Community care tops medical care at preventing heart disease in black Americans

Upgraded community health services, including checkups by phone or in person with a local nurse practitioner at a neighborhood clinic, and free charge cards for medications are almost nine times more likely to benefit black Americans at greater risk of heart disease than full-service physician care alone. The analysis by researchers at Johns Hopkins, to be published in the journal Circulation online March 16, is the first to test which model works best when patients have equal and unrestricted access to health care services.

"Despite physicians' best attempts, current treatment programs have not contained the disproportionately higher number of black Americans, especially women, who have the leading risk factors for coronary heart disease, including high blood pressure, elevated levels of cholesterol, high rates of smoking and diabetes, and a sedentary lifestyle," says lead investigator Diane Becker, M.P.H., Sc.D., a professor at The Johns Hopkins University School of Medicine and Bloomberg School of Public Health. "Our results show that direct involvement from a nurse practitioner and a community health worker is far more effective at helping patients lower their risk factors than the standard in which patients are on their own to follow - or not follow - their doctors' orders."

The Hopkins findings offer an effective strategy for reducing racial disparities in health status, which is quite pronounced in heart disease, the researchers say. Whites have the lowest rate of premature deaths from heart disease of all racial groups in the United States, at 14.7 percent of deaths before age 65, while blacks have among the highest, at 31.5 percent. According to the latest statistics from the American Heart Association, in 2002, 50,000 blacks died from coronary heart disease, which affects 7.4 percent of black men and 7.5 percent of black women, roughly five times the rates in the general population.

According to Becker, the study's results c

Contact: David March
Johns Hopkins Medical Institutions

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