First Aid classes | Researchers explore how COVID-19 affects heart health in Black women

Nearly six months into the COVID-19 pandemic, two things have become clear: The virus profoundly impacts people with heart disease and disproportionately impacts Black people. But the many manifestations of these disparities remains unclear, particularly for one group regularly left out of medical research.

"African American women are often at the intersection of the worst economic and health disparities," said Dr. Michelle Albert, a cardiologist and professor of medicine at the University of California, San Francisco. "They are a group that is often overlooked."

In a collaborative investigation with the Slone Epidemiology Center at Boston University, Albert is leading a study to look at a cohort of women enrolled in the Black Women's Health Study to determine the myriad ways in which COVID-19 is impacting them.

She said she chose to study this demographic because Black women often are at higher risk for heart disease than women in other demographic groups, and they are shouldering an excessive burden during the pandemic.

African Americans with COVID-19 are nearly three times as likely to require hospitalization than white people with the disease, according to a recent study published in the journal Health Affairs. According to statistics compiled by the nonprofit American Public Media Research Lab, Black and Indigenous people die from COVID-19 at more than three to four times the rate of white people.

Cardiovascular disease, research shows, could play a substantial role in those deaths. And for African American women especially, the risks for heart disease are high. Four out of 5 Black women are considered overweight or have obesity – the highest rate of any group in the country, according to the U.S. Office of Minority Health, and they are 60% more likely to have high blood pressure than their white counterparts.

Those risks didn't happen in a vacuum, experts say. Numerous factors place greater stress on African American women that can affect their health.

"The United States has a longstanding history of disparities in education, income, wealth and housing, and these factors, or social determinants of health, disproportionately affect African Americans – and African American women in particular," said Yvonne Commodore-Mensah, assistant professor at Johns Hopkins School of Nursing and the School of Public Health in Baltimore. She also is a faculty member at Johns Hopkins' Center for Health Equity.

"These social determinants of health result in a burden of underlying risk factors for COVID-19: high blood pressure, diabetes, overweight and obesity. These risk factors increase the risk for severe COVID-19 illness and mortality."

African American women may also be more exposed to contagion, said Dr. LaPrincess Brewer, assistant professor of medicine in the Mayo Clinic's department of cardiovascular medicine in Rochester, Minnesota. "They are more likely to hold service sector jobs that increase their risk of exposure to COVID-19. They are more likely to serve as heads of household."

What's more, Albert said, "they are caregivers of multiple generations, including children and elderly relatives and extended family. And they are more likely to experience every kind of bias – medical as well as racial/ethnic biases – in housing and employment."