[Editor’s note: This piece originally appeared as a comment in response to “Intersectional Inequities in Age-Related Risk of Adverse Maternal Cardiometabolic Health,” published in JAMA Cardiology. That article can be read here.]
Elleni Hailu et al. observe that black women are at increased perinatal cardiometabolic risk compared to white women with that risk rising more steeply with age. Their discussion offers a list of theorized interpretations including “structural racism,” “experiences of racism,” “racism-related stress,” “chronic discrimination,” “bias and neglect in health care settings,” & “eco-social theory,” which as per Nancy Krieger, who introduced the term decades ago, “rejects the underlying assumptions of biomedical individualism.”
Yet, individual behavioral & biological factors should be considered to better understand the paper’s observation. Physical activity, diet, & cholesterol, along with genetics, all contribute to cardiovascular (CV) health. Every day of unmanaged risk factors worsens insulin resistance & arterial stiffness, for example, thereby compounding risk with age.
Read the full comment in JAMA Cardiology.
