As blow dryers whoosh and electric clippers hum, hairstylists and barbers across Rochester are asking their clients if they have had their blood pressure checked lately.
Their intention is not to be nosy. They just want to save lives.
As one of various initiatives led by the High Blood Pressure Collaborative, the Get It Done program has trained more than 25 local beauticians and barbers to be community health educators.
“Not only do they offer blood pressure reading and monitoring, they’re trained to encourage their clients to see their doctors” if their readings are high, says Dina Faticone, director of community health and engagement at Common Ground Health, which partners with Rochester-based Trillium Health on Get It Done. “They’re trained to counsel them on lifestyle and behavior change and really are that trusted, go-to resource for many of their patrons.”
This year, salons and barbershops participating in Get It Done have begun hosting events to raise “awareness about high blood pressure and healthy lifestyles not only with their patrons and in their shops but outside of their four walls,” Faticone adds. “So that’s been a really, really great expansion of the program and a way for the stylists and the barbers to give back to the community.”
In light of research showing that low-income Americans have not benefited equally from efforts to minimize risk factors for cardiovascular disease, outreach related to heart health is poised to be a focus of health advocates in Rochester and elsewhere. Using data collected from the U.S. National Health and Nutrition Examination Survey, a study published last month in JAMA Cardiology reveals that while risk factors have decreased among the wealthy and the middle class, those living at or below the federal poverty level—$24,600 for a family of four—do not have improved heart health.
Based on data from 17,199 adults ages 40 to 79, the study shows that the percentage of poor people with a 20 percent or greater risk for heart disease increased from 15 percent between 1999 and 2004 to 16.5 percent between 2011 and 2014. Among the well-heeled, however, the percentage at high risk for heart disease fell from 12 percent to 9.5 percent.
The study also shows that disadvantaged Americans are as likely to smoke as they did two decades ago, but the number of high-income earners in the study’s sample who still light up declined by 5 percent.
“The findings related to income disparity and cardiovascular risk were alarming but not surprising,” says Robert Fortuna M.D., associate medical director of UR Medicine Primary Care. “Although multiple interventions exist to improve (blood pressure) control in low-income and minority populations, there is limited evidence that these interventions actually reduce disparities. When it comes to interventions to improve cardiovascular risk factors, a rising tide does not always lift all boats equally.”
Still, “In our community, there have clearly been interventions that have made improvements in cardiovascular risk factors in select and underserved populations,” Fortuna says.
As is the case nationally, improvement in heart health has not reached all economic classes in the Rochester area.
According to the High Blood Pressure Registry, which is maintained by Common Ground Health and includes clinical data from 60 percent of the population believed to have hypertension in Rochester’s nine-county region, the average high blood pressure control rate for those in poor neighborhoods was 70 percent as of last December compared to 82 percent in affluent neighborhoods.
That gap has led the High Blood Pressure Collaborative to launch programming beyond Get It Done, including health ministries now operating at 12 African-American churches.
“And we’re tracking those participants and seeing that when people have naturally occurring social networks, when there’s a foundation of trust already built among the participants, we see some positive changes in behavior,” Faticone says. The overall high blood pressure control rate among African-Americans in the High Blood Pressure Registry is much lower than that of participants in the health ministries, she adds.
Sparking meaningful change within the complex web of health disparities often means meeting people where they “live, work, play and pray,” says Marc Natale, executive director of the American Heart Association of Rochester and Buffalo.
“Social determinants of health really do underscore a lot of what we do in the community,” he adds.
One way the American Heart Association’s Rochester office interacts with the community is through its 800-square-foot teaching garden at the Freedom School on North Goodman Street, where students tend to crops such as collard greens, peppers, sage and squash.
“Parents are dropping the kids off and picking them up every day, so we’ve overlaid a blood pressure program,” Natale says. “So on Tuesdays at pickup or dropoff, parents can get their blood pressure taken and can get access to resources in the community if they don’t have a primary care provider.”
AHA does not track how many people have had their blood pressure screened at the Freedom School, but approximately 150 students participate in the summer program there, and the service is available to neighbors of the school, Natale says.
AHA also established a 2,050-square-foot teaching garden at East High School last year that now has a pollinator section in order “to provide education and emphasis on the importance of the interdependent nature of our food system,” Natale says.
He adds: “I find that Rochester is such a unique community. I mean, we are much more collaborative in nature. We are ahead of much of the health care curve, and I think for that very reason we tend to see a little more results” from community programming and partnerships.
But challenges still lie ahead.
“When we talk about class divide—when we talk about socioeconomics and social determinants of health, in particular—it’s not just saying to people, ‘You gotta eat more fresh fruits and vegetables.’” Natale says. “It’s so multifaceted. There’s food deserts; there’s limited income, there’s limited transportation to (health services); there’s need for improvement in (access to) better-paying jobs.”
Nevertheless, Rochester is in good stead to make heart health gains a reality for all, Natale says.
“We know that (focus) has to be interwoven in the fabric of everything across the community in order to make that class divide narrow,” he says.
Sheila Livadas is a Rochester-area freelance writer.
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