Targeting Heart Health (Benefits Inclusion & Equity series)

Heart disease and related illnesses, including diabetes, are the #1 cause of death in the US. It's the #1 cause for all racial/ethnic groups of men, and for Black and White women; and it's the #2 cause (barely) for Asian American, Indigenous, and Latino women.

Many wear pink for breast cancer, and many men grow mustaches during Movember for prostate cancer. But all cancers put together are #2.

And why is diabetes part of this conversation? Because, according to the CDC, "over time, high blood sugar can damage blood vessels and the nerves that control the heart." As a result, according to Johns Hopkins Medicine, people with diabetes are 2-4x more likely to develop cardiovascular disease, and "the majority of people with type 2 diabetes will eventually develop [cardiovascular disease]."

Gaps

Unfortunately, there are significant disparities in heart health. Black Americans aged 35-64 are 50% more likely have high blood pressure than Whites, and 50+% more likely than Whites to die from heart disease or stroke.

The rate of diabetes in the US is skyrocketing, from an estimated 9.5% in 1999-2002, to 13.0% in 2018. But compared to Whites, the rate of diabetes is 38% higher for Blacks, 25% higher for Asians, and 24% higher for Latinos. And hospital admissions for uncontrolled diabetes without complications, for complications of diabetes for adults, and for end-stage renal disease due to diabetes are all 1.5 to 3 times higher for Blacks than Whites.

Treatment of heart disease in women and in men is broadly similar, including medications and surgeries. But women are more likely to have heart attack symptoms unrelated to chest pain, including neck, jaw, shoulder, upper back or abdominal discomfort; shortness of breath; nausea or vomiting; unusual fatigue, or even indigestion.

“Because women don't always recognize their symptoms as those of a heart attack, they tend to show up in emergency rooms after heart damage.”

For the sake of all the women in your life, including all the employees at your firm, it's worth educating men and women on this.

What can employers do?

There are many ways to help employees and their families tackle heart health. Here are just a few.

• Look at the Data. Start by looking at your data—directly, or through your health plan administrator or benefit broker. Look for populations that are small enough to influence, but big enough to make a difference, such as medium-to-large offices. This will help identify your best opportunities to make a meaningful impact.
• Encourage walking! We all know the value of exercise, but so many of us think about buying gear and driving to a gym. Start by getting people walking: make sure your firm’s stairways are painted and well-lit, plan walking paths on your campus, organize early morning or lunchtime walking groups, and encourage walking meetings.
• Disease Management programs. Providers who run a range of disease-management and lifestyle-management programs have much to offer here. Also consider specialized diabetes prevention/monitoring programs, such as those from Cecilia Health.
• Go Red for Women. The American Heart Association runs a terrific campaign focused on women's heart health each February, called Go Red for Women, and their resources are available year-round.
• Employee Resource Groups. Which brings me to my final suggestion: talk to your ERGs, and ask what they would recommend. Noone has more of a stake in employee health than employees!

There are so many ways to improve health, including heart health. Don’t worry about finding “the best” ways… pick a path that the organization can effectively support and just do it!

Note: The CDC and other parts of the Department of Health and Human Services publish a lot of health information and population-health data, which are a marvelous national resource. Figures in this article are drawn from a number of sources, including Heart Disease Facts (CDC), National Diabetes Statistics Report 2020, 2019 National Healthcare Quality and Disparities Report, HHS Action Plan to Reduce Racial and Ethnic Health Disparities: Implementation Progress Report 2011-2014, and African American Health: Creating equal opportunities for health (CDC, 2017).

Is your firm addressing heart health, including gaps? Why or why not? And how? Please share in the comments, or message me directly.

In our next article, we'll look at gaps related to cancer.