Addressing disparities in cardiovascular risk through community-based interventions.

Cardiovascular diseases account for a significant portion of deaths and healthcare costs in the United States. Women from ethnic minorities and rural areas carry a disproportionately higher burden of cardiovascular morbidity and mortality. Many factors contribute to this persistent disparity: a comparatively low level of awareness especially among the at-risk populations, increased prevalence of cardiovascular risks linked to the obesity epidemic, and inconsistent levels of screening and treatment of cardiovascular risks. Cultural and social factors that influence lifestyle and behavior also have significant cardiovascular health consequences and contribute to the disparity. Any intervention to address health disparities should include a community-based component that incorporates education at the lay level, as well as the healthcare provider level. We describe a community education initiative to increase awareness and knowledge about heart disease in women and a community-academic collaborative project to improve diabetes and cardiovascular outcome. These programs have been successfully initiated in the Mississippi Delta, a location with some of the highest cardiovascular mortality (especially among the African American women) as well as limited healthcare infrastructure, low socioeconomic levels, and low literacy rates.