Social Drivers of Health Can Impact Regular Exercise, Increase CVD Risk: Melvin Echols, MD

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Black women had the lowest moderate-to-vigorous-intensity physical activity (MVPA) scores when compared with their male counterparts and White men and women in a recent study evaluating physical activity trajectories before and after a cardiovascular disease (CVD) event. The American Journal of Managed Care® spoke with Melvin Echols, MD, the chief DEI officer of the American College of Cardiology, associate professor of medicine in cardiovascular disease at Morehouse School of Medicine, and associate director of clinical research at the Cardiovascular Research Institute, to discuss the topic at hand.

Echols attributed the disproportionate MVPA scores amongst Black women to social drivers of health. Referencing his upbringing, being raised by a single mother after his father passed, Echols witnessed firsthand the responsibilities associated with being a Black woman, often underappreciated within their communities. Echols believes that although Black women serve as pillars in their families and communities, “it comes at an adverse risk to herself.”

Not only are Black women at an adverse risk for CVD events, like coronary heart disease, stroke, and heart failure, but so are Black men. Their MVPA scores peaked in their youth and early twenties—much higher when compared with White men and women—and maintained a persistent decline throughout the rest of their lives.¹ While Black women and men saw MVPA continue to decline throughout their lives, White men and women saw a rebound in their mid-40s to late 50s in MVPA scores.

Another study, when solely measuring physical activity throughout the lives of Black individuals, saw MVPA was highest amongst men, younger age groups, groups with the highest education and income, and those who were employed or married.²

Echols also suggested that what constitutes MVPA to most people may not be common knowledge, and while the American Heart Association provides recommendations on the amount of time an individual should be active, it is not hyper-specific to any type of physical activity. However, it does suggest connecting with others through community exercise and incorporating any variation of weekly strength training.

References

1. Gerber Y, Pettee Gabriel K, Jacobs DR, et al. Trajectories of physical activity before and after cardiovascular disease events in CARDIA participants. JAMA Cardiol. Published online July 23, 2025. doi:10.1001/jamacardio

2. Williams WM, Yore MM, Whitt-Glover MC. Estimating physical activity trends among Blacks in the United States through examination of four national surveys. AIMS Public Health. 2018 May 29;5(2):144-157. doi:10.3934/publichealth.2018.2.144