Cardiovascular disease (CVD) is still the leading cause of death in the United States and globally. The term cardiovascular disease refers to conditions of the heart and blood vessels including, but not limited to, hypertension, coronary heart disease, congestive heart failure, and stroke. In the United States, 85.6 million Americans have some form of CVD (Der Ananian et al. 2018). According to the American Heart Association in 2017, CVD is responsible for over 800,000 deaths a year. Rates of CVD have soared with the increased consumption of energy-dense foods (EDF). The affordability of EDF, the diminished need for physical labor, and obesity combined create an environment that promotes CVD (Diez Roux et al. 2006).
Environments and behaviors increase rates of CVD. Factors that result in obesity and diabetes, such as increased consumption of EDF and reduced physical activity, increase the risk of CVD Diez Roux et al. 2006). Environmental, socioeconomic, and behavioral factors play important roles in the incidence of CVD. Access to quality foods, healthcare, and recreation combined with employment, cost of foods, and behavioral habits (smoking, alcohol abuse, and inactivity) impact rates of CVD. Low socioeconomic and minority communities experience these factors disproportionately (Diez Roux et al. 2006). These communities often lack food and health amenities, employment, and safe means of physical activity perpetuating the cycle of disproportional incidence of CVD.
African Americans account for little more than 13% of the United States population, approximately 46.3 million, and are three times more likely to develop CVD and are two times more likely to die due to CVD compared to their non-Hispanic white counterparts (Der Ananian et al. 2018). This disparity, historically attributed to genetic factors, has according to research, been shown less determinative than socioeconomic, environmental, and behavioral factors to impact incidence and mortality of CVD more directly than genetics Diez Roux et al. 2006). Access to food directly affects choice and in communities lacking adequate access, contributes to increased consumption of energy-dense foods (EDF), which, in turn, increases rates of obesity and CVD (Diez Roux et al. 2006). Diamant et al. (2005) stated that about thirty-two percent of calories are acquired away from home. As portions of EDF increase and the cost of EDF decrease, persons with fewer resources rely more heavily on these foods and beverages increasing their risk to CVD.
This review seeks to find what factors act as barriers to the adoption of healthier habits. Kern et al. (2017) stated that low socioeconomic status is related to lower consumption of a diet that promotes cardiovascular health, as it is more expensive to sustain economically. It has been suggested that policy changes at all levels should shift toward healthier outcomes due to the complexity of food choices in addition to cost (Afshin et al. 2015)