American Heart Association special report highlights trends in awareness among women in the United States regarding heart disease.
Women’s awareness that heart disease is their leading cause of death has declined significantly, from 65 percent of women being aware in 2009 to 44 percent being aware in 2019, according to a new American Heart Association Special Report. The report was published today in the association’s flagship journal Circulation. The decline in awareness was observed among all racial, ethnic and age groups except women age 65 and older.
Virginia Howard, Ph.D., Distinguished Professor in the UAB School of Public Health’s Department of Epidemiology, is one of the co-authors of the report, “Ten-Year Differences in Women’s Awareness Related to Coronary Heart Disease: Results of the 2019 American Heart Association National Survey.”
“Looking across survey years, in 2009, 2012 and 2019, we found that women who were younger versus older, and non-Hispanic black, Hispanic or Asian versus white had lower awareness that heart disease was the leading cause of death,” said Mary Cushman, M.D., professor of medicine at the Larner College of Medicine at the University of Vermont, and chair of the writing group for the statement.
Cushman also called attention to the need identified in this study to increase awareness efforts among women at various socioeconomic levels.
“Women with lower educational attainment and lower household income, as markers of socioeconomic status, also had lower awareness,” Cushman said. “These all point to groups that could benefit most from programs to raise awareness, i.e., lower-income women, less educated women, nonwhite women and younger women. To reach these women, we need to innovate ways to meet them where they are so they can develop healthier lifestyle patterns to support optimal heart health earlier in life.”
The data are the results of the 2019 American Heart Association National Survey, an online survey of more than 1,500 U.S. women over age 25, conducted in January of 2009, 2012 and 2019.
The 2019 survey included questions on age, sex, race, ethnicity, educational attainment, household income and marital status. Awareness was assessed with the question, “As far as you know, what is the leading cause of death for all women?” Common responses included heart attack/heart disease, cancer (all types), and breast cancer.
The 2019 survey found:
- Women with high blood pressure were 30 percent less aware that heart disease is the leading cause of death among women, compared to women overall. Only in 2019 were women asked about high blood pressure history.
- The greatest declines in awareness (adjusted for factors such as education level and income) were among Hispanic women (86 percent decline), Black women (67 percent decline) and women 25-34 years old (81 percent decline).
- Women were more likely in 2019 than a decade ago to erroneously believe cancer is the leading cause of death:
- 5 percent thought breast cancer was the leading cause in 2019 compared to 7.9 percent in 2009; this belief was most common among younger women (ages 25-34).
- 1 percent of women surveyed identified cancer (all types) as the leading cause of death for women in 2019 compared to 26.5 percent in 2009.
- Awareness of heart attack symptomsdeclined among all women. Only 52 percent of women reported that chest pain was a symptom, and 38 percent reported pain that spreads to shoulders, neck or arms was a symptom. Some 28 percent reported shortness of breath as a symptom.
- Awareness of what to do if having heart attack symptoms was mixed. Knowledge that women need to call 9-1-1 was up from 47 percent in 2009 to 54 percent in 2019, but knowing they should take an aspirin was down from 23 percent to 14 percent over the 10-year period.
“Alarms should be sounded to address this highly concerning trend among younger women and women of color,” Howard said. “This signals an urgent call for organizations ranging from public health, government and health care professionals to community organizations such as churches and employers to take on the challenge with full gusto to better inform women of their risk for heart disease. Preventing heart disease remains our No. 1 priority — we should be as close as possible to 100 percent awareness.”
Since 1997, the American Heart Association has conducted national surveys among U.S. women to monitor awareness and knowledge about heart disease. Results indicated that awareness of heart disease as the leading cause of death among women nearly doubled from 30 percent to 56 percent between 1997 and 2012. Awareness of heart attack symptoms also increased from 1997 to 2012.
“Considerable progress has been made by the association and Go Red for Women® over the last two decades to raise awareness and reach tens of millions of women and health care professionals,” Howard said. “Women inspired at the inception of the association’s Go Red for Women movement in 2004, particularly women in their 30s-40s at the time, have championed women’s health for more than 17 years and are still the most likely to recognize heart disease and stroke as their greatest health threats based on the 2019 survey findings.”
“For nearly 20 years, the association and Go Red for Women have been at the forefront of emerging science,” Cushman said. “This survey gives us the data we need to better inform the women in our lives to take charge of their health. The movement is poised to evolve to reach younger generations of women in new, innovative ways.”
In 2019, the movement launched Research Goes RedTM in conjunction with Verily’s Project Baseline placing women in the driver’s seat to accelerate scientific discovery and ensuring equitable representation in clinical trials. Clinical trials have not been inclusive of women historically, especially women of color, hindering the progress of understanding women’s specific risks, symptoms, diagnosis and treatment. Research Goes Red calls on women across the United States to contribute to health research. The initiative aims to develop the world’s most engaged research platform for women.
The Go Red for Women Strategically Focused Research Network, or SFRN, brings together researchers from top institutions to address issues unique to women’s health. All centers train fellows and collaborate with others in the SFRN to advance the mission and impact of the Association.
Co-authors of the survey study with Cushman are Christina M. Shay, Ph.D., Virginia J. Howard, Ph.D., Monik C. Jiménez, Sc.D., Jenifer Lewey, M.D., Jean C. McSweeney, Ph.D., L. Kristin Newby, M.D., Ram Poudel, M.S., Harmony R. Reynolds, M.D., Kathryn M. Rexrode, M.D., Mario Sims, Ph.D., and Lori J. Mosca, M.D., Ph.D.