INTRODUCTION: disparities. According to the census in 2000,
of the largest ethnic of many groups in United States of America are the
African Americans. Mainly, African Americans have African ancestry but may also
have nonblack ancestors. African Americans are the descendent of slaves who
were brought from their homeland in Africa and were forced to work as salves in
the New World. The rights of African American were stringent and their role in
social, political and economical progress were long way denied in United States
explaining their lower socioeconomic status. According to the United States
Census Bureau, 40,893,369 were African American in the year 2016 out of which
47.8% were males and 52.2% were females.
OF SES: Race inequality in health has been persistent since a
long time. Racial difference in health with African American having
comparatively poorer health than whites across a range of health disparities
are indicators. Socio economic Status (SES) remains as one of the strongest
determinants known in health status1. The influence of wealth and income
are seen to be quite strong within the near poverty and poverty population.
Although, the health gradient of SES continues outside the poverty population,
it is at its peak among the poor2. This implies that African
Americans having lower SES are more susceptible of developing health
disparities. According to the census in 2000, the average American would have
expected to live 77.8 years whereas, African American expected to live 73.1
years (National Center for Health Statistic,2007)3.
OF GENES: Understanding genetic ancestry of individuals and
differences in patterns of ancestry among region can inform personalized
medical treatment and studies. Genetic susceptibility can very much influence
the etiology of development of disease. Admixture mapping analysis of
hypertension in African Americans suggests associated with hypertension.
Understanding of these genetic contributions to blood pressure may provide
better insight into the underlying mechanism for ethnic disparities in
cardiovascular diseases and its association to morbidity and mortality4.
Hypertension, cardiovascular disease, stroke, diabetes, HIV/AIDS, sickle cell
anemia, vitamin D deficiency are some of the commonly found diseases in African
DISEASE: A total of 27.6 million of American adults (11.5%)
have been diagnosed with heart diseases.
The increase in the rates of CVD in African American have been attributed
traditionally to hypertension prevalence. The prevalence is highest for African
Americans in the world as 80% of the people in this group are likely to become
hypertensive5. The prevalence of CVD in adults increases with age in
both, the males and the females having lower education and unemployment. Among
the African American 10.3% have heart disease, 5.5% have coronary heart
disease, and 33% have hypertension. The age adjusted death rates for
non-Hispanic black males were 352.4 and 241.3 for non-Hispanic black females
according to 2014 mortality data6. In united states, the mortality
rates from CVD increased steadily during 1900’s to 1980’s and further declined
by 2010’s. The risk factors for development of CVD in African Americans are
hypertension, diabetes, dyslipidemia, physical inactivity, and genetic
African Americans have risk of developing type 2 diabetes. The prevalence of
obesity, genetic traits, and insulin resistance, all contribute to the risk
factors of development of diabetes for African Americans. The prevalence of
diabetes characterized by American Diabetes Association is 1.6 folds higher in
African Americans compared to the whites, and the prevalence of type 2 diabetes
is 1.4 folds to 2.3 folds increased in African Americans. The prevalence has
extended to the children and adolescents8. The cumulative incidence
of diabetes was highest among the Hispanics (11.3%) followed by the African
Americans (9.5%). The overall mortality rate was 20.9 per 100,000, of which
43.9 were non-Hispanic black males and 34% were non-Hispanic black females6.
Lower socioeconomic status
and decrease in the level of education contributes to less awareness and access
to health care in terms of insurance markedly affects the primary, secondary
and tertiary prevention in African Americans.