How can race or ethnicity influence my health?
Your race and ethnicity can affect your health in two ways:
Race and ethnicity can influence a person's environment, which includes many factors such as access to health care, cultural practices, education level, socioeconomic status, and stress level. Race is often closely related to a person's socioeconomic status or how much money they make. Lower socioeconomic status is associated with an increase in chronic stress, which can lead to health problems.10 Lower socioeconomic status is also linked to a diet high in saturated fat, cholesterol, and carbohydrates, as well as to poorer health care and health insurance.11
Awareness of cardiovascular disease is lower in minority populations. In a 2003 survey, less than one third of African-American and Hispanic women were aware that heart disease is the leading cause of death among women, compared with more than half of white women.12
The second way that race and ethnicity can affect your health is through your genes. People of similar geographic ancestry share certain biological characteristics that may predispose them to certain diseases (see "Why are African Americans more likely to develop high blood pressure?").4 Some diseases have a clear genetic link, such as cystic fibrosis in descendants of northern Europeans. However, in most of the diseases that lead to death and disability in the US—such as heart disease, stroke, and high blood pressure—both genes and environmental factors like lifestyle and diet contribute to making some people more likely to develop them. Therefore, it is important to know how your racial and ethnic background may affect your chances of developing heart disease and stroke, and to learn to control the risk factors that are putting you at risk.
How common is stroke in different racial or ethnic groups?
Diseases of the heart and stroke are the leading cause of death in every ethnic group in the US: white, African American, Asian, Hispanic, and Native American.13 Death from heart disease or stroke at any age is highest in African Americans.14 Overall, African American adults are 50% more likely to have a stroke than are white adults, and 80% more likely to have a fatal stroke. Among younger people (45 to 64 years of age), the stroke death rate for African Americans is 3 to 4 times higher than for whites.15
African-American women are 50% more likely to have a stroke and 30% more likely to die of a stroke than white women.13 This increase is likely due to a higher prevalence of high blood pressure in African Americans, although this may not completely explain the difference. See the next section, "Are stroke risk factors more common in certain racial or ethnic groups?", for more.
African American race has been shown to be independently associated with stroke even after adjusting for risk factors such as high blood pressure, diabetes, low physical activity, and high C-reactive protein (CRP), with African Americans still up to 32% more likely to have a stroke than whites. However, the same study showed that African Americans were only 15% more likely than whites to have a stroke if income was taken into account. Low income was independently associated with stroke, and could help explain the association between race and stroke.16
|Race and Stroke Deaths in 200417
(per 100,000 people)