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Heart Group Takes Aim at Structural Racism

— AHA advocates for policies to root out economic, health disparities

Last Updated November 12, 2020
MedpageToday

In a new policy statement, the American Heart Association (AHA) called out structural racism as a major driver of health disparities.

In reviewing the historical context, current state, and potential solutions to structural racism, the authors concluded in a presidential advisory, , that "racism persists; racism is experienced; and the task of dismantling racism must belong to all of society."

"With this advisory, the AHA declares its unequivocal support of anti-racist principles," according to writing committee chair Keith Churchwell, MD, of Yale New Haven Hospital in Connecticut, and colleagues.

Churchwell cited the killings of African Americans George Floyd and Breonna Taylor as part of the problem. An older example of structural racism is the decades-old practice of redlining that denied housing loans to people because of their race, he added during a press conference held ahead of the virtual AHA Scientific Sessions.

Effects of such racism have spilled over into the realm of health today such that, for example, Black people show higher mortality rates from cardiovascular disease and from stroke compared with White people, said AHA president Mitchell Elkind, MD, MS, of NewYork-Presbyterian/Columbia University Irving Medical Center in New York City.

The COVID-19 pandemic has only exacerbated existing health disparities by disproportionately affecting more Black, Hispanic, and Native American communities as well as people in rural areas.

"The path forward requires our commitment to transforming the conditions of historically marginalized communities, improving the quality of housing and neighborhood environments of these populations, advocating for policies that eliminate inequities in access to economic opportunities, quality education, and health care, and enhancing allyship among racial and ethnic groups," the AHA group wrote.

Moving forward, another major goal is affordable access to health insurance for all, according to the chair of the AHA Board of Directors, Bertram Scott. "Medicaid expansion will be the primary focus," he said.

Notably, Churchwell's group said the AHA "must look internally to correct its own shortcomings and advance anti-racist policies and practices regarding science, public and professional education, and advocacy."

In March, a viewpoint article in cardiology programs was published in the Journal of the American Heart Association.

The open-access journal doesn't fall under the direct editorial control of the AHA, and AHA leaders including president-elect Donald Lloyd-Jones, MD, criticized the paper for inflammatory and untrue statements.

The controversy ultimately led to the article's retraction and an apology from the journal's editor-in-chief. The paper's author was reportedly removed from his position as electrophysiology program director after the article was made public.

Working with the AHA in its mission against racism are the American College of Cardiology and the Association of Black Cardiologists. Soon after the killing of George Floyd, the three groups issued a denouncing racism and violence, according to Eduardo Sanchez, MD, MPH, the AHA's chief medical officer for prevention.

"We welcome the opportunity to partner with other like-minded organizations," said AHA CEO Nancy Brown.

  • author['full_name']

    Nicole Lou is a reporter for ľֱ, where she covers cardiology news and other developments in medicine.

Disclosures

Churchwell had no disclosures.

Primary Source

Circulation

Churchwell K, et al "Call to action: structural racism as a fundamental driver of health disparities: a presidential advisory from the American Heart Association" Circulation 2020; DOI: 10.1161/CIR.0000000000000936.