How Functional Medicine Can Close the Racial Health Disparity Gap

Imagine, just for a moment, your heartbeat.

That steady rhythm that signifies life, balance, and existence. Now, imagine that beat stopping because of factors beyond your control: your race, your neighborhood, your socio-economic status.

The sad truth is, for many African Americans and other people of color, their heartbeat, their health, is dictated not by choices, but by systemic factors that have perpetuated disparities for far too long.

Let us embark on a journey — a journey to explore how Functional Medicine could be our beacon of hope in addressing the cavernous health disparities faced by minority communities.

Race shouldn't determine your health

Yet, in America and even globally, it often does. An African American person's zip code can predict their life expectancy — a stark and painful reality that underscores the profound racial disparities in our healthcare system.

For those that don't know about redlining, I'll give you some background. Racial redlining was a discriminatory real estate practice in the US from the 1930s to the 1960s, where African Americans were restricted on where they could live, keeping us segregated. Minority neighborhoods, or zip codes, were marked as high-risk, hindering residents from obtaining loans or quality housing.

This system not only prevented these communities from accumulating wealth through homeownership, but also limited their access to quality education and amenities. Although redlining is now illegal, its historical impact still shapes housing patterns and racial disparities in many American cities.

Race shouldn't determine your health. Yet, in America and even globally, it often does.

The numbers behind the disparity

The World Health Organization reports that heart disease is the leading cause of death globally, taking an estimated 17.9 million lives each year. And the Centers for Disease Control reports that for the past 20 years, African Americans have faced a higher risk of heart disease compared to their white counterparts, with 30% more African Americans than non-Hispanic whites dying from heart disease in 2019 alone.

Systemic issues persist in healthcare, with African Americans often receiving inferior care due to biases, misunderstandings, and the negative perception of marginalized groups, which consequently worsens their health outcomes.

African American women are nearly 300 percent more likely to die from childbirth than white women.

When medicine sees color

How did we arrive at this grim reality? One answer lies in the systemic racism ingrained in our healthcare system. David R. Williams has shown that factors like implicit bias, residential segregation, and negative stereotypes play a role in perpetuating health disparities.

But there's more. Race-based medicine still thrives, with doctors making decisions based on a patient's skin color rather than concrete medical observations.

For example, it's often thought that African Americans have more muscle mass than those from other races. So, doctors might evaluate their kidney health a bit differently based on this idea. And certain blood pressure medications, called ACE inhibitors, are believed to work better in White patients than in Black patients — so, doctors might not always give them to Black people with high blood pressure.

Dorothy Roberts astutely points out that even today, many doctors use race as a medical shortcut. This means that decisions, sometimes life-altering, are made based on skin color rather than genuine medical observation. Such practices have dire consequences, perpetuating a cycle of mistrust and substandard care.

Moreover, as Wanda Irving shares, racism in healthcare often minimizes and dismisses the pain of Black women. Their experiences, their symptoms, and their concerns are regularly sidelined, contributing to higher mortality rates and overall poorer health outcomes.

Where Functional Medicine comes in

So, where does Functional Medicine come into play? At its core, Functional Medicine aims to identify and address the root causes of diseases. It's about personalized, holistic care.

This approach provides a unique opportunity to specifically target racial health disparities by taking into account genetics, environment, and lifestyle — not just the color of one's skin. Imagine a healthcare model that doesn't just treat symptoms but delves deep into individual histories, lifestyles, and genetics to provide tailored care.

My father's story

Allow me to share a deeply personal story. On a regular Monday in September 2014, I received a frantic call from my brother. I'm in Atlanta and my brother is in Chicago.

Our father, a robust figure, an emblem of strength, a Vietnam Veteran, and a Chicago Police Officer for over three decades, was struggling to breathe. He was getting fitted for a new home oxygen device. His oxygen level was at a mere 88%. My heart sank as I knew this was dangerously low.

The oxygen technicians were trying to send him to the hospital, and I joined in with them, begging him to go. Despite my pleas and the urgency of the situation, he resisted hospitalization, saying, "I'm tired. I'm so disgusted with myself."

He had lived a life that many would say was normal or 'unhealthy' depending on who you're talking to — smoking, drinking, and subscribing to the Standard American Diet. Yet, he believed, as many do, "you gotta die from something." But as his health dwindled, regret colored his last days.

The next day, our world crumbled. My father passed away from heart failure. His favorite saying, 'You gotta die from something,' just haunted me. And although, yes, "technically" we do all die from "something" — whether it be a heart attack, a stroke, accident, or even in your sleep from old age… yes, we do all die from something. But he didn't have to suffer.

I realized that heart failure wasn't just an ailment. It was the culmination of years of unchecked stress as a Black man, a veteran, a police officer, a provider for his family; an unhealthy lifestyle of smoking, drinking; and a lack of preventive care.

I know I'm his daughter, and not his doctor — even though I am a doctor — but… what if I could have helped him actually enjoy making some lifestyle changes? I didn't know about Functional Medicine back then. What if his doctor could have helped him?

My father's story isn't just a singular event. It's a story shared by countless African American families across the United States. It's a story of missed prevention, lack of awareness, and, most importantly, a healthcare system that fails to address the root causes.

What if we could change the narrative? What if functional medicine is the key?

"You gotta die from something." But he didn't have to suffer.

Cheryl's story

Functional medicine could have saved my father. By focusing on lifestyle changes, understanding personal histories, and determining root causes, we can not only treat but prevent heart disease. Heart disease is a silent killer, but it doesn't have to be.

Unlike traditional medicine, which often treats symptoms rather than root causes, Functional Medicine takes a comprehensive approach. It views the body as an interconnected system and addresses underlying causes of diseases. Most importantly, it treats patients as individuals, going beyond generalized assumptions. Instead of a one-size-fits-all, pill-for-an-ill approach, it delves deep into patients' histories and tailors interventions to restore balance and health.

For example, consider Cheryl, a 45-year-old vivacious African American woman with hypertension — a condition that has a strong hold on the African American community. A conventional approach might solely prescribe medications for her blood pressure.

Functional Medicine, however, would take a deeper dive. It would consider her genetics, family history, and life experiences, such as socioeconomic factors or chronic stressors that African Americans often face.

So, we're pulling out our detective glasses and magnifying lens. We're digging deep — into Cheryl's genes, her family's medical tales, and the mosaic of experiences that have colored her life. We might identify stress from racial discrimination as a contributing factor to her health condition. Did you know that the weight and chronic stress of racial discrimination can literally press down on one's heart? We can initiate stress-reducing interventions like mindfulness practices such as meditation.

We might also uncover that she lives in a "food desert" where access to fresh, healthy foods is limited, contributing to a diet high in sodium and processed foods. Her doctor might also collaborate with community organizations to improve her access to healthier food options.

Her doctor also conducts a genetic assessment, revealing certain genetic markers that make her more susceptible to salt-sensitive hypertension. Using this genetic insight, coupled with a thorough understanding of her lifestyle, diet, and environment, her doctor provides her with a personalized dietary plan. This plan not only addresses salt intake but also includes foods and supplements that can potentially counteract her genetic predisposition… yes, we can do that in Functional Medicine!

This approach recognizes and addresses both the biological and social determinants of her condition. Because health? It's not just skin deep — it's the whole captivating story of life itself.

Chronic stress and the heart

So, let's take a moment to focus on chronic stress, which is a contributing factor to heart disease — but unfortunately, traditional medicine does not focus on this. Chronic stress can have a direct and indirect impact on heart health:

1. 1.

   Inflammation

   Chronic stress triggers an inflammatory response in the body, leading to increased inflammation levels. This inflammation can damage blood vessels and contribute to atherosclerosis, the buildup of plaque in arteries.

2. 2.

   High Blood Pressure

   Stress activates the body's "fight or flight" response, causing an increase in heart rate and blood pressure. Prolonged elevated blood pressure can strain the heart and arteries, increasing the risk of heart disease.

3. 3.

   Hormonal Changes

   Chronic stress stimulates the release of stress hormones like cortisol. Elevated cortisol levels can lead to insulin resistance, weight gain, and metabolic changes, all of which contribute to heart disease risk.

4. 4.

   Heart Strain

   Prolonged stress can increase heart rate and force the heart to work harder, potentially leading to heart muscle damage.

It's crucial to manage and mitigate chronic stress to maintain heart health and prevent the development or exacerbation of heart disease. Functional Medicine can help with that. Such integrative strategies emphasize individual autonomy and strengths, thus fostering a deeper level of patient-practitioner collaboration and a more comprehensive, long-lasting approach to health restoration.

Five ways Functional Medicine tackles the gap

By applying the principles of Functional Medicine, we can tackle racial health disparities head-on. Here's how:

And maybe by applying this approach, the provider can learn about each patient, treating them like a person instead of a “race.”

Reimagining healthcare

Imagine the possibilities if this approach were available to minority communities. Addressing systemic and biological imbalances, recognizing the importance of socio-economic factors, and truly individualizing care could revolutionize health outcomes.

Our minority communities deserve more than just palliative care; we deserve a future where we thrive. We need change. But this isn't just about healthcare reforms — it's about societal transformation.

By integrating Functional Medicine into community clinics, training providers in understanding racial disparities, and ensuring that care is truly patient-centered, we can begin to mend the heartbeat of African American communities. It's time we ensure that race no longer predicts one's health outcome. It's time for Functional Medicine to take center stage in this battle against racial health disparities.

That steady heartbeat, the symbol of life and health, can be a reality for all, regardless of race.

Let's reimagine healthcare — making it equitable, just, and functional.