Stroke. Healthy People Web Site.

Accessed May 1, 2019.

2. A Public Health Action Plan to Prevent Heart Disease and Stroke. The Centers for Disease

Control and Prevention Web

Site. Accessed June 6,2019.

3. Saab KR, Kendrick J, Yracheta JM, Lanaspa MA, et. al. J Am Soc

Nephrol 2015, 26 (2) 247-257; DOI: Accessed

May 31, 2019.

4. Carnethon MR, Pu J, Howard G, Cardiovascular Health in African Americans A Scientific

Statement From the American Heart Association. Circulation. 2017;136: e393–e423.

DOI:10.1161/CIR.0000000000000534. Accessed May 30, 2019.

5. Morris KC, Mensah GA, Boulware EL. Age, Race and Cardiovascular Outcomes in

African American Veterans. Ethn Dis. 2016; 26(3): 305–314. doi: 10.18865/ed.26.3.305 .
Accessed June 1, 2019.

6. Ronaker Re, Greiner M, Simms M. Comparison of risk scores for the prediction of
stroke in African Americans: Findings from the Jackson Heart Study. Am Heart J. 2016;
177:25-32. DOI:10.1016/j.ahj.2016.04.007. Accessed May 31, 2019.

Burke LE, Ma J, Azar KMJ et. al. Current science on consumer use of mobile health for cardiovascular disease

prevention: a scientific statement from the American Heart Association. Circulation. 2015;132:1157-1213.

Accessed June 1, 2019.

7. Development of a Web-Based Health Care Intervention for Patients With Heart Disease:
Lessons Learned From a Participatory Design Study. JMIR Res Protoc. 2017 May; 6(5):
e75. doi: 10.2196/resprot.7084. Accessed June 1, 2019.
8. Burke LG. Jun P, Chair MA. Et al. Current Science on Consumer Use of Mobile Health
for Cardiovascular Disease Prevention: A Scientific Statement From
Association. Circulation. 132(12), 22 September 2015, p 1157-1213. DOI:
10.1161/CIR.0000000000000232. American Heart Association. Circulation. 2015;132:1157-1213.
Accessed June 1, 2019.

9. Arena R, Guazz M, Lianov L. Healthy lifestyle interventions to combat

noncommunicable disease--a novel nonhierarchical connectivity model for key
stakeholders: a policy statement from the American Heart Association, European Society
of Cardiology, European Association for Cardiovascular Prevention and Rehabilitation,
and American College of Preventive Medicine. Mayo Clinic Proceedings. 90.8 (Aug.
2015): p1082+. DOI:
American Heart Association. Circulation. 2015;132:1157-1213. Accessed June 1, 2019

10. Stroke. Centers for Disease Control Web Site. Accessed
June 1. 2019.