Keith C. Ferdinand, MD, FACC, FAHA, FASPC, FNLA, FPCNA (hon.), holds the Gerald S. Berenson Endowed Chair in Preventative Cardiology, Professor of Medicine, Tulane University School of Medicine, and Clinical Advisor for NACHC’s Million Hearts, Preventing Heart Attacks and Strokes in Primary Care project.
As most of us now recognize, racial and ethnic disparities in hypertension and overall cardiovascular health in the US have led to a persistent mortality gap, especially between white and black individuals. These persistent gaps in health have led to increased healthcare costs and compromised our promise of equal opportunity in society.
We as clinicians should recognize that overcoming these disparities is not only a practical necessity but a moral imperative.
Controlling hypertension requires multilevel effort
Hypertension is the most prevalent and potent of all cardiovascular risk factors, but it is equally poorly identified and controlled. Multilevel efforts will be needed by all of us to overcome these disparities in health: at the patient level, clinician level, and healthcare system level.
At the health center we have special relationships with our patients. They trust us, speak to us about their beliefs and uncertainties, and share information with us about their adverse environmental conditions. We have opportunities to help them overcome clinical uncertainty and address the social determinants of health where people work, live, play, and pray.
“One of the essential qualities of the clinician is an interest in humanity,
Francis Weld Peabody, MD (JAMA, 1927)
for the secret of care of the patient is in caring.”
How the health center care team can help patients feel control over their health
Although individual members of our healthcare team, including physicians, nurse practitioners, advanced practice nurses, registered nurses, pharmacists, medical assistants, and others cannot overcome the inequities in the healthcare system related to insurance status, geographical availability, and financing, we can do a lot to show our care and concern for our patients.
We can encourage health-seeking behaviors. We can offer interpretation and language translation services when appropriate. We can give our patients an easier way to understand healthy lifestyles and assist them with access to medications and affordability. And we can spot the red flags that would lead us to recommend and intensify medications.
Team-based care, which includes our patients, is the best way to control hypertension and other cardiovascular disease risk factors. We can do more to share decisions and empower patients with validated tools, such as self-measured blood pressure monitoring. These efforts will go a long way to help patients feel control over their health, increase adherence, and ultimately improve outcomes to save lives.
Let us share our love with our patients.
“There’s power in healing work. But it isn’t personal power. It cannot satisfy an individual’s craving for self-importance. It’s a real power that has nothing to do
From the Healers by Ayi Kwei Armah
with our small selfish dreams. It’s the power to help life create itself. ”
To learn more from Dr. Ferdinand, read his latest publication:
The case for eliminating racial and ethnic cardiovascular disparities in the USA
Racial and ethnic disparities in cardiovascular health in the USA result in a persistent mortality gap between white and Black individuals, increase healthcare costs, and compromise an egalitarian society. Solutions to racial inequities require risk factor control and the implementation of evidence-based medicine and anti-racism policies. Overcoming these disparities is not only a practical necessity but also a moral imperative.
To use some of the latest resources from NACHC’s Million Hearts® program,
visit: https://www.nachc.org/topic/heart-disease-and-stroke/
- Effects of Uncontrolled Blood Pressure
- Did You Knows and Quick Tips to Prevent Heart Attacks and Strokes: Blood Pressure
- Controlling Hypertension Learning Series: The Four Most Impactful Strategies for Achieving Success