Heart guidance for American Indian, Alaska Native women

Dr. Jason Deen, a cardiologist and Blackfeet nation descendent, lends context to the new AHA statement he co-authored.

The American Heart Association today published guidance for clinicians who provide maternal care to members of the American Indian and Alaska Native (AIAN) communities. [See the AHA’s news release.]

“I think this inaugural report on cardiac disease reflects the AHA’s recognition of the distinct characteristics of this population. Our target audience is anyone who cares for Native communities in the United States, in particular primary care physicians within Indian country or cardiologists who might see these patients,” said statement co-author Dr. Jason Deen, a UW Medicine pediatric cardiologist who practices at Seattle Children’s Hospital.

The AHA paper offers recommendations to clinicians about how to counsel American Indian and Alaska Native women to lead heart-healthy lives — framed in context of the unique constellation of risk factors that confront these communities in pregnancy and in life. 

“There are measurable health disparities in cardiovascular disease prevalence and outcomes in American Indian and Alaska Native women,” Deen said. “These all are centered around the social determinants of health, which for this population are mainly a result of systemic racism.”

Deen is a descendant of the Blackfeet nation and director of the Indian Health Pathway at the University of Washington School of Medicine. He shared a patient vignette to describe Indian communities’ generational cycle of disease risk:

“We see a lot of American Indian and Alaska Native women with underlying risk factors entering pregnancies. For instance, if a woman’s diabetes is poorly controlled during pregnancy, her baby is usually born with an increased body size, which creates a childhood risk for obesity.

“This is the embodiment of generational transmission of the adverse effects of racism. It’s what a lot of black and brown communities experience. These guidelines are part of the effort to interrupt that cycle — not just for a woman’s health now, but for the next generations. It’s focused on community health as much as individual health.”

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Tags:heart diseasecardiologyAmerican Indian / Native Americanheart health

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