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Cardiovascular Medicine, Chronic Disease, Ethics, Health Disparities, Pediatrics, Public Health

Community violence can increase risk of heart disease

People living in violent communities are at a higher risk for heart disease, according to an article in the California Report. The article, which lists heart disease as the leading cause of death in West Oakland, an area that is home to a considerable amount of violence, explains that the chronically high stress levels that members of these communities experience can lead to cardiovascular conditions such as high blood pressure and diabetes.

That’s because stress triggers the release of the hormones adrenaline and cortisol, both of which affect blood pressure and other cardiovascular functions. These hormones are great when it comes to escaping temporarily stressful situations, like running away from a lion or an armed aggressor (mothers surging with adrenaline have been known to single-handedly lift cars off of their trapped children). These bursts of physical activity burn off the hormones that, by raising their heart rate, briefly made them both faster and stronger. But constantly high stress levels lead to a toxic build-up of these hormones, as Stanford’s Robert Sapolsky, PhD, has noted.

Constant exposure to violence, addiction, and the other stressors that can plague low-income communities like West Oakland, mean chronically high adrenaline and cortisol levels and therefore, for some, chronically high blood pressure and blood sugar that can lead to heart disease. Bay Area doctor Nadine Burke, MD, who is quoted in the article, notes that these effects are especially threatening to the children that grow up in violent communities.

That childhood trauma and community dynamics have long-term health effects is old news. But Burke feels that, in the case of children who suffer bad health as a result of being trapped in violent communities, passive observation is not enough:

“In my mind when I am looking at communities that are exposed to what I call very high doses of trauma and adversity, I think that historically our culture has wanted to say, ‘Those kids: they fail in school and they get into fights and they have awful outcomes and poor communities are more likely to have high blood pressure [and] heart disease,’” Burke says. “And we take that as conventional wisdom as if this is intrinsic to this population. I think that a lot of our community just kinda sees it as ‘that’s life’ or ‘that’s just how our community is.’ We accept some of these ideas as part of a community norm… I don’t accept it as a norm.”

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