Heart disease stands as the top cause of mortality in the United States, not showing any bias.
In 2021 alone, around 695,000 citizens succumbed to heart disease according to the freshest statistics from the Centers of Disease Control and Prevention (CDC).
Although some risk-contributing lifestyle factors could be altered by an individual's choices, others are beyond one's control. Recent studies suggest that LGBTQIA+ adults may have poorer heart health than heterosexual cisgender individuals.
Preliminary research presented at the American Heart Association's meeting in March 2018 found that Lesbian, gay and bisexual adults were 36% less likely to possess ideal cardiovascular health when compared with their heterosexual counterparts considering risk factors like smoking habits and blood glucose levels.
By July 2021, AHA published another study in Circulation revealing higher instances of cardiac ailments among transgender and gender diverse population versus cisgender groups.
Such concerning health conditions can be partly attributed to stress resulting from discriminative behavior against transgenders or due to transphobia says Geoffrey Barnes M.D.,, Associate Professor in Internal Medicine at University of Michigan Health System who also works as a cardiologist there.
According to him healthcare disparities along with other contributing risk factors faced by LGBTQIA+ adults stemming out from discrimination present complex challenges which call for solutions on systemic societal & personal fronts.
Evaluating the Increased Heart Disease Risk Among LGBTQIA+ Community
Jennifer Huang, M.D., a cardiologist and associate professor of pediatrics at Oregon Health and Science University, brings our attention to a concerning issue with these words: "A variety of factors contribute to the elevated heart disease risk in marginalized communities like LGBTQA+."
She elaborates, "Members of the LGBTQIA+ community frequently experience unique types of stress, aversion towards healthcare system engagement, and family exclusion. They also are likely to represent lower socioeconomic groups - these intersecting issues amplify their overall health risks."
1. Increased Smoking and Obesity Rates
Both smoking and obesity play a significant role in creating risk factors that can lead to heart attacks and strokes, according to Dr. Barnes. Not only can tobacco products have adverse effects on the cardiovascular system, including damage to the heart and blood vessels, but they also increase the risk of developing various heart ailments. Nicotine present in cigarettes ramp up blood pressure levels- another prominent factor leading to cardiac diseases.
Moreover, there is a considerable connection between obesity and conditions such as diabetes and elevated cholesterol levels - both recognized as key risk elements for cardio-related illnesses by CDC.
In terms of smoking habits within different groups of adults identified by sexual orientation in America, statistics from CDC reveal higher usage among lesbians, gays, bisexuals. These demographics show about 15 % are smokers as compared with approximately 11% for straight individuals.
According to a study published in January 2017 edition of American Journal of Preventive Medicine, it was discovered that transgender adults contain a high rate (approximately 36%) smokers than cisgender adults (21%).
Looking at obesity rates across these demographic divisions reveals interesting data too. For instance, research conducted in May 2019 published in International Journal of Environmental Research and Public Health outlined findings regarding potential links between sexuality type & propensity towards obesity: Lesbian/bisexual women exhibited increased obese numbers while men identifying themselves gay bore lower instances relative their heterosexual equivalents.
2. Lower Rates of Preventive Care Among LGBTQIA+ Community
Many members of the LGBTQIA+ community are not frequently engaging in preventive health care, and there are numerous contributing factors to this trend according to Dr. Barnes.
In general, individuals within the LGBTQ+ demographic often face elevated levels of discrimination and stress overall. Moreover, many harbor fears that they may encounter similar prejudices when interacting with the healthcare system," says Dr. Barnes.
According to survey findings published by the Center for American Progress (CAP), around seven percent of participants identified as LGBTQIA+ reported that they had ever deferred or avoided undertaking preventive health checkups.
Adverse encounters with physicians can lead patients to pass over future medical appointments making it more difficult for them manage chronic conditions like high cholesterol levels, hypertension, and diabetes effectively notes Dr. Barnes.
3. Increased Probability of Discrimination and Stress
Those from the LGBTQIA+ community, when seeking health services, may face tangible discrimination, as stated by Dr. Barnes.
LGBTQIA+ individuals demonstrate a higher probability of encountering unfair treatment and bias at medical facilities compared to their heterosexual and cisgender peers, based on data from CAP. Examples of adverse experiences include conscious misidentification or refusal of care due to their personal identity. Instead of finding assurance in these environments, numerous people within the LGBTQIA+ community are subjected to stressful and unsecured circumstances during doctor visits.
The connection between such discrimination-induced stress and negative health impacts is typically called minority stress theory. This doesn't solely impact those belonging to ethnic or racial minorities: In a research study published in December 2020 by International Journal of Behavioral Medicine it was concluded that sexual minorities encounter distinct stressors that directly affect heart health.
"Heightened levels of overall stress can influence physiologic response in an individual - resulting in increased blood pressure along with changes in behavior such as decreased physical activity and unhealthy eating habits," suggests Dr. Barnes.
4. Persistent Health Insurance Obstacles
Accessing affordable healthcare in the U.S is a challenge, regardless of who you are. Even with health insurance, high medical expenses can accumulate and cause financial strain. This issue becomes particularly problematic for individuals within the LGBTQIA+ community due to hurdles in obtaining inclusive health insurance.
Studies reveal that 44% of the LGBTQIA+ demographic residing in the U.S inhabit states without comprehensive insurance protections, as stated by pro-LGBTQ organization GLMA: Health Professionals Advancing LGBTQ Equality. These circumstances might result in unjust exclusion or denial from insurance coverage.
Further information from GLMA mentions that 43% of people part of the LGBTQIA+ grouping live in locations not actively opposing transgender exclusions regarding health insurance services provision. This situation illustrates how transgenders may legally be denied their right to coverage for their healthcare needs by insurers.
The expense related to receiving adequate treatment poses significant issues and acts as a deterrent for members within the LGBTQIA+ spectrum seeking care. And this is including but not limited to other adverse conditions such as heightened cholesterol levels or hypertension that could ultimately deteriorate heart health over time if left unchecked.
Guidelines for Sustaining Cardiac Wellness
Dr. Barnes suggests that the medical system and the LGBTQIA+ community need to cooperate to enhance this group's health.
Though institutional reforms are necessary, meanwhile, there are several measures you may take to safeguard your cardiac wellness.
1. Establish a Trusting Relationship with a Reliable Health Care Provider
It is crucial to find a medical professional who demonstrates understanding and acceptance. Dr. Huang advises seeking health guidance that can be specifically tailored to fit your individual situation and preferences.
Building trust with your healthcare team may require patience, but the higher degree of honesty you provide about your life and circumstances will enhance the precision of care they offer back significantly.
According to Dr. Huang, "A deep understanding about you is vital for any provider to render truly good care.” He further maintains that it might seem safer not sharing too much information initially, however in the long run, openness will pave way towards better health care provision.
2. Understand Your Potential Risk Factors
All individuals, including those who belong to the LGBTQIA+ community, could benefit from becoming informed about the risk factors for heart disease - be they smoking habits, high blood pressure levels, elevated cholesterol counts, or diabetes diagnoses- says Dr. Barnes. "Enhancing your understanding of these items and collaborating with healthcare professionals can significantly improve an individual's health in the LGBTQ+ community."
Changes might include giving up smoking, better management of blood pressure and even aimed weight loss.
3. Engage in Physical Activities
Unsurprisingly, physical exertion is a surefire way to maintain cardiovascular health. As guided by the CDC, adults should strive towards achieving at least 30 min of moderate-intensity workout for five out of seven days each week.
This objective can be met with frequent engagement in aerobic exercises such as brisk strolling, cycling, stair climbing, rope skipping or even swimming; just to name a few examples. Consistency here is key and could only be maintained when one indulges in an activity that brings pleasure alongside its heart-healthy benefits.
How Many Miles is 10,000 Steps and the Benefits of Walking
4. Uphold a Nutritionally Balanced Diet
A diet predominated by whole foods such as fruits, vegetables, whole grains and lean meats is vastly superior to one largely composed of processed food items like fried dishes, pastries, and store-bought snacks.
For the sake of cardiovascular health, endeavor to minimize the consumption of saturated and trans fats as per advice from the American Heart Association. Trans fats worsen LDL (or 'bad') cholesterol levels while reducing HDL (or 'good') cholesterol levels. An elevated level of LDL coupled with lower HDL cholesterol corresponds to an increased risk for heart disease.
