For Elston Harris, heart attacks are a curse passed down through generations.

Several men on Harris’ father’s side, including her uncle, died of heart attacks. Harris, 59 and a former college basketball player, suffered a similar fate after suffering a heart attack himself in 2017. The only “minor” symptoms he noticed of his heart attack were pain in his back and gas retention.

For Harris, the curse may have turned into a blessing. While being treated at Advocate Trinity Hospital, a medical center on Chicago’s southeast side, he was referred to cardiologist Dr. Marlon Everett and given a “strategy” to follow. This includes focusing on putting God first, eating healthy, and getting medical checkups. But aside from Everett’s expertise, Harris said she was relieved because Everett looked like her.

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“If you’re African American or Black, you know, ‘Okay, he might have grown up here, he might eat this, or he heard them doing that.’ It’s easier to interact with people who are there,” Harris said. In Chicago. “So I feel much more at ease with people who are following in similar footsteps.”

According to the American Heart Association, about 60% of black adults in the United States have heart disease, and black Americans have the highest death rate from heart disease compared to other races and ethnicities.

But the experience of having a cardiologist who looks like Harris is rare. Only 4.2% of cardiologists are Black, according to a 2021 report by the Association of American Medical Colleges. A previous study published in the journal JAMA Cardiology in 2019 had similar findings, finding that Black physicians make up just 3% of the cardiologist workforce. The same report found that 51% of cardiologists were white and 19% were Asian.

Increasing the number of Black cardiologists could mean improved heart health for Black patients.

“Underrepresented health care professionals are more likely to practice in communities where cultural sensitivity can engender trust, and their presence is proven to improve outcomes,” the AHA said on NBC. said in a statement to the news. “When it comes to heart health, this connection is especially important among Black Americans.”

Why are there so few black cardiologists?

Dr. Mary Branch, a cardiologist based in Greensboro, North Carolina, first entered cardiology about 20 years ago after observing a white interventional cardiologist who was “very accepting of me.” He said he was interested. Her path to becoming a cardiologist is steep, requiring four years of medical school, three years of internal medicine residency, three years of cardiology fellowship, and several board exams, which she says can be difficult to follow. Told.

Branch, a fourth-generation physician, said his path has also included financial strain and discrimination, hurdles that are all too common for Black medical students, and one of the reasons why said there’s a reason there are so few black doctors in cardiology.

Ms. Branch is the first Black woman to join the cardiovascular disease fellowship at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina. At one point during her fellowship, she said, she lived in a hotel while looking for safe housing.

Branch said she “still shows up” to social gatherings even though she doesn’t have a place to stay. “Really, it’s just God saying you need it,” she said. “So we have to go on. But it meant a lot of hard choices.”

Branch said many Black medical students can experience severe microaggressions that can prevent them from becoming cardiologists.

The margin of error for black trainees can be “very small,” she says. A 2006 study published in the Journal of the National Medical Association found that most medical students and residents of all races felt treated poorly, but blacks were more likely than whites to He said he felt more stress at medical school. Their perceived stress stems from their minority status and their experiences of racism during training.

A 2021 study published in the Journal of General Internal Medicine found that the proportion of Black physicians in the United States has increased by only 4 percentage points over the past 120 years. The study also found that the proportion of black male physicians has remained unchanged since 1940. There is little data on the representation of black women in cardiology, but according to The Lancet’s 2021 Outlook, they make up just 2.8% of the physician workforce. .

Everett, a member of the Association of Black Cardiologists, a national organization that draws attention to the negative impact of heart disease on Black people, cited a lack of adequate training programs for doctors who want to become cardiologists. Most cardiology programs may only have three or four cardiology training positions, but “we’re just not getting those training positions,” he said. Told.

“Until we have programs that mandate diversity in training programs, we will never achieve much inclusivity, especially in sought-after training programs such as cardiology,” Everett added.

The organization is also responsible for recruiting black patients to clinical trials where black participants are underrepresented. A 2021 study published in the Journal of the American Heart Association found that Black adults were underrepresented in cardiovascular clinical trials funded by the National Institutes of Health.

That could mean doctors don’t have the best information available about how to treat Black patients.

“It’s really important to get more Black patients into trials so we can get better data. More data means better information and, hopefully, better outcomes.” said Everett.

“Feeling safe”

For many Black patients, having a Black cardiologist creates a sense of trust and security, which can be difficult due to a history of racism and mistreatment of Black patients in the health care system.

Nikita Ochsner first examined Branch last year after doctors discovered that Branch had a heart murmur, detected during a sleep study. Ochsner, 45, said she had never previously sought care from a cardiologist and was “scared” to even be referred to one. However, her fears were put to rest when she met Blanche.

After treating Blanche, Ochsner discovered that she had a disease that made it difficult for her heart to pump blood.

Ochsner’s family has had heart-related problems. In 2019, her brother died suddenly at the age of 31 due to high blood pressure, and her grandmother died at the age of 77 from heart disease. Her father, who died of cancer at age 39, “had high blood pressure for most of her life.” she said.

Ochsner said that when he told Branch details about his brother and other family members, “she understood right away.” Ochsner “didn’t feel good” about undergoing surgery to have a defibrillator inserted into her heart, but she trusted her doctor’s opinion.

“She was very caring,” said Ochsner, who lives in Greensboro, North Carolina. “She was very understanding, down-to-earth and approachable, and really helped me understand how this was going to change my life.”

Ochsner said that as a Black woman who often has to advocate for her own health, the fact that Blanche is also a Black woman “was important to me.”

Blanch said the added layer of trust and reassurance that is common between Black patients and Black doctors can motivate patients to stay on their heart medications and continue making healthy lifestyle changes. said.

For example, “hypertension is a huge problem in our community,” she said. Black cardiologists may also be treated for high blood pressure, “so they can empathize and connect in that way,” she said.

Like Ochsner, Kia Smith, 42, is a black woman who sought cardiac care from a black doctor. Smith, who lives in Ellenwood, Georgia, said she consulted Dr. Camille Nelson, a cardiologist at Atlanta Heart Associates, after she experienced an increase in her heart rate in 2020. said. She believes that if she had chosen a non-Black cardiologist, she would have been treated like a “dramatic jumper” and her symptoms would have been ignored, Smith said. she said.

“Every time I had a concern, she didn’t ignore my concerns or personal experiences,” Smith said of Nelson. “She also explained everything scientifically, which helped me get to a point where I felt confident that I was going to be okay.” Nelson said Smith’s symptoms were caused by stress. He said it was possible and recommended training habits to make the heart healthier.

Dr. Zainab Mahmoud, a cardiologist and lecturer in medicine at Washington University in St. Louis, said many Black women say they feel heard and understood under her care. Having a provider who understands the experiences of Black patients “creates this kind of trust and improves the patient-provider relationship,” she says.

“Then they are more likely to have their family come and have their family and friends come to see me as well,” Mahmoud added. “I’ve seen that happen more times than I can count.”

Get more black physicians into cardiology

Increasing the number of Black cardiologists has become a focus of major health organizations in recent years.

AHA’s Scholars Program provides cardiology resources to Black students at historically Black colleges and universities where more than 70% of Black health care professionals earn degrees.

The organization is also committed to broader efforts, saying in a statement that strong education will help develop the next generation of Black doctors, nurses and researchers. One major goal is to increase the number of Black students enrolled in graduate science, research, and public health programs.

Similar to the AHA, the American College of Cardiology has implemented diversity efforts through internal medicine programs to bring Blacks, Latinos, and other underrepresented groups into cardiology.

“The problem is that it’s not just heart disease,” says Dr. Melvin Echols, director of diversity, equity and inclusion at ACC. “It’s all about health care. We see that the percentage of African American physicians is significantly, very low. What we’re trying to do is, number one, make sure that people actually have access to information and resources. I think it should make it easier.”

Harris, who survived a heart attack in 2017, said it was “by the grace of God” that he ended up at Advocate Trinity Hospital, where he had a cardiologist he trusted when his life was on the line.

“He was there during my episode, and we immediately developed a relationship after that,” Harris said of Everett, a cardiologist. Ms Harris has been in his care “since then”.