The American Dream states that you’re free to create your own vision of prosperity and success, no matter where you come from. But for some Black Americans, this dream is harder to achieve due to racial inequalities that impact their mental and physical health. Below, Dr. Victor Nwanguma, SMGOR infectious disease specialist, talks about chronic health conditions impacting Black individuals today and steps that can be taken to reduce risk.

Heart Disease

Heart disease is the leading cause of death in the United States and the number one killer of Black Americans. Related risk factors include environmental stress, hypertension, obesity, and high cholesterol. Even though the overall death rate has declined over the past two decades, a higher number of younger Black individuals are suffering from cardiovascular diseases that are more common in older white Americans.


Diabetes is the inability of the body to regulate blood sugar. While the disease process is complicated, studies show obesity and a sedentary lifestyle play a significant role. Black American females are being diagnosed with type 2 diabetes at almost twice the rate of white women, according to data from the Centers for Disease Control.


It’s true that survival rates for different types of cancers have improved across the board owing to innovative therapies and increased awareness. However, socioeconomic barriers specific to Black Americans such as lack of health insurance and low health literacy often prevent early detection and treatment. Black American males represent the highest documented incidence and mortality rates in cancers of the prostate, while breast cancer mortality in females was reported to be 41% higher than white women in 2014.


Black individuals make up a smaller percentage of COVID-19 cases, yet, have a significantly higher death rate due to limited access to health care, poverty, as well as urban segregation. “Black Americans suffer from chronic medical conditions such as obesity, hypertension, heart disease, and cancer at higher rates as well,” notes Dr. Nwanguma, “making them at higher risk to have poor outcomes.” Lastly, medical distrust—stirred up by tragedies such as the Tuskegee Experiment—also plays a critical role as Black Americans are more likely to be skeptical of scientific data and thus less likely to accept services such as administration of the COVID-19 vaccine. “But, I strongly recommend members of the Black American community to speak to their health care providers about receiving the COVID-19 vaccine when it’s available to them, as vaccine trials across race, ethnicity, and gender demographics have proven its safety and efficacy.”

How to Reduce Your Risk

Now that you’re familiar with the main health conditions disproportionately affecting the Black American community, how can you take ownership of your health?

  • Inform yourself. Don’t be afraid to speak up when the information you’ve received from your doctor or nurse isn’t clear. Ask questions and bring home pamphlets whenever possible. Dr. Nwanguma says it’s important to know what tests were ordered and the meaning of your results. “A lot of my patients believe that they were tested for sexually transmitted infections and cancer with routine lab work. They’ll dismiss their symptoms believing these conditions were ruled out, which can lead to delayed diagnoses and advanced disease.”
  • Maintain a personal wellness plan. Your doctor (or one at a free clinic in your area) can evaluate your current health status and help you develop a wellness routine. Your wellness goals will change, and you’ll learn to become a better self-advocate over time. Dr. Nwanguma emphasizes being up to date on age-appropriate cancer screenings, such as mammograms, pap smears, and colonoscopies.
  • Seek specialist advice. As previously noted, community distrust in the health care system is rooted in racism and medical violence. If you don’t feel that your voice is being heard, reach out for a second opinion. Seeking out a specialist or secondary opinions and advice at a different point of care when facing a serious illness, can save your life.