Disease Is The Leading Cause Of Death

Heart Disease, the killer among men and women worldwide, does not just refer to one type of disease. It usually includes several other heart conditions including coronary heart disease and stroke to name a few. These diseases are the onset of many different contributing factors that will be discussed later. As discussed previously this disease is the leading cause of death so it is no surprise every 37 seconds a person succumbs to cardiovascular disease and that 647,000 Americans die from heart disease each year. In 2014-2015 cardiovascular disease alone cost the country about $213.8 billion while adding a 46% increase for patients already receiving inpatient care from local hospitals.

High blood pressure, high blood cholesterol, and smoking are key risk factors for heart disease. Half of Americans, about 47%, have at least one of these three risk factors which make researchers think is there a certain ethnicity that is more prone to heart/cardiovascular disease than another. Other factors that contribute to the onset of heart disease include obesity, an unhealthy diet, physical inactivity, and excessive alcohol use. As an African American studying Public Health, this disease is common in my family as well as some of the described behavior that brings about the onset of this disease. In this, I wanted to see if there was a correlation between race, income, amount of family members within a household and heart disease. I know African Americans and other minorities are at a higher risk than their white counterparts but to what extent? Could this correlation be attributed to the lifestyles many minorities are forced to live, could this be a genetic disease within their family DNA, or is the onset of heart disease random and affects individuals regardless of different variables that play into everyday life?

African Americans are three times more likely to die from and/or experience cardiovascular diseases than their White counterparts including heart disease. During the slave era many slaves ate spare food from their slave owners i.e. the leftovers or sometimes scraps from an animal the family didn’t eat. Usually, slave owners spare food included: meat, pork feet, chicken, pig intestine, black eye peas, etc. The average location of meat which was usually in the form of pork was three or four pounds a week. The type of food the Africans were introduced to during slavery still remains in their diet today. Most of the spare food slaves ate was high in calories, fat, and sodium. Many of the meats they ate are being associated with cancer and diseases today. A slave's diet progressed into a diet that was not from the motherland of Africa. According to Africa’s available source of food; wheat, barley, yams, and legumes were staples of the diets. The meat was only eaten on special occasions because the cost was too much to afford.

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Poor African American families are at a higher risk of developing chronic diseases due to problems stemming from obesity. Factors such as food environment, media influence, and the economy make it more difficult for Blacks to overcome the obstacle of obesity. Individuals living in low-income communities face many barriers in accessing fresh produce, such as lack of adequate transportation and expensive fresh food market prices. Furthermore, low-income Latino and African-American neighborhoods have fewer number of supermarkets that are easily accessible to them compared with higher income neighborhoods. Research has shown that due to less access to fresh food, African Americans are forced to purchase items from places such as gas stations where the food isn’t healthy and a carton of cigarettes and a pint of alcohol is cheaper than the small amount of fresh food that may be available to purchase. These neighborhoods are usually filled with many fast food restaurants such as McDonald’s and KFC whose food are high in cholesterol and ingredients that can lead to high blood pressure and/or high cholesterol. Food at these establishments can be purchased for half the price of fresh fruit and vegetables that would be offered at a supermarket.

Fruit and vegetable consumption is recommended by the American Heart Association and others as part of a healthy diet and specifically for reducing cardiovascular disease, the leading cause of morbidity and mortality in the United States. However, broad recognition now exists that price, availability, and other structural factors are meaningful barriers to fruit and vegetable consumption in the general population, and particularly among low-income adult (Sacks, 2015). For the first time ever, this generation of children growing up are not predicted to outlive their own parents due to diseases stemming from skyrocketing obesity rates that are shortening lifeps and increasing morbidity rates. The New England Journal of Medicine released a special report where they stated that the prevalence of obesity, especially among young children, is likely to continue to rise; with obesity occurring at younger ages.

Another contributing factor to heart disease that is not a variable listed is smoking. Smoking mixed with the lack of fresh food poses a combined threat regardless of ethnicity. I however want to focus on the African American community and smoking. Dr. Akiko Hosler and Mr. Isaac Michaels conducted a study in Schenectady, New York about the association between food distress and smoking among different ethnic adults. They took data from health interviews and food environment assessments in order to weigh the problem. The study identified six indicators that contributed to smoking and food distress including depression, anxiety, alcohol consumption, and disability. The study also identified participants that lived in food deserts, used food pantries, and/or SNAP were more than likely to be current smokers as well.

Environmental factors involving transportation, infrastructure and safety limit African-American children’s options for physical activity. Facilities such as parks, gyms, or recreation centers are far and few in the African American community. I am not sure if this is due to budget issues or just the lack of concern for the community as a whole. Crime in predominately African American communities is rather high and the concern for safety is always at the forefront of residents minds. Adding to the factor that technology is at an all-time high and children don’t play outside as they did in times past plays, a role into the growing issue of obesity. Parents are less likely to encourage their children to play outside or even exercise in the home if they live in an unsafe neighborhood. It seems to be the common norm if we look at the statistics.

Gender is another variable that is associated with the risk of heart disease. Studies suggest that women are more prone to developing heart disease compared to men. Before a woman goes through menopause the estrogen produced in the body protects the heart by increasing good cholesterol and decreasing bad cholesterol. Once a woman has hit menopause the levels of cholesterol go unbalanced and gives way to the onset of heart disease. Diabetes increases the risk of heart disease in women more than it does in men, perhaps because women with diabetes more often have added risk factors, such as obesity, hypertension, and high cholesterol. Although women usually develop heart disease about 10 years later than men, diabetes erases that advantage. In women who've already had a heart attack, diabetes doubles the risk for a second heart attack and increases the risk for heart failure. It is important to note that a person can develop heart disease as a child and progress silently over time without any signs or symptoms and randomly appear in the form of a heart attack that could potentially be deadly.

The data presented to us about Western Governor Township expresses some interesting numbers and forces us to take a hard look at how Heart Disease can affect anyone regardless of race, gender, income background, and previous history of the disease. The data many different variables that could contribute to Heart disease along with other data that we analyzed as well. Looking to previous knowledge regarding cardiovascular disease and the data presented African Americans have a higher risk of developing Heart Disease than any other race in Western Governor Township. The alternate hypothesis included income markers and compared heart disease history with annual household income. African Americans in Western Governor’s Township do not have a higher risk of developing heart disease in comparison with the other races represented.

I wanted to test these hypotheses using multiple methods including Analysis of Variance (ANOVA), Cross tabulations, and linear regression. The tools used to test a statistical hypothesis are correlation and linear regression. ANOVA is considered one of the most commonly used techniques in biostats to compare the means of different groups of data. Correlation and linear regression give the exact same P value for the hypothesis test, and for most experiments. I decided to use both ANOVA and Cross Tabulation in order to test my two hypotheses. ANOVA allows us to test multiple variables at one time without running into common issues when testing two variables at a time. Since my hypothesis focused on the Black community I needed to be able to compare the other ethnicities in order to see if in fact this community did have a higher prevalence of heart disease in the area. I listed race as the factor and I compared this with several other dependent variable such as history of heart disease and annual household income.

I wanted to learn a bit more about the significance behind each category and how they all eventually compared to one another. When I used cross tabulation, which is usually used when there is categorical data available that can be divided into mutually exclusive groups, it was easier for me to see the comparison between multiple factors and how heart disease impacted or didn’t impact each one. After testing these hypotheses I was amazed to see a different result from the computed data. I conducted several ANOVA test on the provided data with the first being the relationship between race and family history of heart disease (Table 1). In this table the we separated those who had a family history of heart disease from those who did not in order to gain a better understanding of what we were looking at within the township.

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