Heart Disease Risk Knowledge and Associated Sociodemographic Factors Among African American Adults in Baltimore
A cross-sectional study of 178 African American adults in Baltimore reveals that while overall heart disease risk knowledge is relatively high, significant gaps exist regarding specific factors like HDL cholesterol and age, with higher knowledge levels strongly associated with older age, higher education, greater income, and moderate physical activity.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Heart disease remains the leading cause of death in the United States, claiming nearly a million lives every year. While medical treatments have advanced, the burden of this disease falls unevenly on different communities, with African American adults facing a disproportionate share of the risk. Preventing heart disease often comes down to recognizing the warning signs early and making informed choices about lifestyle, such as managing blood pressure, maintaining a healthy weight, and avoiding tobacco. However, knowing what to do requires a foundation of understanding. This understanding, often called health literacy, is the ability to access and apply information about health to make good decisions. If people do not fully grasp which factors put them at risk, they may struggle to take the necessary steps to protect their hearts, regardless of how much medical care is available to them.
A team of researchers set out to explore this specific gap in understanding among African American adults in Baltimore. They wanted to see how much people knew about the risks of heart disease and whether that knowledge was linked to their age, income, or education. To do this, they worked with 178 adults participating in a community program called EngAGE with Heart. The participants, who were recruited from local churches and faith-based communities, completed a survey designed to test their knowledge. The survey asked 16 specific questions about heart disease, covering topics like the dangers of smoking, the role of high blood pressure, and the meaning of cholesterol levels. The researchers then scored these answers to see who had low, moderate, or high levels of knowledge.
The results painted a picture of a community that is largely aware of the major, well-known dangers but still missing some critical details. On average, the participants scored well on the basics. A vast majority correctly identified that being overweight, smoking, having high blood pressure, and having diabetes are all significant risks for heart disease. For instance, nearly 87 percent of the group knew that carrying extra weight increases risk, and about 86 percent recognized the dangers of smoking and high blood pressure. However, the picture became less clear when the questions turned to more complex concepts. Less than half of the participants could correctly identify that HDL cholesterol is a risk factor related to heart disease, and fewer than half understood that getting older is a risk factor in itself. This suggests that while the broad strokes of heart disease prevention are understood, the finer points of how the body works and what specific numbers matter are often lost.
The study also revealed that knowledge was not distributed equally across the group. The researchers found that a person's age, education, and income were strong predictors of how much they knew. Adults who were 65 years or older were significantly more likely to have high knowledge scores compared to those under 50. Similarly, people who had attended some college or more had better scores than those with a high school diploma or less. The most striking difference was linked to money. Participants who reported an annual household income of at least $20,000 were much more likely to have high knowledge levels than those earning less. In fact, the data showed that having an income above that threshold was associated with nearly five times the odds of having higher knowledge compared to those below it. Even the amount of physical activity a person did mattered; those who engaged in moderate exercise for about an hour to two and a half hours a week tended to know more about heart disease risks than those who were less active.
These findings highlight that knowing how to prevent heart disease is not just a matter of individual effort but is deeply tied to the resources a person has. The researchers suggest that the gaps in knowledge, particularly regarding cholesterol and age, point to a need for better communication. Health messages often assume a level of background knowledge that not everyone possesses. For communities facing economic challenges, the path to understanding heart health can be blocked by a lack of access to clear, simple information. The study concludes that to truly help people protect their hearts, health education must be tailored to be accessible and relevant to the specific lives and resources of the people it aims to serve. By focusing on these gaps and the social factors that create them, public health efforts can move beyond simply listing risks to ensuring that everyone has the tools to understand and act on them.
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