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Share on Pinterest Fly View Productions/Getty ImagesAround 60 million women in the US have cardiovascular disease (CVD).Women from racial and ethnic minority groups are at greater risk of CVD death.A new American Heart Association (AHA) statement emphasizes that doctors must also consider social determinants of health when screening for CVD.These include factors such as discrimination, environment, and language barriers.

An estimated 60 million women in the US (equal to 44% of the population) live with some form of cardiovascular disease (CVD).

Additionally, 1 in 5 deaths among women stems from CVD with those from racial and ethnic minorities at greater risk.

Traditional contributing factors, such as obesity, smoking, diabetes, and high cholesterol, are frequently considered by doctors when assessing a patients CVD risk.

However, a new scientific statement from the American Heart Association (AHA), published in its journal Circulation, highlighted that medical professionals must look beyond these when monitoring and treating CVD in women, especially those from underrepresented groups.

In comparison to other women, Black women in the US (including African American and Afro Caribbean) have the highest rate of heart disease, stated Dr. Heather M. Johnson,a preventive cardiologist at Boca Raton Regional Hospital, part of Baptist Health South Florida, who was not involved with the report.

The AHA researchers stated that nontraditionalsocio-economic factors such as discrimination and environment must be considered if the gap in CVD treatment and survival between whites and racial and ethnic groups is to be reduced.

Many of these are often overlooked but can significantly affect health risks, care, and outcomes.

Understanding both traditional and nontraditional risk factors are important to prevent heart disease, but also to support the early diagnosis and treatment of heart disease in women, Johnson told Healthline. How bias, discrimination, and racism can affect your health

In the statement, the researchers said: Behavioral and environmental factors and social determinants of health disproportionately affect women of underrepresented races and ethnicities.

These factors result in a higher prevalence of CVD and significant challenges in the diagnosis and treatment of cardiovascular conditions, they added.

Five social determinants of health were emphasized in the AHAs statement. But what are they and how do they influence CVD?Discrimination

The AHA noted that discriminatory barriers faced by ethnic communities lead to high levels of stress. This, in turn, contributes to CVD issues such as inflammation and hypertension.

Research also highlights that minority groups can encounter racial bias and stereotyping from white healthcare providers which may lead to patients having their concerns dismissed or receiving poorer care.

Studies show this is often due to the activation of stereotypes that influence clinical judgment, said Heather Orom, PhD, associate professor of community health and health behavior at the University at Buffalo.

Furthermore, when actions are perceived as racially motivated or discriminatory, this can put a wedge between provider and patient and create an environment of mistrust, said Dr. Deborah L. Crabbe, a professor of medicine at the Temple Heart and Vascular Institute at Lewis Katz School of Medicine.

As a result, she told Healthline, patients may not follow through with care recommendations and may even seek other providers, perhaps delaying care for their medical condition.Language barriers

Understanding medical terms and phrasing can be tricky enough for patients at the best of times. However, things are complicated further when the doctor and patient dont share the same first language.

Language barriers can reduce patients satisfaction with their care, care quality, and safety, explained Orom.

Furthermore, she told Healthline, such barriers can hinder the doctor-patient relationship, prevent patients from advocating for themselves, and inhibit the doctor from understanding the full complexity of a patients condition and their life circumstances. Environment

The AHA statement revealed that environmental factors, such as air pollution, high long-term arsenic exposure, and cadmium and lead exposure, have been linked to CVD.

Studies show minority groups are more likely to live in areas with more air pollution and closer proximity to toxic waste and other hazards.

For decades, polluting industries, waste facilities, and other sources of exposure, such as highways systems, have been more likely to be placed in neighborhoods of color, Orom revealed. This stems from the fact these communities have had less political and economic clout. Assimilation to a different culture

The AHA statement didnt expressly state how acculturation or assimilation to a different culture can impact CVD.

However, this is an important factor for CVD that often is missed, stated Dr. Yu-Ming Ni, a cardiologist at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center.

For instance, he shared with Healthline that older studies of Japanese individuals showed those who traveled to Hawaii and then to the continental U.S. had higher CVD rates than their peers who stayed in Japan.Healthcare access

It was noted in the AHA statement that there is evidence that SDOH factors experienced in youth, such as inability to access healthcare or inability to afford care, may affect heart health into adulthood and contribute to CVD risk factors and outcomes in adulthood.

Research shows that Black, Hispanic, Asian-American, and Native individuals are less likely to have health insurance.

But healthcare access isnt only about insurance, said Crabbe. For example, [it also] includes geographic access to a particular health care service.

Orom concurred, stating there is a typically lack of high-quality healthcare facilities in neighborhoods where people of color have historically lived.

Other social burdens can limit access, too. For example, United States Census Bureau data shows that ethnic minority groups are generally poorer compared to white populations. Poverty can prevent individuals from purchasing necessary medications, for example.

Finally, Michele Horan, a registered nurse and COO of Healthy Alliance, shared that other daily stressors such as care responsibilities and the potential of eviction can reduce the capacity of underserved communities to access healthcare.

In most cases, these urgent situations are prioritized over ones health and well-being, Horan told Healthline. Addressing life challenges, in my experience, will almost always surpass healthcare, accessible or not. What to discuss with your doctor

If you think youre at higher risk of CVD, its crucial to ensure your doctor is aware of your concerns and potential risk profile.

Ni said discussing with your doctor means they can be more aggressive with screening.

For example, doctors might choose to test for disease states with no symptoms earlier than usual if the fear is that someone has a higher risk due to the environment they live in, he explained.

Tests and screenings generally vary depending on the patient and their history.

Its recommended that everyone understands their individual risk for heart disease and has a preventive heart health evaluation, Johnson said.

This assessment, she explained, includes a detailed discussion of their traditional and nontraditional risk factors for heart disease.

According to Johnson, further preventative screening tests are also possible and include:Electrocardiogram (EKG or ECG)Coronary artery calcium scan (also known as a calcium score)Special cholesterol tests What can healthcare professionals do to help?

According to the AHA researchers, culturally sensitive, peer-led community and healthcare professional education is a necessary step in CVD prevention.

Language barriers can be overcome by providing translators or simply using language apps, such as Google Translate. Studies show that using such app in healthcare settings can significantly improve both doctor and patient satisfaction.

Horan said healthcare providers need to screen patients from minority groups in a culturally competent and sensitive way.

Identifying barriers and the root cause behind them with a proactive lens is often the only way to effectively coordinate care in a manner that addresses their patients full spectrum of needs, she asserted.

Education is vital for both medical professionals and patients, said Crabbe.

Healthcare organizations can provide training and education to staff regarding the challenges that minorities and women face in receiving healthcare, she noted.

Meanwhile, Crabbe continued, opportunities to provide education to improve the health literacy of minorities and women could help improve patient acceptance of healthcare recommendations, and thus compliance.

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Hagel suspended for Game 3 due to hit on Barkov

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Hagel suspended for Game 3 due to hit on Barkov

Tampa Bay Lightning winger Brandon Hagel was suspended one game by the NHL Department of Player Safety on Friday night for what it labeled “an extremely forceful body check to an unsuspecting opponent” that injured Florida Panthers captain Aleksander Barkov.

Hagel will miss Saturday’s Game 3 in Sunrise, Florida. The Panthers lead the series 2-0.

Around midway through the third period of Thursday’s Game 2, Tampa Bay was on the power play while trailing 1-0. Barkov pressured defenseman Ryan McDonagh deep in the Lightning zone. With the puck clearly past Barkov, Hagel lined him up for a huge hit that sent the Panthers captain to the ice and thumping off the end boards.

A penalty was whistled, and the officials conferred before calling a “five-minute penalty.” After review, Hagel was given a 5-minute major for interference. Barkov left the game with 10:09 remaining in regulation and did not return to the Panthers’ 2-0 win.

Lightning coach Jon Cooper said after the game that he didn’t expect Hagel to receive a major penalty for the hit.

“Refs make the call. I was a little surprised it was a five, but it was,” he said.

The NHL ruled that Hagel’s hit made “some head contact” on Barkov.

“It’s important to note that Barkov is never in possession of the puck on this play and is therefore not eligible to be checked in any manner,” the league said.

In the Friday hearing, held remotely, Hagel argued that he approached the play anticipating that Barkov would play the puck. But the Department of Player Safety said the onus was on Hagel to ensure that Barkov was eligible to be checked. It also determined that the hit had “sufficient force” for supplemental discipline.

It’s Hagel’s first suspension in 375 regular-season and 36 playoff games. He was fined for boarding Florida’s Eetu Luostarinen in May 2022.

The Panthers held an optional skate Friday. Coach Paul Maurice said Barkov “hasn’t been ruled out yet” but “hasn’t been cleared” for Game 3.

“He’s an irreplicable player,” Panthers defenseman Seth Jones said of Barkov. “One of the best centermen in the league. He’s super important to our team.”

The Lightning lose Hagel while they struggle to score in the series; they scored two goals in Game 1 and were shut out in Game 2. Tampa Bay was the highest-scoring team in the regular season (3.56), with Hagel contributing 35 goals and 55 assists in 82 games.

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Goalies Montembeault, Dobes leave Caps-Habs

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Goalies Montembeault, Dobes leave Caps-Habs

The Washington Capitals and Montreal Canadiens lost their starting goalies because of injuries in Game 3 of their first-round series Friday night.

Canadiens starter Sam Montembeault was replaced by rookie Jakub Dobes, who made his playoff debut, in the second period. Capitals starter Logan Thompson left late in the third period after a collision with teammate Dylan Strome.

The Canadiens won 6-3 to cut their series deficit to 2-1.

Montembeault left the crease with 8:21 remaining in the second period and the score tied 2-2. Replays showed him reaching for the back of his left leg after making a save on Capitals defenseman Alex Alexeyev. Montembeault had stopped 11 of 13 shots. For the series, he stopped 58 of 63 shots (.921 save percentage) with a 2.49 goals-against average.

Dobes, 23, was 7-4-3 in 16 games for the Canadiens in the regular season with a .909 save percentage. Dobes had a win over the Capitals on Jan. 10, stopping 15 shots in a 3-2 overtime win.

Thompson was helped from the ice by a trainer and teammates after Strome collided with him with 6:37 left in regulation right after Canadiens forward Juraj Slafkovsky made it a 5-3 Montreal lead. Thompson attempted to skate off on his own but couldn’t put weight down on his left leg.

Backup goalie Charlie Lindgren replaced Thompson, who had been outstanding for the Capitals in the first two games of the series, winning both with a .951 save percentage and a 1.47 goals-against average. He made 30 saves on 35 shots in Game 3.

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