In an effort to find out why some ethnic groups have higher rates of heart disease than others, the National Institutes of Health has funded a new University of Michigan center to study the issue.
Scientists say the University’s Center for Integrative Approaches to Health Disparities is groundbreaking because it considers biological and ethnic factors that may contribute to heart disease. Researchers plan to take socioeconomic status; race; psychological factors such as stress, depression and social relationships; and health behaviors into account when studying heart disease.
Studies have shown that African Americans have a higher rate of heart disease and mortality than white people.
The National Institutes of Health has awarded the center $7 million that is expected to support it until at least 2012.
The center’s director, Epidemiology Prof. Ana Diez-Roux, said the center will take an interdisciplinary approach to consider a wider range of potential causes for the different rates of heart disease between races.
Epidemiologists, psychologists, demographers, statisticians and a wide range of medical health professionals will work together in the center.
To start with, the center will focus on three projects.
The first is a partnership with the Jackson Heart Study, a long-term study of African Americans in Jackson, Miss. in which healthy individuals are followed over time in order to identify social and geographic predictors of cardiovascular risk.
Older studies have shown that environmental factors in a person’s neighborhood are related to his or her risk of developing cardiovascular disease. Researchers consider a variety of factors about the neighborhood, including its beauty, walking environment, overall safety and gym quality. Researchers also study the availability of healthy food and the social atmosphere of the neighborhood.
The second study focuses on the link between genetics and environmental factors to blood pressure control. It examines why some medications affect people differently.
The third study, led by James Jackson, the director of the Institute for Social Research, and Elizabeth Young, a professor in the Psychiatry Department, looks at the roles of coping mechanisms with stress and how they relate to heart disease.
Because many patients become depressed after a heart attack or other heart troubles, these mechanisms are often employed by patients as a way to deal with depression.
Coping behaviors include eating more than usual, smoking and drinking heavily. There is no documented difference in coping behaviors between races.
However, epidemiological studies have shown that “despite high levels of racism, stress, and probably lower economic positions, African Americans have lower rates of depression than whites,” Young said. “The question is why they have lower rates when they have higher rates of stress.”
One reason might be that African Americans may be using coping habits more than white people. Data shows a higher rate of obesity in African Americans, so they might “just have more stress in their lives,” Young said.
The study also looks at the lifestyle changes patients are asked to make following heart trouble. These changes often eliminate a patient’s coping mechanisms.
The center will focus on a few pilot studies too, like the role assimilation has on cardiovascular risk factors among Hispanic people.
Another study looks at neighborhood effects on cardiovascular disease, specifically in Detroit.
Diez-Roux said she hopes the center “will help us move beyond simplistic explanations of these differences, like saying ‘It’s just genetics,’ or ‘It’s just biological,’ and then work to develop better ways to eliminate these differences.”