Systemic barriers play a big role in this racial disparity.
These aren’t factors that individuals have very much control over, and Black Americans face these detrimental social determinants in large numbers, thanks in part to the impacts of structural racism.“These are factors that not only contribute to the risk of heart failure, but they contribute to the risk of the risk factors. They actually play a role at every level,” says Dr. Khan.
None of these data points have an easy root cause: It’s a mix of individual clinician biases, institutional racism in medical school training, preferential hospital procedures, and systemic racism based on who participates in clinical trials and other studies that give doctors the information they need to treat heart failure. These factors all come together and deepen the chasm in terms of who develops and dies from heart failure.
One other element worth noting: These systemic biases have sowed skepticism among marginalized communities, making the barrier to treatment even higher. “There’s a fundamental distrust among communities that have been taken advantage of by the medical field that automatically sets the stage for challenges,” explains Dr. Khan.
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