Rita—a 42-year-old branch manager, wife, and mother of two—is stunned to learn she has stage 2 hypertension. Though she exercises regularly and has given up salt, her blood pressure is dangerously high. Her doctor recommends medications and stress management to help prevent heart disease or stroke. He doesn’t mention that Rita, a Black woman, is at higher risk of hypertension from chronic stress.
Hypertension is common but disproportionately affects Black communities
Alarmingly common, hypertension affects nearly half of US adults (48%) and 3 in 10 employees, more than depression (2 in 10 employees) and diabetes (1 in 10 employees). But hypertension is even more prevalent among non-Hispanic Black adults in the US, affecting 56%, compared to 46% of non-Hispanic Asian adults, 48% of non-Hispanic white adults, and 39% of Hispanic adults.
“Weathering” is one of the reasons for the health disparity, research shows. Coined by public health researcher Dr. Arline Geronimus, “weathering” refers to the accelerated deterioration of health among people who endure repeated exposure to acts of discrimination and racism throughout their lives—microaggressions at work, for example, or gun violence against Black males. While everyone experiences stress in their lives, people in Black and other marginalized communities experience unique and constant stressors in a race-conscious society.
Research has shown that attempting to cope with or withstand acute and chronic stressors can have a significant negative effect on mental and physical health that accumulates over time. Among white and Black populations, Black women are at highest risk for stress-related conditions such as hypertension, followed by Black men.
Hypertension can wreak havoc on health and healthcare costs
What’s more, hypertension is a major risk factor for several serious conditions. Left untreated, hypertension can damage the heart, brain, arteries, kidneys, and even eyes. Aneurysm, coronary heart disease, heart failure, and stroke are some of the potentially catastrophic consequences of unmanaged hypertension. From 2017 to 2020 in the US, 59% of non-Hispanic Black women and 58.9% of non-Hispanic Black men had some form of cardiovascular disease.
These conditions, in turn, wreak havoc on healthcare costs. Heart disease and stroke are leading causes of disability and death in the US and among the most costly for employers. On average, an employee with hypertension costs $3,500 more in annual healthcare costs than an employee without hypertension. On top of that, lost productivity due to hypertension costs an average $462 per employee per year.
At a macro level, between 2019 and 2020, the costs of heart disease, stroke, and other cardiovascular diseases (total CVD) were $254.3 billion in direct costs and $168.0 billion in lost productivity/mortality.
More strategies are needed to help people control blood pressure
Unfortunately, most people with hypertension don’t have it under control, including those for whom taking blood pressure medication has been recommended, and disparities exist here, too. Blood pressure control is lower among non-Hispanic Black adults (25%) than among non-Hispanic white adults (32%).
To reduce the burden of hypertension and CVD, the CDC recommends that employers take a multifaceted approach to supporting employee health, including doing the following:
- Implementing workplace health promotion programs focused on helping employees manage cholesterol and high blood pressure. The CDC’s Employer’s Guide outlines a process that begins with assessing employee health conditions and risks and how workplace culture could be affecting employee health.
- Fostering a healthy work environment that supports flexible work hours and work-life balance.
- Offering stress management programs that include mindfulness resources and mental health support to help employees manage stress and build resilience.
- Ensuring health plan coverage for medications, such as cholesterol/lipid control medications, blood pressure control medications, and home blood pressure monitoring devices with no or low out-of-pocket costs.
- Offering lifestyle coaching and monitoring for employees with high blood pressure, prehypertension, or high cholesterol.
- Encouraging physical activity and healthy eating by fostering a workplace culture that supports taking breaks for movement, offering healthy food options, and providing educational programs on healthy lifestyle choices.
- Offering smoking cessation programs and a smoke-free workplace.
- Providing home blood pressure monitors to employees with hypertension and reimbursing clinicians for support services required for self-measured blood pressure monitoring.
Add hypertension support for Black employees and their families
Employers can go a step further and add targeted support to promote the health and well-being of Black employees and their family members. Black communities historically have experienced barriers to mental health care, including bias, stigma, and lack of culturally competent providers. Today, only one in three Black adults with mental illness receives treatment.
Digital mental health apps can break through these barriers and address challenges unique to Black communities, including weathering.
Calm Health offers culturally relevant, evidence-based support for Black employees with hypertension
Hypertension & Health for Your Black Wellness is a stress-management program designed to foster emotional well-being among African Americans with hypertension through evidence-based practices and culturally relevant exercises.
Developed by clinical psychologist Dr. Tiffany G. Townsend and narrated by actress and voice-over artist Jameelah McMillan, the Calm Health program uses proven, research-backed strategies that may help listeners reduce stress, refocus their thoughts, and lead a healthy, meaningful life. Sessions include the following:
- Let’s Talk About High Blood Pressure
- Working with Hypertension: A Holistic Journey
- Rewriting Your “Stress Story”
- Stress While Being Black in America
- Facing Race-Related Stress with Dignity
- Self-kindness: The Real Superpower
- Stress Less by Letting Go of Mental Hooks
- Unleashing the Power of Problem Solving
- Holistic Wellness and Spiritual Connections
- Guided Breathing and Other Relaxation Tools
Dr. Townsend educates listeners about the effects of stress on the mind and body and how holistic practices, such as deep-relaxation techniques and mindfulness strategies, may help reduce stress. The goal of the program is to empower people like Rita with the knowledge and tools to support their health and well-being.
American Heart Month and Black History Month are the perfect time to take action
February, which honors both heart health and our country’s Black history, is the perfect opportunity to explore how you can better support Black employees struggling with hypertension. By taking a proactive, culturally relevant and holistic approach, you can advance health equity and support better health and cost outcomes.
For more information on proactively supporting employee mental health and well-being, check out our pricing or connect with a Calm specialist today.
