Heart Disease and Women

Literature Review

Heart disease is the most common cause of death in American women (Centers for Disease Control and Prevention, 2019). 400,00 women succumb to cardiovascular disease (CVD) per year, 1,080 per day, and one death every 80 seconds; heart disease also kills more women than all cancers combined (Women's Heart Alliance, n.d.). According to womenhealthcare.gov, CVD is caused by plaque build-up in the arteries preventing oxygen from getting to the heart. Heart failure, irregular heartbeat, atrial fibrillation, and heart valve disease are the most common types of heart health issues facing women (Womenshealth.gov, 2017). Heart disease is sometimes referred to as the silent killer and goes undiagnosed because "women often experience no symptoms or have different symptoms than men do" (NIH, n.d.).

Women have specific risk factors that make them more susceptible to the deadly disease and are at higher risk due to conditions such as endometriosis, gestational diabetes, polycystic ovary syndrome, preeclampsia, and early menopause. The National Institutes of Health, National Health, Lung, and Blood Institute (NHLBI) state, "About 80% of women from the ages of 40-60 have one or more risk factors for heart disease" (NIH, n.d.). Risk factors include high blood pressure, high blood cholesterol, family history, genetics, environmental factors (specific to certain occupations), race, ethnicity, and age (risk increases after age 55). Dr. Jennifer Mieres, a spokeswoman for the American Heart Association and director of nuclear cardiology at the New York University School of Medicine, found that metropolitan areas in the South and the Midwest are the least friendly cities for women's heart health. "The heart-unhealthy cities seem to share some things in common, Mieres said, like a plethora of fast-food restaurants, a tendency for people to drive instead of walk, and high smoking rates" (Dotinga, 2008).

Prevention is the key if women are to take action and reverse these fearsome trends. Government websites and non-profit organizations promote a heart-healthy lifestyle and encourage women to embrace moderate aerobic activity, stress reduction techniques, increased sleep, avoiding alcohol and smoking, and adopt healthy eating habits to lower blood pressure, cholesterol, and sugar levels.

The Women's Heart Alliance

In 2012, Ronald O. Perelman, CEO of MacAndrews & Forbes, and activist Barbara Streisand co-founded the Women's Heart Alliance (WHA), a non-profit organization headquartered in Washington, D.C. The organization's mission is to "Stop women's cardiovascular disease by promoting gender equity in research, prevention, awareness, and treatment" (Women's Heart Alliance, n.d.). Streisand talks about what motivated her to start the Women's Heart Alliance:

I was staggered to learn about something called "the Yentl syndrome" — a phrase coined in 1991 by then-director of the National Institutes of Health Bernadine Healy to illuminate a medical disparity. Healy found that women who had heart attacks were not getting the same quality of care as men. Misdiagnosed or under-treated symptoms explain why, for the past 30 years, more women than men have died of heart disease. (Streisand, 2015, para. 2).

The Women's Health Alliance emphasizes that most medical research and treatments are focused on men, which motivates the organization's goal to raise awareness and impact change within the medical research community. Streisand argues the need to "improve access to quality of care… create curriculum reform in medical schools so that doctors and other health care professionals have a better understanding of women's hearts…[and conduct] more research on sex differences in heart disease" (Costello, n.d., para. 14). The organization addresses the lack of education and gaps in awareness, prevention, diagnosis, and treatment with regard to CVD. Figure 1 shows the results of the survey. The research (Merz et al., 2017) concluded:

• There are significant knowledge gaps for women and a general lack of awareness of the risks of CVD.

• Those who had a personal connection to the CVD were more inclined to make the disease a priority.

• Heart disease is a stigmatized issue, and many women do not address it with their PCPs.

• Heart disease is not a priority for physicians, heart health assessments are not routine, and PCPs are not prepared to assess CVD.

WHA Strategic Communication Plan

The Women's Health Alliance requires an integrated strategic communication plan centered around women's heart disease and a national-level awareness campaign. The overall goal is to increase general awareness of this health crisis and have the medical community acknowledge gender differences. The communications objectives are to:

1. Increase awareness and encourage women to participate in health checks.

2. Change behaviors and reverse the stigma and stereotypes.

3. Educate the medical profession on the need to conduct more research on sex differences and increase risk assessments.

4. Improve access to quality care.

Target Audiences 

It's critical with any communications strategy first to identify the specific target audiences we need to reach to meet the stated objectives. The communication objectives focus on how the target audiences need to think, feel, or act after exposure to the campaign messages. The national-level awareness campaign has four key publics:

1. High-risk groups. Minority women over 40 who need access to information and quality care.

2. Primary care physicians. Educate PCPs and ensure they conduct the assessment of women's heart health as part of routine visits.

3. U.S. Congress. Advocate for increased government funds and research devoted to women and heart disease.

4. WHA Advisory Board members and donors. Individual and corporate donors who contribute to the non-profit must receive consistent information about the organization's activities.

Recommended Strategies and Tactics

The Women's Health Alliance leverages its website, social media channels, and strategic partnerships with public and private sectors to reach the target audiences. Still, they could do more to reach their strategic goals. Analysis of the research data indicates the organization must execute certain initiatives:

1. Capitalize on the name recognition of its co-founder Barbara Streisand and lobby Congress for more research dollars and increase the frequency of her online engagements.

2. Improve physician education, reform the curriculum in medical schools, develop a Public Service Announcements (PSA) video testimonial, and leverage Google online ads to target locations where physicians spend time online.

3. Partner with employers named on Forbe's America's Best Employers For Women 2020 that best align with the WHA mission to co-brand an internal #getHeartChecked campaign because women are more receptive to receive messages from friends and co-workers.

4. Develop an educational prevention program with state universities located in metropolitan areas with the highest obesity rates.

References 

About the Women's Heart Alliance. (n.d.). Women's Heart Alliance. Retrieved from https://www.womensheartalliance.org/about/.

America's Best Employers For Women 2020. (n.d.). Forbes. Retrieved from https://www.forbes.com/best-employers-women/.

Centers for Disease Control and Prevention. (2019, November 20). Leading Causes of Death-Females-All races/origins. Centers for Disease Control and Prevention. https://www.cdc.gov/women/lcod/2017/all-races-origins/index.htm

Coronary Heart Disease. National Institutes of Health, National Health, Lung, and Blood Institute (n.d.). Retrieved from https://www.nhlbi.nih.gov/health-topics/coronary-heart-disease.

Costello, P. (n.d.). Barbra Streisand on the Women's Heart Alliance and cardiovascular health. Stanford Medicine. Retrieved from http://stanmed.stanford.edu/2017spring/barbra-streisand-on-the-womens-heart-alliance-and-cardiovascular-health.html.

Dotinga, R., (2008, May 19). Minneapolis Tops List of Heart-Healthy Cities for Women. ABC News. Retrieved from https://abcnews.go.com/Health/Healthday/story?id=4885062&page=1.

Heart disease and women. (2017, February 3). Womenshealth.Gov. Retrieved from: https://www.womenshealth.gov/heart-disease-and-stroke/heart-disease/heart-disease-and-women.

Listen to Your Heart: Learn About Heart Disease | NHLBI, NIH. (n.d.). Retrieved from https://www.nhlbi.nih.gov/health-topics/education-and-awareness/heart-truth/listen-to-your-heart.

Merz, B., Noel, C., Andersen, H., Sprague, E., Burns, A., Keida, M., Walsh, M. Norine, Robinson, British. (2017). Knowledge, Attitudes, and Beliefs Regarding Cardiovascular Disease in Women: The Women's Heart Alliance. Journal of the American College of Cardiology, 70(2), 123-132.

Streisand, B. The battle for women's hearts—And lives—The Washington Post. (2015, April 10). Retrieved from https://www.washingtonpost.com/opinions/the-battle-for-womens-hearts-requires-open-minds/2015/04/10/6437825e-de1e-11e4-be40-566e2653afe5_story.html?hpid=z3&utm_term=.2ca56552f371.