Which U.S. Populations Are More at Risk for Heart Disease, Diabetes, Hep B, and Hep C?
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Health disparities in America are real. Here’s how to lower your specific risk with preventative screenings and vaccines.
There are many diseases that disproportionally affect specific populations in America. Heart disease rates soar among Black Americans, for example. Hepatitis B rates are strikingly higher for Asian Americans. Native Americans have the highest hep C mortality rate of any U.S. group, and Hispanic Americans face much greater odds of developing type 2 diabetes.
“There are health disparities in many health conditions and diseases, such as cancer, heart disease, stroke, diabetes, mental illness, and others,” confirms Monica Webb Hooper, Ph.D., health disparities deputy director of the National Institutes of Health National Institute on Minority Health (NIMHD) in Bethesda, MD. “The burden is markedly greater among American Indian or Alaska Native persons, Hispanic or Latino persons, and Black or African American individuals, with cases, hospitalization, and deaths on the order of two times greater in these populations compared with white persons,” she adds.
The root causes of many health disparities are systemic in nature, Webb Hooper explains. That can mean unequal access to healthcare and quality of care. It can also mean cultural barriers to healthcare, and lack of sufficient outreach and education to minority groups. All fuel the problem of health disparities in the U.S., Hooper says.
“If I’m a lucky American who has employer-based healthcare, and I go to a doctor who every year says, ‘OK, here’s what’s on the list of things you need to know and that we need to check on,’ I’m going to have a much better chance of doing the preventive measures, or identifying a risk factor, or treating it early and avoiding worse outcomes,” says Kathryn Kietzman, Ph.D., director of the Health Equity Program at the UCLA Center for Health Policy Research, in Los Angeles.
“But, if someone without healthcare has something like hepatitis B or hypertension, which can go undetected for years, they’re less likely to seek preventative care and be able to catch those conditions early. It’s a pretty profound relationship between health disparities and access to care,” Kietzman says.
To adequately address how these diseases affect different populations, widespread change needs to happen across the healthcare system, alongside socioeconomic and environmental changes, both experts agree.
“Healthcare systems can re-think and reformulate their policies, practices, and services to ensure that our most disadvantaged receive the same level of care and treatment as the most advantaged,” says Webb Hooper. “And, scientists can work directly with communities to learn what the needs are, and test approaches to meaningful improvement.”
There are also meaningful ways for individuals to combat this issue on the clinical side of care. Many of these diseases could be prevented outright through screenings and vaccinations—and better health outcomes could be reached through the right treatment and care—especially if the disease is caught on the early side, the experts agree.
“I always encourage individuals, families, and communities that experience health disparities to do everything within our own power to take care of our health and that of our significant others,” Webb Hooper says. “That means annual check-ups, eating well, exercising as much as possible, learning as much as possible from reputable and evidence-based sources of health information.”
No matter who you are, or what additional risk level you may face for various health conditions due to larger forces you can’t always control, there are meaningful ways to prevent and treat a whole host of diseases—especially when you adopt a preventative approach. Vaccines, regular health screenings, and lifestyle changes can make a huge difference in lowering your odds of facing an unwanted health outcome down the line.
Here are a few of the bigger health disparities in the U.S.—and the communities they affect most—as well as what you can do about them.
Asian Americans and Hepatitis B
In the U.S., one in 12 Asian Americans are infected with chronic hepatitis B, a liver disease that’s also one of the leading causes of liver cancer. In contrast, just one in 1,000 non-Hispanic whites develop this disease. And while Asian Americans account for about 6% of the nation’s population, they make-up nearly half of the 2.4 million people infected with chronic hepatitis B, according to the Stanford Medicine Asian Liver Center. This health disparity is largely attributed to the high rates of transmission between mothers and their children, as mothers often unknowingly carry the infection, and to lower rates of vaccination in the Asian American population, due to cultural, financial, or language barriers.
The promising news is that it’s an entirely preventable disease through a vaccine that’s been available since the early 1980s. And, while it’s incurable, you can treat hepatitis B and slow the progression of the disease and reduce the risk of liver cancer.
One of the big challenges of hepatitis B is the lack of red flag symptoms when it’s early enough to do something about it, reports the Stanford Medicine Asian Liver Center.
That’s why hep B disease screenings, which entail a simple blood test, can make a big difference, especially if you’re in a high-risk group. Since one of the primary transmitters of hepatitis B is birth, it’s important to get screened early in life to catch any possible infection.
Left untreated, hepatitis B can lead to serious health issues. The leading cause of cancer-related deaths for Asian Americans is liver cancer from hepatitis B infections. So, early detection of hepatitis B can be a gamechanger—even a lifesaver—for people living with this disease.
Black Americans and Heart Disease
Heart disease, an umbrella term that covers a number of serious heart conditions including heart failure, arrhythmia, high blood pressure, and more—is the leading cause of death in America. And the mortality rate is even higher for Black Americans. Black Americans are 30% more likely to die from heart disease than non-Hispanic white Americans, according to the Department of Health and Human Services.
There are ways to turn these numbers around, says the American Heart Association. You can mitigate the risks associated with heart disease through lifestyle changes and health screenings.
Obesity, diabetes, and a sedentary lifestyle are all risk factors that spike the odds of developing heart disease. And there are ways to eliminate or reduce your chances of developing such risk factors.
For instance, high blood pressure, a.ka., hypertension—which is the highest in the world among the American Black population—can be checked regularly for signs that it’s getting a little too high. And you can take measures to keep your BP in a healthy range, including eating a healthy diet packed full of fruits and vegetables, getting regular exercise, and reducing life stress.
Hypertension is another condition that can easily go undetected due to lack of symptoms. So, it’s important to stay on top of monitoring it with the help of your doctor. Obesity and diabetes also disproportionately affect Black Americans, and both are preventable and treatable, especially through dietary choices and physical activity, per the AHA.
Hispanic or Latino Americans and Diabetes
Hispanic Americans face a greater risk of developing diabetes than non-Hispanic white Americans. In fact, if you’re a Hispanic or Latino adult, you have a 50% chance of developing type 2 diabetes, compared to a roughly 40% chance for non-Hispanic white Americans.
Hispanic Americans are also more likely to deal with the severe health outcomes that are related to diabetes: They have higher rates of kidney failure and vision loss, and they’re twice as likely to be hospitalized for end-stage renal disease, according to the U.S. Department of Health and Human Services Office of Minority Health.
The higher rate of diabetes in Hispanic Americans may be linked to many different issues, including biological factors and environmental challenges, such as limited access to healthy foods, lack of health insurance, language barriers, and cultural values. Regardless, there are opportunities to lower these numbers and prevent negative health outcomes, according to the CDC.
Here’s how: Hispanic Americans are also more likely to have prediabetes, which is when your blood sugar levels are too high to fall in the healthy range, but not high enough to be officially diagnosed as type 2 diabetes. While there are no symptoms associated with prediabetes, there is a screening test available that determines if you’re at risk. You can visit your doctor to check your blood sugar levels on a regular basis.
By catching high blood sugar levels in the prediabetes stage, you’ll still have time to make lifestyle changes that can prevent type 2 diabetes from developing—and the health fallout that can follow.
Native Americans and Hepatitis C
Hep C rates are twice as high among American Indians and Alaskan Natives as they are for non-Hispanic whites. And, hepatitis-related mortality rates are nearly tripled in the Native American population, according to Indian Health Services. Hep C, a bloodborne disease, is spread mainly through shared needles and mother-child transmission. Reasons for its prevalence in the Native American community may be due to higher risk for injection drug use, as well as personal and historical trauma in this population that can lead to increased drug use, according to research.
Early detection can make a world of difference. Screening through a blood test can help catch this viral infection, which can lead to liver cancer or liver failure if left untreated.
Because early detection and treatment options are so promising, the Department of Indian Services adopted a plan to reduce or eliminate cases of hep C in the American Indian population. The Cherokee Nation even launched its own hep C elimination program, and within the first year of its inception, they’d screened more than half of their target population and started treating nearly 90% of those who’d been diagnosed with hep C.
A 2020 study found that community-based disease elimination programs like the Cherokee Nation’s can make a huge difference with screening and treatment rates—and greatly improve health outcomes for the communities they’re based in.
When Communities Come Together
Local and regional programs are one of the more promising ways to address many health disparities, says Keitzman. She was involved in a project in Los Angeles that partnered with community-based organizations and ambassadors to raise awareness about health disparities and increase preventive care.
“We were able to reach more people in the community through trusted messengers who could share why these preventive services are so important,” she explains. “Addressing issues of access to appropriate and good quality care is a very necessary step,” she says. “And, it’s important to pay attention to culture, context, and the social determinants of health in all efforts to move the needle on health equity.”
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