Primordial prevention of cardiovascular disease among African-Americans: Asocial epidemiological perspective

Background The primordial prevention of cardiovascular disease (CVD) among African-Americans represents a formidable challenge for public health, This paper discusses the nature of this challenge, highlighting the role that e conomic and cultural factors play in shaping the distributions of major CVD risk factors among African-Americans, The paper concludes with specific su ggestions for research. Methods, Data from recent national health surveys on black/white difference s in major CVD risk factors like hypertension, obesity, cholesterol, cigare tte smoking, and physical inactivity were reviewed for the purpose of ident ifying promising avenues for primordial prevention research among African-A mericans, Results, Cigarette smoking has a delayed onset among African-Americans comp ared to whites. Black/ white differences in "vigorous" leisure-time physica l activity (e.g., social dancing and team sports) are not apparent until ar ound. age 40. These findings have relevance for primordial prevention work in black communities since they suggest the existence of broad-based, healt h-relevant cultural norms which could support primordial prevention program s, such as regular physical activity, across the life cycle, Conclusions. CVD primordial prevention programs among african-Americans mus t he grounded in an understanding of how cultural values as well as economi c conditions shape CVD risk factor distributions in this population. Ultima te success will depend on the strength of the partnerships that public heal th researchers, primary care providers, and community residents are able to build. (C) 1999 American Health Foundation and Academic Press.