By Denise Williams | News & Views
The Centers for Disease Control and Prevention (CDC) and its Million Hearts offshoot recently unveiled a new prevention campaign targeting African Americans aged 35-54 who are at risk for heart disease. The “Live to the Beat” initiative is a welcome intervention, according to cardiologist, speaker/educator and AACVPR board member Columbus Batiste, MD, FACC, FSCAI, who believes it makes perfect sense to focus on this demographic. In fact, he speculates, doing so promises to shift the dynamics of the country’s healthcare crisis entirely.
The disproportionate incidence of hypertension, stroke, heart attack and heart failure in Black and Brown people in the United States is irrefutable, Dr. Batiste notes. Thankfully, there is now greater awareness and understanding of this risk among members of the African-American community, who ‘Live to the Beat’ encourages to proactively lower their risk with small steps that will improve their blood pressure, cholesterol and blood glucose levels.
The concept resonates with Dr. Batiste, who is known on the lecture circuit as “The Healthy Heart Doc” and who co-founded a nonprofit built around that moniker. In his own practice, he already strives to get patients to leverage what he calls “atomic habits” that they can build on: parking farther away from a destination to increase walking distance, taking the stairs instead of the elevator, getting an extra 15 minutes of sleep per night or making better choices at quick-serve restaurants, to name a few. Watching the effect of these actions collectively add up and pay off, Dr. Batiste suggests, just might be the remedy for the defeatist attitude that has been holding some African Americans back from making positive changes.
Various mindsets might be at play, depending on which expert is asked. Dr. Batiste believes one culprit could be resignation, after watching family member after family member succumb to disease, that “living sicker and dying sooner” is a shared and immovable fate. Or perhaps, he suggests, it’s a manifestation of Maslow’s Hierarchy of Needs, wherein the pleasure trap tells us to eat for comfort rather than for well-being and to live for the moment, because who knows what tomorrow holds.
If these and other mental barriers can be knocked down, the implications are mind-blowing. If members of the African American community can be motivated to switch their behaviors for better habits during these prime wealth-generating and child-rearing years targeted by “Live to the Beat,” the hope is that they can dodge the chronic disease and polypharmacy that loom in their mid-60s and beyond. “If you offset that now," Dr. Batiste agrees, “there’s an opportunity to tap into this group and really change the trajectory of their future and disease burden that we know will begin to increase as one grows older.”
On the other hand, he warns, the financial ramifications are likely to hit hard for African Americans aged 35-54 who fall to disease as well as anyone they are responsible for – whether that means children, aging parents or both.
Aside from maintaining the ability to earn income and care for their families, Dr. Batiste says middle-aged Black parents who conscientiously act to avoid cardiovascular disease set a living example for their sons and daughters. “Everyone is more inclined to follow a life lived than a sermon preached,” he says, meaning that as parents demonstrate deliberate behavior changes – and as their children witness them – they build healthy habits inside of the kids, whether they are in kindergarten or high school.
Healthcare Professionals, Stand Up!
Per “Live to the Beat,” the habits at-risk African Americans aged 35-54 should aspire to include eating healthier and getting more exercise – ideally under regular provider care.
To Dr. Batiste, that recommendation represents a golden opportunity for the healthcare community to step up and restore the high-touch relationship with patients that has worn away over time. He points to a breakdown between providers and patients due to the hurried pace of clinical visits, the lost connection and the subsequent absence of trust. In some cases, he continues, there also is “perhaps a lack of cultural connection, a lack of understanding, a lack of empathy in terms of someone’s particular circumstances.”
And while some studies do suggest Black people may be more inclined to have screenings or follow up when their providers look and sound like them, Dr. Batiste insists that the biggest factor is intention to care. That’s a value, he says, that providers can convey through small gestures such as physical touch, eye contact and interest in or knowledge of a patient’s background – but also by making recommendations that show they have put themselves inside that patient’s unique circumstances.
Subsequently, according to Dr. Batiste, it becomes possible to dispense guidance beyond the generic. “We now become more tangible and more specific,” he says, offering a few examples. For a patient who lives in a neighborhood where it may not be safe to walk, for instance, the advice might be drilled down from “be more active” to “walk around the mall or Home Depot or Costco several times on multiple days of the week.” For the patient who doesn’t have room in the budget for fresh produce, meanwhile, the counsel might shift from “eat more fruits and vegetables” to “buy frozen fruit from a large-batch grocery outlet and make homemade smoothies.”
“It’s important to be very specific and intentional,” Dr. Batiste explains. “It’s important to acknowledge the journey for people. Acknowledge that their circumstances are not of their own choosing, and that they choose health. They want to choose wellness because they understand the importance of it, but it’s a matter of trust and building that trust.”
Dr. Batiste, whose passion for preventing cardiac disease amplified after losing his own father 12 years ago this coming summer, says that after trust it’s all about meeting people where they are. He’s elated if patients can get on board with a plant-based diet, but he knows that lifestyle isn’t for everyone. But caring enough to find out where change can take place at the individual level and optimizing it is crucial to producing results.
“We all have only one life to live,” he reminds us.