Prior to the COVID-19 pandemic, data showed that high blood pressure disproportionately affects Black communities. In fact, according to the American Heart Association, the prevalence of high BP in Black women was nearly 40% higher than white women in the U.S. The pandemic and recent coverage of ongoing verbal and physical violence against Black people has increased the visibility of long-standing historical and structural inequities.
Ongoing police brutality and violence against Black communities further contribute to chronic stress and “weathering” that have made them more vulnerable to underlying heart conditions, such as high blood pressure.
With larger structural and social drivers for these health inequities, the AMA and a coalition of national physician organizations are collaborating with ESSENCE—the leading media, technology and commerce company serving Black women and communities for 50 years—to meet the common goal of supporting health and wellness with health professionals and loved ones.
In collaboration with ESSENCE, the AMA, AMA Foundation, Association of Black Cardiologists, American Heart Association, Minority Health Institute and National Medical Association have launched the “Release the Pressure” campaign to provide Black women with resources to identify and track their BP numbers. The campaign also aims to help Black women develop a wellness plan with existing personal support systems of family and friends to manage their heart health virtually. The organizations have a shared goal of engaging more than 300,000 Black women by 2021.
“We have the opportunity to collectively improve our health and we know that preventive care is vital to breaking the devastating impact of high blood pressure within the Black community,” said AMA President Patrice A. Harris, MD, MA. “By joining forces with national physician organizations, heart health experts and ESSENCE, we will partner with thousands of Black women, sharing resources that are important to understand their blood pressure numbers and take action to manage their blood pressure.
“Combining our collective efforts, we strive to improve health outcomes within the Black community,” said Dr. Harris.
Black women are encouraged to make the pledge to lower their blood pressure, set a goal, monitor BP at home, activate a personalized wellness plan and check in with their “squad.” But it goes beyond lowering blood pressure. AMA Chief Health Equity Officer Aletha Maybank, MD, MPH, shares further insight into the spirit behind the Release the Pressure campaign and its impact on Black women.
It’s more than a behavioral change program
“The campaign is about coming together and supporting Black women to improve their heart health and maintain a healthy blood pressure,” said Dr. Maybank, group vice president of the Center for Health Equity at the AMA. “We know high blood pressure increases the risk of heart attack and stroke, and we want to be able to provide an environment that makes sense culturally and that women trust.”
When COVID-19 hit, it pushed the campaign to evolve its narrative, emphasizing that it is more than a behavioral change program.
“We fully understand that behaviors are very much driven by the conditions and structures in which you live,” said Dr. Maybank. This impacts what people have in terms of flexibility regarding jobs, monetary and financial resources, and where they can live. It then “determines and dictates the kind of behaviors that they are able to do in order to have optimal health,” she said.
Increase visibility of long-standing inequities
There have been mixed messages during the height of the stay-at-home order about what it means for receiving health care.
“For those with other chronic conditions, a lot of people internalized that they were not supposed to go to the doctor and that became a problem,” said Dr. Maybank. “Our goal is to focus on that, but we want to make sure that we’re framing increased visibility of long-standing concerns due to our legacy of structural inequities.
“At the end of the day it causes harm, meaning early deaths and increased suffering, so it’s really important that we frame that part of it,” she said. “The solutions to improving blood pressure for Black women are not just about what their behaviors will be, but it’s about all these other kinds of structures and drivers of inequities.
“We also want to provide the opportunity downstream to help support Black women and their families meet their health goals and understand that all these other influences are out there too,” Dr. Maybank added.
Building a community goal for a heart healthy culture
A key part of the Release the Pressure campaign is to foster the relationship between patient and health professional.
“It’s supposed to be like a true partnership and a community effort instead of just being its own silo in a top down approach of a physician telling you what to do,” said Dr. Maybank. “Now we have a partnership between the physician and the patient, and then the patient has partnerships with their own family and friends.”
“You can see ecologically that this is building more of a community goal for a heart healthy culture,” she said, adding that this is what is unique about the campaign because “we’re not saying to do this alone.”
Instead, the campaign focuses on “the idea that we operate in squads and are comfortable in our friendships and our groups of friends,” said Dr. Maybank. “It’s about how we can also work towards supporting squad care, understanding that that’s good for our physical, emotional and spiritual health as Black people.”
Capitalize on strengths not deficits
“Patients and their health care providers may come from very different places culturally and also just racially,” said Dr. Maybank. “The Release the Pressure campaign is a resource for the provider to let them see into the world of their Black female patients of what they value and the strengths that they have.”
The campaign also helps physicians and other health professionals understand “how to build health based on those strengths instead of just looking at the deficits and the negatives,” she said. “Let’s understand the assets of that community and of that patient, and the strengths to capitalize on that.”
The AMA continues to compile critical COVID-19 health equity resources to shine a light on the structural issues that contribute to and could exacerbate already existing inequities. Physicians can also access the AMA’s COVID-19 FAQs about health equity in a pandemic.
