Trevor Atherley, MD, FACC FRCP (C)

February has been celebrated as American Heart Month since 1964 following a proclamation by President Johnson two months earlier. The American Heart Association supports this decision, which reminds us to focus on our hearts and to encourage friends, family and communities to improve their health by choosing heart healthy lifestyles

Did you know that people who have close relationships at home, workplace, or in their community tend to be healthier and live longer? One reason, according to the National Heart, Lung, and Blood Institute (NHLBI), is that we’re more successful at meeting our health goals when we join forces with others.

Cardiovascular disease includes diseases of the heart and blood vessels and accounts for more deaths annually in the USA, than all forms of cancer and chronic lung disease combined.

Heart disease is the leading cause of death for adults in the USA claiming 695,000 lives each year, that is 1 of every 5 deaths. Heart attacks are the most notable form of heart disease; every 40 seconds someone in the United States has a heart attack and 1 of every 5 heart attacks occurs without the person being aware of it.

 Half of all African American adult men and women have some form of heart and cardiovascular disease.  Heart disease affects men and women almost equally, in fact fewer women than men survive their first heart attack.

It is important therefore for us all to recognize and adopt methods of diminishing our chances of developing heart disease and where heart disease is already present to minimize death and suffering caused by it. About 90 percent of middle-aged people have one or more risk factors for heart disease, such as diabetes, high blood pressure, high blood cholesterol, or being a smoker or overweight. Having multiple risk factors increases your risk of heart disease.

WARNING SIGNS OF A HEART ATTACK

Catch the signs early

Don’t wait to get help if you experience any of these heart attack warning signs. Some heart attacks are sudden and intense. But most start slowly, with mild pain or discomfort.

Pay attention to your body and call 911 if you experience:

1. Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes – or it may go away and then return. It can feel like uncomfortable pressure, squeezing, fullness or pain.
2. Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.

Sometimes heart attacks may occur with uncommon symptoms.

1. Shortness of breath. This can occur with or without chest discomfort.
2. Other signs. Other possible signs include breaking out in a cold sweat, nausea or lightheadedness.

Symptoms vary between men and women

As with men, women’s most common heart attack symptom is chest pain (angina) or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.

Learn the signs for heart attack and remember: Even if you’re not sure it’s a heart attack, have it checked out.

Minutes matter. Fast action can save lives - maybe your own.

Call 911 if you experience heart attack warning signs. Calling 911 is almost always the fastest way to get lifesaving treatment.

An emergency medical services (EMS) team can begin treatment when they arrive – up to an hour sooner than if someone gets to the hospital by car. EMS staff are also trained to revive someone whose heart has stopped. Patients with chest pain who arrive by ambulance usually receive faster treatment at the hospital, too.

For many reasons, it’s best to call 911 so that an experienced EMS team can begin treatment and arrange rapid transport to the emergency room.

Why don’t people act fast enough

 Many people having a heart attack wait more than two hours before getting help. Some people feel it would be embarrassing to have a “false alarm.” Others are so afraid of having a heart attack that they tell themselves they aren’t having one. These feelings are easy to understand, but they’re also very dangerous. If you or someone close to you shows signs of a heart attack, call 9-1-1 and get help right away!

How can I help to avoid a heart attack?

1         Don’t smoke and avoid second-hand smoke.

2         Treat high blood pressure if you have it.

3         Eat foods that are low in saturated fat, trans fat, sodium (salt) and added sugars.

4         Be physically active.

5         Reach and maintain a healthy weight.

6         Control your blood sugar if you have diabetes.

7         Get regular medical check-ups.

8         Take medicine as prescribed.

You don’t have to make big changes all at once. Small steps will get you where you want to go.

Trevor Atherley, MD, FACC FRCP (C)

Angela Vaughan MBA,BSN.RN

Where can you find information about Paid Caregivers?

We are witnessing more and more Baby Boomers with chronic illnesses opting to stay home versus moving into the nursing homes. The problem is who in the family can afford to remain available and manage their responsibilities. In the US, it has been recognized that in the past caregivers would graciously sacrifice their income to care for their loved ones.

How To Become A Paid Caregiver For A Family Member – Forbes Health states:

“As more baby boomers enter their golden years, the need for caregivers and care partners continues to grow. In fact, about 48 million Americans provide unpaid care to an adult family member or friend, a number that has increased by 8 million between 2015 and 2020, according to the National Alliance for Caregiving and AARP’s Caregiving in the U.S. 2020 study.[2”

In many ways providing this type of full-time care is economically reasonable but hard on the caregiver financially. In recognizing the benefits of having a family member care for the person,  Medicaid and Veteran Affairs  have a program to pay the Caregiver for providing various tasks.

It is not easy finding information regarding paid caregivers for any state. With a little research, here is the link that will bring you a step closer to finding out the department you need to contact: https://www.medicaid.gov/about-us/where-can-people-get-help-medicaid-chip/index.html

For anyone reading this article and live in NJ, please refer to Resources for Caregivers (nj.gov):

Jersey Assistance for Community Caregiving (JACC)

Jersey Assistance for Community Caregiving (JACC) is a program that provides in-home services to seniors aged 60 and over who require a nursing facility level of care but wish to remain in their homes. Qualified individuals may have the opportunity to hire their own eligible family, friends, or neighbors to provide the care they need.

Services available through JACC include the following: care management, personal care assistance, caregiver relief (respite), home modifications, special medical equipment and supplies, chore services, personal emergency response system, home-delivered meal services, social adult day care, and transportation. JACC has a monthly co-pay based on the participant’s (and spouse’s) income. For more information, visit: https://www.nj.gov/humanservices/doas/services/a-k/jacc/

Angela Vaughan MBA,BSN.RN

July is BIPOC Mental Health Awareness Month

Dr. Brenda Boatswain

Trigger Warning: racism, abuse, oppression and hate crimes affect our mental health

Black, Indigenous, and People of Color (BIPOC) communities have faced historical injustices, racism and oppression which have been shown to affect both our physical and mental health. BIPOC communities have also demonstrated resilience, tenacity and triumph in the face of such adversity. BIPOC Mental Health Awareness Month is a time to acknowledge and bring awareness to both realties.

The true mental illness we often see today is racism and the effects of racism. Everyone is encouraged to be aware of racism and its effect on the health of all Americans, especially those who are BIPOC and from oppressed and underestimated populations. We use this awareness to heal and work together to dismantle systems of oppression that research shows are detrimental to our health and well-being.

The mental health effects of racism may include experiencing the following:

• Sad, depressed, or have suicidal thoughts
• Anxiety and vigilance, on guard for the next discriminatory experience
• Internalized racism (believing negative messages about BIPOC populations) and decreased self-worth
• Pessimistic and hopeless about the possibility of change
• Distress and post-traumatic stress
• Anger
• Lack of energy for planning, thinking, and coping
• Increased likelihood of using alcohol and substances

Each year, mental illness affects:

-14% of Asian adults

- 17% of Black adults

- 17% of Native Hawaiian/Pacific Islander adults

- 18% of Hispanic/Latinx adults

- 19% of American Indian/Alaska Native (AI/AN) adults

- 36% of multiracial adults

- 47% of LGB adults

Data on BIPOC mental health can be found on the Mental Health America website: https://www.mhanational.org/bipoc-communities-of-color

Talking with a culturally competent and responsive licensed mental health professional helps. We talk and share our stories to replace abuse, oppression, and trauma with triumph, hope, and healing. We heal so our families and communities can remain healthy and strong. The takeaway message is that you are not alone. Support and help are available to support your mental health and well-being.

Resources

988- Using 988 is free. When you call, text, or chat 988, your conversation is confidential. 988 provides you with judgment-free care. Talking with someone can help save your life. Specialized counselors can address Black mental health; attempt survivors; youth; Native American, Indian, Indigenous & Alaska Natives; maternal mental health; Veterans & Service members; deaf, hard of hearing, & hearing loss individuals; individuals with neurodivergence; disaster survivors; loss survivors; LGBTQI+ individuals; and more. Available in over 200 languages.

Resources to connect to individual therapy can be found here: https://www.mhanational.org/racial-trauma

Resources for free group support can be found here: https://www.nami.org/support-education/support-groups/

Sources:

https://www.mhanational.org/racial-trauma

https://www.nami.org/advocacy/policy-priorities/supporting-community-inclusion-and-non-discrimination/mental-health-inequities-racism-and-racial-discrimination/

https://omh.ny.gov/omhweb/disaster_resources/webinar-addressing-grief.pdf

https://omh.ny.gov/omhweb/cultural_competence/the_mental_health_effects_of_racism.pdf

 Dr. Brenda Boatswain

June is Men’s Health Month: An opinion piece

Alecia Thompson-Branch, MD

June is Men’s Health Month. I would have celebrated the men in my life with a hug, and a gentle reminder to make an appointment to get those essential health screenings that sometimes without encouragement would be delayed or not be performed at all. I would have donned a blue ribbon on my clothing to spark conversation and remind the men that I came into contact with to be mindful of their health and get regular preventative care. I would have recommended routine physical exams including blood pressure checks, cholesterol, diabetes, and electrocardiogram, depression, hepatitis and HIV screening. For men over 50 years old, a rectal exam of the prostate gland and a colonoscopy are recommended and performed even earlier if there is a significant family history or concerning symptoms.1 June is Men’s Health month.

My heart is heavy. Recent weeks have proven challenging. Instead of promoting men’s health with my usual vigor, I find myself enraged and aghast at the video of Amy Cooper in Central Park, breaking the law but having the audacity to use “white privilege” when called to task by a black man who was bird watching, saying “I’m going to tell them an African-American Man is threatening my life.”2 At least she called him a man. I find myself crying unstoppably at the unspeakable image of a black man, his neck being pressed into by the knee of a police officer, crying out “I can’t breathe” for 8 mins and 46 seconds, and then, he lays still.3 Was he too not a man? I’m drawn to the sunglasses casually perched on top of his killer’s head. My Black son asked with concern “Mommy, why are you crying?” Another life lost meaninglessly. June is Men’s Health Month.

As a mother of 2 black sons, and wife to a black man, I was horrified. While these threats to Afro-descended people, especially men, are widely known in the Black community, to witness it in such stark clarity, for the abject racism it was, left me almost bereft of hope that progress had been made since the Civil Rights Movement in the 60’s. Had we simply masked the lynchings and the cross burnings with other forms of hurting, isolating and making vulnerable the black community? The short answer is yes. African American men have higher rates of death from heart disease, the number one killer of adults in the US.4 They also have higher rates of arrests and dying under violent circumstances at the hands of police compared to other races.5 It seems a lot to ask for Afro-descended men to worry about diseases and health conditions that may cause them to die in the long term like heart disease, when they are preoccupied with simply surviving their blackness. June is Men’s Health Month.

The list of African-American men to die at the hands of police is not short. Being black portends a higher risk for death for many different diagnoses: heart disease, hypertension, stroke, kidney disease, diabetes, asthma, lung and prostate cancer.^6,7,8 The reason for this discrepancy may be multifactorial, related to lower socio-economic status, or otherwise undetermined social or genetic factors. Being black also puts a man at higher risk of death by police. While we campaign to alert men to the need to perform preventative health assessments during this month, we must take the opportunity presented by the recent racially-based occurrences to address other systemic injustices, abuse of “white privilege,” and criminalization of Afro-descended men.9 June is Men’s Health Month.

The outpouring of support for the African American community and the attention drawn to social disparities, like the Civil Rights movement back in the 1960’s, I hope will galvanize multi-cultural collaboration, discussion, policy implementation and subsequently offer long lasting and meaningful change. Everyone has biases, racial or otherwise. However when the biases are racially-based and result in the systematic killing of unarmed Black men by “officers of the law”, open dialogue and change is mandatory. When a white woman feels very comfortable on camera purposefully making false allegations and specifically mentions race as an inciting factor, change must occur. When Miss Cooper herself doesn’t even view the incident as an act of racism, one that could have had potentially disastrous effects and resulted in false arrest, or physical harm at the hands of police, change must come. The psychological impact of being an African American male in a world where your skin color automatically casts suspicion cannot be overlooked. How does one even begin to quantify the degree of stress that this imparts throughout the course of one’s life and account for its impact on health outcomes? June is Men’s Health Month.

The public forum through which these incidents were revealed to the world, hurtful as they may be to watch, was essential in bringing to light what Afro-descended peoples have been experiencing for generations. Through open conversation with our multi-racial colleagues and friends, we can become aware of our own internal biases and force others to give voice to their preconceived notions and explore them; we can permit people to openly speak to their fears; we can have conversation about presumed or real differences and stereotypes among racial, religious and cultural groups. These conversations are essential in order to minimize fear, expand knowledge, and mitigate reliance on stereotypes to inform us of how we act when interacting with a member of another race/cultural/religious group. How do doctors, especially non-Black physicians relate to African American men? How are they engaged in order to build trust? The Tuskegee Syphilis trial is not a figment of our imagination.10 How do you counsel someone about their health when you may have pre-conceived notions about who they are, and perhaps they as the patient has a concern that they will not receive fair and equitable care, that health information is not being divulged or being used for something other than what is stated? With racial and social biases at play how do we form a truly therapeutic alliance that leads to optimal care for a population that is in the highest risk stratification for many diseases? The task ahead is not easy. Let’s talk, let’s learn, let’s advocate. June is Men’s Health Month.

References
1. https://brighamhealthhub.org/prevention/10-essential-health-screenings-for-men
2. https://www.nytimes.com/video/us/100000007159234/amy-cooper-dog-central-park-police-video.html
3. https://www.nytimes.com/2020/05/31/us/george-floyd-investigation.html
4. https://www.cdc.gov/nchs/hus/spotlight/HeartDiseaseSpotlight_2019_0404.pdf
5. https://www.statista.com/chart/21872/map-of-police-violence-against-black-americans/
6. https://www.cdc.gov/vitalsigns/aahealth/index.html
7. https://abcnews.go.com/Health/diseases-common-minorities/story?id=14722258
8. https://www.kidney.org/news/newsroom/factsheets/African-Americans-and-CKD
9. https://www.cbsnews.com/news/white-privilege-racism-ibram-x-kendi-robin-diangelo/
10. https://www.tuskegee.edu/about-us/centers-of-excellence/bioethics-center/about-the-usphs-syphilis-study

Alecia Thompson-Branch, MD