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Dr. Hamerton Jeanty’s grandmother died of a stroke in her mid-80s, but he wonders how much more time she might have had if she viewed hypertension as a challenge, not her destiny.
As a Black woman, she was at greater risk for high blood pressure for a number of reasons: genetics, lifestyle, environment and socioeconomics, Jeanty said. And, like many minorities, she didn’t firmly believe in the power of medicine, he said. So her condition progressed without challenge and she died possibly a decade earlier than if she had fought back, he said.
“I am a firm believer that a good, long life means something,” said Jeanty, a hospitalist for the Mohawk Valley Health System. “It’s not anything to shrug off. An extra functional five years has value.”
And that is why, he said, it’s important for the medical community to reach out to patients – especially minority patients who face higher risks – with information; with screenings; and with a willingness to work together to give patients the best life possible for as long as possible.
Jeanty is part of a collaborative group that’s doing just that in Oneida County. The Mohawk Valley Partnership to Combat Heart Disease is working to overcome the health disparities that put minority groups at greater risk from heart disease and stroke. The group started, under a different name, during the COVID-19 pandemic as a task force to make sure minorities had equal access to the COVID-19 vaccine.
But the members worked so well together that they decided to continue working together to overcome more health disparities in the county, said Patricia Charvat, senior vice president of marketing and strategy for the Mohawk Valley Health System.
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Members include the American Heart Association, The Center, the Community Foundation of Herkimer & Oneida Counties, Excellus BlueCross BlueShield, the health system, the Mohawk Valley Latino Association, the Rome and Utica branches of the NAACP and the Upstate Family Health Center in Utica.
They have begun their new work, funded by a grant from the Cabrini Health Foundation, with a church tour in Rome, continuing a strategy that worked well with the COVID-19 vaccine.
During the pandemic, the groups already had worked with pastors to help get their congregations to trust the science of vaccines, said Jacqueline Nelson, president of the NAACP in Rome who also served on the state’s vaccine equity task force.
”I thought the churches. It’s always about the churches,” she said. “If you can talk to the pastors or the priests, the folks will listen to them.”
Not all of the churches have ended up being primarily minority churches, in part because Rome doesn’t have a huge minority population, Nelson said. But anyone can benefit from the educational and blood pressure screening sessions, she said. And she expects more minority participation once the church tour expands to Utica.
Nelson hopes the focus on minority health in Rome will continue with more programs targeting more diseases, she said.
Disparities in heart disease and stroke
When it comes to heart disease and stroke, the disparities faced by Black people, and especially women, often lead to earlier and more severe disease, Jeanty said.
“I grew up in a family that loved salt,” Jeanty said. “My genetic pool, I am Black, we have a higher salt sensitivity. We just do. For us, it will push us toward hypertension disproportionately.”
Genetics and lifestyle are important, but much of the Black community also faces higher risks from the environment in which they live and from the socioeconomic disadvantage a disproportionate number of them face, he said.
But almost every kind of minority faces some kind of risk disparity for cardiovascular disease, Jeanty said. Hawaiians and Pacific Islanders actually face the highest risk of cardiovascular disease, he pointed out.
“What we have to appreciate is that everyone’s genetics are slightly different,” he said. “Everyone’s socioeconomic factors are different. Everyone’s environmental factors are different. But it’s not just Black people. As an African American, I feel compelled to make sure that the message goes out to Black people. But the message has to go out to everyone.”
Addressing disparities
On a recent Sunday morning, the service at First Baptist Church of Rome focused on member’s souls. The program after church, attended by about 16 members, focused on their hearts with healthy food, blood pressure screenings and lots of information about healthy lifestyles and warning signs.
The church’s membership is about half Karens from Myanmar, but most of them happened to be away at an event that Sunday, said Pastor Letta Palmer, who serves on the NAACP’s religious affairs committee.
The members who attended benefited, even if they weren’t mostly minorities, Palmer said. “The program that they did,” she said, “a lot of my people are aging and some of them don’t really look at life as something that’s going to nip them in the bud in a while.”
She wants to make sure they’re aware of what help is available and what they can do to age well, and hopes to collaborate on more programs in the future, Palmer said.
The programs are definitely paying off, Nelson said. As an example, she talked about a man at one of the churches who found out his blood pressure was elevated after the nurse took it twice. After work on Monday, he went to the hospital to get it checked and was diagnosed with hypertension and put on medication, Nelson said.
“That,” she said, “is what we’re looking to do. It could have been worse. He could have had a stroke or something if it continued without him knowing it.”
Building health
Getting people to be proactive about their health is exactly the point when it comes to fighting heart disease, Jeanty said. He envisions a modern model of health care in which patients and primary care doctors collaborate with trust and honest communication to keep patients as healthy as possible as long as possible.
That means scrapping the “punitive” model of health care in which disease has been perceived as the punishment for bad decisions, he said. “You could do everything right in life,” Jeanty said. “You could eat the best healthiest diet and still get cancer.”
But working toward a healthier lifestyle and managing chronic conditions lowers the risk of the worst outcomes, such as stroke and early death, and let patients live better for as long as they have, a chance his grandmother didn’t take, he explained.
“People need to be told that small, incremental changes have massive impacts,” Jeanty said.
That model applies to everyone, but many people from minorities start out further behind, he noted.
“How do we push beyond the disparities?” Jeanty asked. “How do we obtain the outcome despite the fact that we have these communities that have the odds stacked against them?”
Well, that’s what the Mohawk Valley Partnership to Combat Heart Disease is working on, starting in the pews on Sunday mornings.
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