Heart Health is Good Health 

February was Healthy Heart Month, but there is no time limit on talking about heart disease, particularly for American Indian and Alaska Native (AI/AN) populations. The ALTSD Office of Indian Elder Affairs (OIEA) had an opportunity to talk with a Native American physician about heart disease, its causes, and prevention tactics to ensure elders and those at risk get screened and/or treated. 

From the community of Tohatchi, New Mexico on the Navajo Nation, Dr. Karen Sopko (pictured above) is a cardiologist at New Mexico Heart Institute. Many colleagues refer Native American patients to her because they know she can connect with them in ways that non-Native physicians cannot. 

“I knew from a young age that I was interested in medicine. I would go to doctor appointments with my grandma and grandpa, and I always wondered what the doctor was telling them,” said Dr. Sopko. During her residency, she learned more about the high prevalence of heart disease among American Indians and Alaska Natives. “When I started training, heart disease was rare in tribal communities. Then one of my mentors told me that heart disease was going to be a big problem over the next few decades, and he was right because of the growing rates of diabetes.” 

According to the Indian Health Service (IHS) and the Centers for Medicare and Medicaid Services (CMS), heart disease remains a leading cause of mortality among AI/AN individuals. Here are some key statistics: 

• Prevalence: Heart disease affects approximately 21% of AI/AN adults, compared to about 12% in the general U.S. population. 

• Mortality Rates: AI/AN populations have higher death rates from heart disease, with rates that are 30% higher than those of their white counterparts. 

• Risk Factors: Common risk factors, including obesity, diabetes, and hypertension, are prevalent in AI/AN communities, contributing to the high incidence of heart disease. 

 Diabetes and high blood pressure are key contributing factors of heart disease and unfortunately are also prevalent across many age groups in tribal communities. Other social disadvantages like low employment, limited access to healthy foods, and long traveling distances to health care clinics also may contribute to poor health among Native people and elders.  

“It’s hard to get people to change their lifestyle, their diet and get good exercise. It’s hard because the reservation has limited resources. Most Native families can’t afford healthy food because prices are high at the few grocery stores that are on the reservation. They have to go to border towns and often get processed food because it lasts longer and makes more sense financially. Also, the Navajo Nation doesn’t have resources as far of exercise facilities in different communities. Access to these kinds of lifestyle changing resources is limited, just like access to quality health care is limited,” Dr. Sopko said. 

 Several factors contribute to the high rates of heart disease among AI/AN populations: 

• Lifestyle Factors: Limited access to healthy foods and safe recreational spaces can lead to poor diet and sedentary behaviors. 

• Cultural and Historical Context: The impact of historical trauma, socioeconomic challenges, and cultural disconnection can lead to mental health issues, which in turn can affect physical health. 

• Health Disparities: Access to healthcare services, preventive care, and education about heart health is often limited in many AI/AN communities. 

• Prevalence of Risk Factors: High rates of obesity, diabetes, and smoking contribute to the increased risk of heart disease. 

 “We need more community ways to encourage healthy diets. Doctors don’t have a lot of time to give patients examples and go over a healthy diet, exercise and what’s good for them. Tribes need more resources like nurses, physiologists, physical therapists and dietitians to be part of their clinic and a patients’ health care plan. Those experts can take the time to explain the WHY – why taking medication is important, why daily exercise is needed, why eating healthy can help. Our elders and Native patients need to understand the reasoning behind it all and not just telling them what to do,” added Dr. Sopko. 

Dr. Sopko recommends that those who live with or care for elders living with heart disease should visit regularly with their primary care physician and take of their health as well. 

“It goes back to the perception of health care as Native people. I encourage physicians, caregivers and family members to use our cultural teachings as a tool to express the elder’s responsibility for their health and help change their attitude about treatments and doctor visits,” said Dr. Sopko. “Our elders are pillars of the community. We look up to them. We go to them for advice. But we also must help set the example for them and start living healthier for the sake of our culture, language and traditions. We need our elders in order to thrive and be successful in life. It’s public health 101 – the success of a community is based on their health.” 

Healthy Heart Lifestyle Tips 

• Balanced Diet: Emphasize whole foods, including fruits, vegetables, whole grains, and lean proteins. Limit processed foods high in sugars and unhealthy fats. 

• Regular Physical Activity: Aim for at least 150 minutes of moderate aerobic exercise each week. Engaging in traditional physical activities can also promote cultural connections. 

• Regular Health Screenings: Regular check-ups can help monitor blood pressure, cholesterol levels, and blood sugar, enabling early intervention. 

• Stress Management: Incorporate relaxation techniques, such as meditation, traditional practices, or community gatherings, to support mental well-being. 

• Community Support: Engage in community health programs that promote heart health awareness and education.