Research has shown a definitive connection between racial and ethnic differences in maternal heart health and an increased likelihood of preterm birth, preeclampsia, and cardiovascular problems among Black and Hispanic mothers and their infants.
Research has demonstrated a strong connection between racial and ethnic disparities in maternal heart health and higher risks of preterm birth, preeclampsia, and cardiovascular complications for Black and Hispanic mothers and their children.
A recent study from Northwestern University further investigates these disparities and uncovers an important finding: addressing social determinants of health, particularly education, could significantly close these gaps. Enhancing education alongside factors like income and healthcare access could decrease the heart health disparity between Black and white women by 82%, and completely eliminate it between Hispanic and white women.
This indicates that social and environmental influences, rather than biological variances at birth, are the primary factors behind significant inequalities in cardiovascular health during pregnancy.
The research was published on January 14 in Circulation: Cardiovascular Quality and Outcomes.
“If racial and ethnic groups had similar average educational levels, the differences in heart health among these groups could be greatly diminished,” stated Dr. Natalie Cameron, the primary author and an instructor in general internal medicine at Northwestern University’s Feinberg School of Medicine.
“The connection between education and heart health is intricate and may be linked to factors like income, health insurance, access to healthcare, and health education,” Cameron noted.
Methodology of the study
Researchers at Northwestern examined data collected at the start of pregnancy from 9,104 participants in the Nulliparous Pregnancy Outcomes Study, who identified as Hispanic, non-Hispanic Black, or non-Hispanic white.
The team first computed cardiovascular health scores for the participants based on six criteria: blood pressure, body weight, physical activity, diet, smoking habits, and sleep quality. They then assessed how these scores varied among the groups.
To identify the causes of these differences, the researchers looked into self-reported individual and neighborhood factors, including maternal age, education level, income, health insurance, mental health, experiences of racial discrimination, and neighborhood hardships.
The analysis revealed that these individual and community factors accounted for all differences in cardiovascular health between Hispanic and white participants, along with 82% of the noted disparities between Black and white participants.
Additionally, educational attainment had the most significant effect on the disparities in maternal cardiovascular health.
Call for action
These results reinforce a growing body of evidence highlighting the influence of social and environmental factors on health outcomes. Other scientists at Northwestern have reached similar conclusions in studies focusing on non-pregnant populations.
Cameron emphasizes the necessity for reforms at various levels to tackle the racial and ethnic disparities in heart health, commencing even prior to pregnancy.
“From a public health perspective, it is crucial to enhance access to nutritious foods, create safer environments for walking and play, and improve availability of preventive healthcare. Researchers and policymakers should collaborate with communities to implement these changes effectively, respecting their neighborhoods and overall well-being,” she stated.
Cameron further highlighted that healthcare systems and providers need to proactively screen for social determinants of health early in life, before the onset of pregnancy.
“When a specific need is identified, healthcare providers can connect patients with social workers and community resources to help meet these needs,” she explained.
In light of these new findings, Cameron advocates for the next steps to involve “designing, implementing, and testing programs aimed at addressing these social and environmental factors to improve heart health before pregnancy.”
This research received support from the National Institutes of Health/National Heart Lung and Blood Institute (R01 HL161514).
