Cardiovascular disease remains the leading cause of death among Black Americans, and agencies across the St. Louis region are working to equip residents with the knowledge and resources needed to reduce its toll.
“I think about how we can empower people and improve the conditions in our Black communities when it comes to economic and systemic factors that contribute to cardiovascular disease,” said Dr. Kanika Cunningham, director of the St. Louis County Department of Public Health.
The health department, the American Heart Association’s Missouri affiliate, Hope in the Ville and the Doula Lab are among community partners working to educate residents about prevention and treatment.
A leading killer
“When we think of cardiovascular disease, we’re talking about the diseases that impact the heart and blood vessels,” Cunningham said. “It can be someone who has congestive heart failure, someone with a history of heart attack.”
Cardiovascular disease includes heart disease and stroke and is often driven by plaque buildup in artery walls. High blood pressure, high cholesterol, diabetes, poor diet and physical inactivity remain major risk factors.
Deaths from heart disease and stroke declined slightly last year but still outpace all other causes nationwide, according to the American Heart Association. Even with that decline, Black Americans are 54% more likely to die from cardiovascular disease than white Americans, according to a 2023 Tulane University study.
Social risk factors
“There used to be more focus on unhealthy eating, not exercising, but that Tulane study and medical conversations I have been a part of show factors that take the ownership off the individual,” Cunningham said. “We have to look at economic disparities.”
She noted that daily exercise can be difficult for people who live in unsafe neighborhoods or lack walkable streets and that chronic stress tied to poverty increases cardiovascular risk.
The Tulane study pointed to a range of social conditions linked to higher cardiovascular risk, including unemployment, low family income, food insecurity, limited education, lack of regular health care or private insurance, housing instability and social isolation.
Local disparities
Heart disease remains the leading cause of death in St. Louis County, with an average of 2,403 deaths per year from 2019 to 2023, according to public health records.
Black residents are 1.67 times as likely as white residents to die from heart attacks. Hospitalizations are also higher, with 17 heart attack admissions per 10,000 Black residents compared with 10.7 among white residents.
Heart failure deaths among Black residents occur at nearly 1.5 times the rate of white residents. Hospitalizations for heart failure are more than three times higher.
Prevention efforts
The county health department offers six-week workshops focused on managing chronic conditions, building healthier habits and improving communication with health care providers.
“It’s a great opportunity to learn how to communicate with your health provider,” Cunningham said. “We’ve seen some great results, and I think the workshops encourage and empower participants.”
The American Heart Association also partners with community organizations to increase awareness and improve access to basic health tools.
Its Libraries with Heart initiative provides free blood pressure kits through several local library systems.
“Libraries are an access point for a lot of great resources for community services, and we thought why not a blood pressure cuff,” said Rachelle Bartnick, senior community impact director for the AHA Missouri affiliate.
Hope in the Ville has worked with the AHA to increase access to fresh produce through a food pantry and urban gardens in North St. Louis and nearby neighborhoods.
“Being in collaboration with these established entities further builds trust,” Bartnick said.
Maternal risks
The Doula Lab addresses cardiovascular disease as a leading cause of maternal mortality through education, screenings and wellness support.
“We all know the statistics for Black women. No matter your income or health insurance, you are 3 to 4 times more likely to pass away giving birth,” said Marvella Ying-Clayburne, a certified doula and the organization’s operations manager.
She highlighted the dangers of preeclampsia, a blood pressure disorder that can develop during pregnancy or after birth.
“I don’t think people know that it can happen within the first year after birth,” Ying-Clayburne said. “So a lot of women are dying because of pre-eclampsia because they’re not being seen by their doctors.”
The Doula Lab also hosts programs focused on men’s health, including blood pressure monitoring and discussions around mental well-being.