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Unformatted text preview: Race, Ethnicity, and Geography Geography
Disparities in Heart Disease in Women Disparities Of Color Of Graham-Garcia et al. 2001 Graham-Garcia BACKGROUND BACKGROUND Heart disease is the number one killer of men Heart and women (401 of 100,000 women in US). and African-American dying at higher rate than African-American Caucasian. Substantial geographic variations in CVD rates Substantial among minority women, especially in the South Why such differences? Why THNICITY AND CARDIOVASCULAR HEALTH HEALTH African-American women live about 6 ½ African-American years less than Euro-American women. years For African-American women aged 35-74 For years, death rate from heart disease is 69% higher than Euro-American women. 69% Contributing Factors Contributing Obesity High sodium intake High fat diet Misperceptions about seriousness Severity of hypertension Cost of treatment Lower access to health care Possibly low birth weight Geographical Differences Geographical Southern-born African-American women Southern-born have highest rates of CVD have Northeast-born African-American women Northeast-born have next highest rate have Caribbean-born African-American Caribbean-born women third-highest rate women Latino Women CVD is leading cause of death for Latino CVD women of all origins women In 1997, 34% of death rate for Latino In women = CVD women Large population in California, Texas, but Large also in the South: Florida, Georgia also 12/01/09 Socioeconomic Status Socioeconomic Risks of Southern Living (Mortality among poor Risks African American) African Population density Lack of access to health care High-crime neighborhoods Dilapidated housing Environmental hazards Ethnic/racial stress Social injustice Risks in the Southern US Risks Highest rates of death from myocardial infarction (heart Highest attack); stroke; renal failure (Kidney). attack); 8 Southern states rank in top ten for highest heart Southern disease mortality for women. disease Why? Why? Isolation lacking resources Low income Limited access to health care Poor disease prevention and health promotion Poor efforts efforts MYTHS AND MISCONCEPTION MYTHS CVD not just a man’s disease Presentation is different for women than Presentation men: men: Gastrointestinal pain Nausea Fatigue Women may not recognize symptoms; Women Result: delay seeking health care, high mortality mortality Modifiable Risk Factors Modifiable
Risk factors is higher among ethnic minority women than Risk white women white High blood pressure African American develop at High earlier age, Mexican American, Cuban also higher rate than white than Tobacco use [23% African-American, 18% Latino Tobacco women smoke] women High cholesterol High Sedentary lifestyle Of 10 states w/lowest levels of physical activity, 7 Of are in South are Poor nutrition Modifiable Risk Factors Modifiable Poor nutrition; In the south US dietary sodium and Poor saturated fat intake is high and Potassium intake is low saturated Obesity/Overweight
-Very high prevalence in the south -African American women average 17 pounds heavier than -African Euro- American women Euro-High rates for Latinas; childhood obesity -High Psychological stress: may be influenced by Family conflicts, social class hierarchy, culture, lifestyle Family Low SES Low rates of insurance Less preventive care For Latinos, language issues Modifiable Risk Factors Modifiable Menopause Menopause 10 years after menopause, CVD rates for 10 women as high as for men women Declining estrogen; HRT helps Diabetes -may be even more significant risk for -may women than men (type 2 increase by age and higher among Black and Hispanic, 80-90% of all type 2 patient) Hispanic, Implications for Trans-cultural Nursing and Continuing Education and Trans cultural nursing curricula and Trans continuing education continuing Primary prevention Primary Secondary prevention Secondary Access to care and partnership Advocacy Health care research Partnership, local state national Awareness of the need for cultural sensitivity Awareness Culturally competent health care education Health promotion; lifestyle change Primary prevention Primary Key to decreasing CVD mortality Tobacco prevention Physical activity Nutrition Stress reduction Implications for Trans-cultural Nursing Nursing Secondary Prevention Implications for Trans-cultural Nursing Nursing
Early detection and care Hypertension, cholesterol, diabetes Hypertension, screening screening Smoking cessation Stress reduction Chronic disease management Estrogen replacement therapy Implications for Trans-cultural Nursing Nursing Access to care and partnership Local, state , national levels Community base program Nurse-managed clinics Promote structural and institutional change Promote Eliminate language barriers Improve community social relations Implications for Trans-cultural Nursing Nursing Advocacy Reduce health care barriers Reduce social inequality Reduce Affordable health care for all Increase health care access Promote disease prevention Professional nursing organizations lobbying Increased need for nurses as advocates for Increased minority women Implications for Trans-cultural Nursing Nursing Trans cultural nursing curricula Trans Trans cultural nursing courses Trans-cultural experiences Trans-cultural nursing models Incorporation of disease-specific data Continuing education symposia Implications for Trans-cultural Nursing Nursing Awareness of the need for cultural Awareness sensitivity and care sensitivity Cultural similarities and differences Cultural congruent nursing care Cultural sensitivity Cultural Language barriers Language Social factors ...
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