Introduction
CVD describes a cluster of conditions that affect the circulatory system and heart. CVD includes heart failure, stroke, coronary heart disease, and peripheral vascular diseases. “In America, approximately 23.5 percent of people die due to CVD” (Balfour et al., p 1, 2016). The diseases are ranked as the second cause of death for Hispanics. “There is a high variation in the prevalence rate among three Hispanic subgroups: Mexicans, Cubans, and Puerto Ricans” (Shaw et al., p. 2, 2018). The prevalence rate of CVD between the subgroups differs due to factors such as genetics, the rate of smoking, and cholesterol. “However, the prevalence rate of the Hispanic subgroups is lower compared to the non-Hispanic group to CVD, and the phenomenon is termed the Hispanic Paradox” (Balfour et al., p. 8 2016). The Hispanic paradox highlights the complex relationship between ethnicity, lifestyle, and genetics in the development of cardiovascular disease. The health disparities between the Hispanic subgroups result from factors such as inequitable access to care and poverty levels between the subgroups. The mortality rates between the subgroups differ due to the factors that cause health disparities. According to Rodriguez et al. (2017), “mortality rate due to heart disease is high among Puerto Ricans, where 265 men out of 100000 die, while the mortality rate for Mexicans is 196 deaths out of 100000 men” (p. 5). There is a need to develop interventions to reduce the high health disparities in Hispanic populations due to CVD. The intervention should be program and policy-based to be effective in reducing CVD among Hispanic groups. The deductions made in the paper analyze cardiovascular disease among Hispanics in the United States.
Prevalence and Etiology
The prevalence rate of CVD differs from the Hispanics living in the United States compared to those living in their origin country. “Due to generation evaluation, Hispanics living in America have a higher probability of developing CVD than those living in their home country” (Shaw et al., p. 962, 2018). The high probability is a result of the changes in nutrition patterns. Not all studies support the Hispanic paradox theory. “A survey by Hunt outlined that Mexican Americans have the same probability or a higher probability of developing CVD than Non-Hispanic groups” (Shaw et al., p. 964, 2018)
Several trends have been documented that illustrate the prevalence of Hispanic groups to CVD and address the Hispanic paradox. “Coronary heart disease accounts for at least 37000 deaths of individuals in America every year” (Balfour et al., p. 4, 2016). Hispanic men have a high prevalence of CVD compared to women. Heart failure describes a situation where the heart’s ability to pump enough blood in the body has been reduced. The condition is often associated with other health problems, like diabetes. Hispanics have a high probability of heart failure occurring compared to non-Hispanic whites and non-Hispanic Blacks. The occurrence of heart failure is even higher among Hispanic women. The prevalence rate of stroke among Hispanic groups is difficult to determine, as there is significant variation among different subgroups. “Studies have found that Hispanics’ overall stroke prevalence rate is about two times higher than non-Hispanic whites” (Rodriguez et al., p. 7, 2017). However, this varies significantly by country of origin, with stroke rates being highest among Hispanics from Cuba and lowest among Hispanics from Mexico.
Smoking is a significant factor that causes CVD. The smoking rate of Hispanics is lower than that of black Americans and non-Hispanic whites. However, there is a variation between Hispanic groups. Puerto Ricans and Cubans have a higher rate of smoking and thus have a higher probability of CVD than Dominican men. Cholesterol is the second factor that causes CVD. Hispanic men and women have low prevalence rates of cholesterol compared to non-Hispanic whites. Most Hispanics are aware of their high cholestasis level; thus, most Hispanics are under medication and treatment. “Genetic differences between Hispanic subgroups can be accounted for the high rates of CVD among the subgroups” (Rodriguez et al., p. 7, 2017). Therefore, the low rates of CVD in Hispanics compared to non-Hispanic whites and non-Hispanic blacks are due to the low rates of smoking and cholesterol. However, there is evidence of a high risk of CVD among Hispanic subgroups such as the ‘Cubans and Puerto Ricans.
Health Disparities/Inequities
The Hispanic subgroups in America, such as the Cubans, Puerto Ricans, and Mexicans, have different health disparities. Mexicans have the highest rates of CVD diseases, such as heart failure, of any Hispanic subgroup. Several factors contribute to these disparities. “Mexicans have a high probability of living in poverty and have less access to healthcare” (Ortega et al., 2020, p. 7). The poverty levels increase their consumption of fast food, which is linked to high cholesterol levels. They are also more likely to be overweight or obese and to have diabetes and high blood pressure. Puerto Ricans are more likely to smoke than Mexicans or Cubans.
There are disparities in mortality rates among Mexicans, Puerto Ricans, and Cubans for cardiovascular diseases. Compared to the mortality rates of Mexicans and Puerto Ricans, Cubans have a significantly lower mortality rate for cardiovascular diseases. “The mortality rate for cardiovascular diseases among Cubans is half that of Mexicans and Puerto Ricans” (Rodriguez et al., p. 5, 2022). There are several possible explanations for the disparities in mortality rates among Mexicans, Puerto Ricans, and Cubans for cardiovascular diseases. One explanation is that Cubans can access better healthcare and prevention measures than Mexicans and Puerto Ricans. Another explanation is that Cubans have a healthier lifestyle than Mexicans and Puerto Ricans. Cubans are more likely to eat a healthy diet and exercise regularly than Mexicans and Puerto Ricans.
Interventions
A high prevalence of diabetes and obesity in Hispanic populations are major risk factors for cardiovascular disease. “Ethnic-based programs focusing on lifestyle changes and disease prevention can be effective interventions to reduce the incidence of cardiovascular disease in these populations” (Khan et al., p. 7, 2022). Such programs may include education on healthy eating, physical activity, and weight management. They may also provide support for making lifestyle changes, such as quitting smoking. These programs can be delivered in various settings, such as community centers and schools. These programs can be tailored to the specific needs of the Hispanic population. For example, they may be delivered in Spanish or use culturally relevant materials. They may also address the social determinants of health that contribute to diabetes and obesity, such as poverty and lack of access to healthy food. The effectiveness of these programs will ultimately depend on the engagement of Hispanic communities. It is important to involve community members in the planning and implementation of these programs to ensure that they are culturally relevant and responsive to the community’s needs. Additionally, it is important to ensure that they are accessible and affordable.
The formulation of policies on affordable and equitable access to health care can help prevent health disparities among Hispanic subgroups about cardiovascular diseases. “Many policies can be put in place to help ensure that Hispanic groups have equitable and affordable access to health care” (Ortega et al., p. 8, 2020). One such policy would be to provide financial assistance to those unable to afford health insurance. This would help to ensure that everyone has access to the care they need and would also help to offset the cost of care for those who are already insured. Another policy that could be implemented is increasing bilingual healthcare providers’ availability. This would help to ensure that Hispanic patients can communicate effectively with their care providers and would also help to make the healthcare system more culturally competent. Finally, it is also important to ensure Hispanic patients access culturally appropriate care. This can be done by increasing the availability of culturally sensitive care providers and providing educational materials and resources specifically geared toward the needs of Hispanic patients.
Conclusion
In conclusion, the prevalence of cardiovascular disease between Hispanics non-Hispanic whites, and non-Hispanic blacks is low. However, the prevalence rate between Hispanic subgroups such as Cubans, Puerto Ricans, and Mexicans is low. The factors that cause the difference in prevalence rate between Hispanic subgroups and non-Hispanic groups include the rate of smoking, cholesterol levels, and genetic factors. The smoking rate and cholesterol level are lower in Hispanics than in non-Hispanic groups. The smoking rate and cholesterol level vary among subgroups. Petro Ricans smoke more compared to Mexicans and Cubans and thus have a higher rate of developing cardiovascular diseases. The health disparities vary according to subgroups. Mexicans have the highest rates of CVD diseases, such as heart disease, compared to any Hispanic group. The mortality rate of the subgroups differs due to lifestyle discussions and the ability to access health care. The highly effective intervention strategies include ethnic-based programs focusing on life changes, disease prevention in the Hispanic groups, and policies enhancing equitable health care access. For future research on the topic of cardiovascular diseases in Hispanics, I would recommend research done on the economic burden of cardiovascular diseases among Hispanics.
References
Balfour, P. C., Ruiz, J. M., Talavera, G. A., Allison, M. A., & Rodriguez, C. J. (2016). Cardiovascular disease in Hispanics/Latinos in the United States. Journal of Latina/O Psychology, 4(2), 98–113. Web.
Khan, S. U., Lone, A. N., Yedlapati, S. H., Dani, S. S., Khan, M. Z., Watson, K. E., Parwani, P., Rodriguez, F., Cainzos‐Achirica, M., & Michos, E. D. (2022). Cardiovascular Disease Mortality Among Hispanic Versus Non‐Hispanic White Adults in the United States, 1999 to 2018. Journal of the American Heart Association, 11(7). Web.
Ortega, A. N., Pintor, J. K., Langellier, B. A., Bustamante, A. V., Young, M.-E. D. T., Prelip, M. L., Alberto, C. K., & Wallace, S. P. (2020). Cardiovascular disease behavioral risk factors among Latinos by citizenship and documentation status. BMC Public Health, 20(1). Web.
Rodriguez, F., Hastings, K. G., Boothroyd, D. B., Echeverria, S., Lopez, L., Cullen, M., Harrington, R. A., & Palaniappan, L. P. (2017). Disaggregation of Cause-Specific Cardiovascular Disease Mortality Among Hispanic Subgroups. JAMA Cardiology, 2(3), 240–247. Web.
Shaw, P. M., Chandra, V., Escobar, G. A., Robbins, N., Rowe, V., & Mascara, R. (2018). Controversies and evidence for cardiovascular disease in the diverse Hispanic population. Journal of Vascular Surgery, 67(3), 960–969. Web.