Karen Lombardi, a school instructional coach, had just taken an unruly child out of a classroom when she felt severe chest pains. She drove to Yale New Haven Hospital, sweating profusely and hyperventilating, and was diagnosed with a heart attack. Five weeks later, she was back in the hospital with more chest pains. It was another four months before Lombardi, 61, learned the cause of her pain, received effective treatment and returned to active exercise. She considers herself lucky because many women with heart disease never get an accurate diagnosis.
Gail Williams was 15 when her mother died of a heart attack. “The world seemed like it got dimmer, a shade darker than it was,” said Williams, now 60, of New Haven. The death of Shirley Mae Burgess, Williams’ mother, at age 41 was a shock and a tragedy for her family. But it also is a story of how economic and social determinants of health shape lives. Even though deaths from heart disease have been falling, it is still the No. 1 killer for both men and women, reports the Centers for Disease Control and Prevention (CDC).
In ancient Greece, a woman who complained of pain—or one who acted outside the limited social norm available to her—was thought to be suffering from “wandering womb,” which was closely related to hysteria. The uterus was thought to float free within a woman’s body and cause all kinds of medical and emotional issues. The cure, for the most part, was marriage. Of course, that’s silly, but consider how far we haven’t come in the treatment of women’s complaints about pain. Recent data on women’s shoddy treatment by health care providers paints a stunning picture of medical apathy and worse.
The death rate from heart disease plummeted nationally over several decades for all racial and ethnic groups, but the rate of decline has slowed slightly and African Americans and low-income individuals are still at a higher risk of developing the disease and dying from it, according to a report from the National Center for Health Statistics. The report isn’t surprising to Dr. Edward Schuster, medical director, Stamford Health Cardiac Rehabilitation Program. “In the United States, there’s a lot of talk about income disparity, which is a political hotcake,” Schuster said. “But what we are seeing is a life expectancy disparity. According to a recent Journal of American Medical Association, if you’re a man in the top 1 percent of income, you can expect to live 13 years longer than someone in the 1 percent at the bottom.”
Heart disease is largely preventable by maintaining a balanced diet, a healthy weight and moderate exercise, with only 20 percent of cases involving genetics, said Dr. David L. Katz, who heads the Yale-Griffin Prevention Research Center, which works with communities to develop programs to control chronic diseases. But significant groups in lower income and urban areas don’t—or can’t—act on the message, Katz said.