Heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups in the U.S. Across the country someone has a heart attack every 40 seconds, and one person dies every 33 seconds from heart disease.
On top of these harrowing stats, there is mounting evidence that members of the LGBTQ+ community experience health disparities across several cardiovascular risk factors compared to their peers. Various studies suggest these causes for this discrepancy and elevated risk:
- Many LGBTQ+ adults experience significant psychosocial stressors — including violence and discrimination — that can compromise their cardiovascular health.
- Multiple analyses of population-based data has found a higher prevalence of cardiovascular risk factors among members of the LGBTQ+ community, including tobacco use, elevated body mass index, and diabetes.
- In many parts of the country, members of the LGBTQ+ community face systemic barriers for accessing healthcare services — including preventative checks that could indicate the likelihood or existence of high blood pressure, which is a major risk factor for CVD.
The Enormous Cost of Cardiovascular Disease
As the leading cause of death and disability, cardiovascular disease (CVD) is, unsurprisingly, the most expensive chronic condition to treat, with an annual price tag of $363 billion — and climbing. A report by the American Heart Association warns:
“Expenses associated with cardiovascular disease are expected to soar in the coming years and surpass medical cost estimates for other chronic diseases, such as diabetes and Alzheimer’s.”
Naturally, self-insured employers must bear this increasingly heavy financial burden. Not only is CVD routinely among the top drivers of employer health care costs, but the price tag is inflated by direct and indirect costs. Cost-related research compiled by the American Heart Association highlights that:
- High blood pressure raises an employee’s healthcare costs by nearly one-third.
- Employees with CVD lose 56 hours per year in productivity, and cost $1,119 more per year in insurance.
- Hypertension-related absenteeism costs U.S. employers $10.3 billion per year.
Reducing the Risks — and the Costs
Employers can take an active role in helping LGBTQ+ employees boost their heart health, and consequently reduce the organization’s cardiovascular disease-related medical claims spending. Here are three strategies to consider:
1. Provide Educational Resources
Employers can distribute educational resources across various channels (e.g., internal social media, corporate newsletter, lunchroom bulletin board, etc.), that help LGBTQ+ employees understand how and why they are at elevated risk of cardiovascular disease — and just as importantly, what they can do about it.
2. Encourage LGBTQ+ Employees to Access the LGBTQ+ Healthcare Directory
The LGBTQ+ Healthcare Directory is a free, searchable database of all kinds of doctors, medical professionals, and healthcare providers knowledgeable and sensitive to the unique health needs of LGBTQ+ people across the U.S.
This resource (and others like it) are especially vital to many members of the LGBTQ+ community who, as noted earlier, face barriers to accessing healthcare services, including blood pressure checks and other types of preventative care. “The LGBTQ+ community is a marginalized group of individuals,” commented Dr. Rekha Mankad, a Mayo Clinic cardiologist. “And one of the first issues is the fact that they may not come to get regular health checks.”
3. Offer a Digital Heart Health Solution as a Benefit
Digital heart health solutions empower LGBTQ+ employees to take their blood pressure reading whenever they wish — and without the need to visit a doctor’s office — by slipping a cuff onto their upper arm, which connects via Bluetooth to an app on their smartphone. Within seconds, they see their current blood pressure level, and can keep an eye on long-term trends. In addition, employees can input and track their cholesterol levels (high cholesterol is linked to an increased risk of heart disease), as well as get personalized lifestyle and nutrition tips to improve their heart health.
Digital heart health solutions can potentially do more than help LGBTQ+ employees improve their heart health. They can also help employers achieve significant, sustainable cost savings. In a third-party analysis of employer claims data commissioned by Hello Heart, Validation Institute found a cost savings of $2,382 per participant who used Hello Heart in the first year. The analysis also observed an increase in costs for primary care visits among Hello Heart users, which may be attributable to the program encouraging users to engage in preventive care.
LGBTQ+ adults experience worse cardiovascular health relative to adults who do not identify as LGBTQ+. Employers have an opportunity to be part of the solution. Providing educational resources, helping LGBTQ+ employees connect to supportive and compassionate healthcare professionals, and offering heart-health focused digital therapeutics as a benefit are all strategies that can go a long way towards making a positive difference.
1. Gazit T, Gutman M, Beatty AL. Assessment of Hypertension Control Among Adults Participating in a Mobile Technology Blood Pressure Self-management Program. JAMA Netw Open. 2021;4(10):e2127008, https://doi.org/10.1001/jamanetworkopen.2021.27008. Accessed October 19, 2022. (Some study authors are employed by Hello Heart. Because of the observational nature of the study, causal conclusions cannot be made. See additional important study limitations in the publication. This study showed that 108 participants with baseline blood pressure over 140/90 who had been enrolled in the program for 3 years and had application activity during weeks 148-163 were able to reduce their blood pressure by 21 mmHg using the Hello Heart program.) (2) Livongo Health, Inc. Form S-1 Registration Statement. https:/www.sec.gov/Archives/edgar/data/1639225/000119312519185159/d731249ds1.htm. Published June 28, 2019. Accessed October 19, 2022. (In a pilot study that lasted six weeks, individuals starting with a blood pressure of greater than 140/90 mmHg, on average, had a 10 mmHG reduction.) NOTE: This comparison is not based on a head-to-head study, and the difference in results may be due in part to different study protocols.
2. Validation Institute. 2021 Validation Report (Valid Through October 2022). https://validationinstitute.com/wp-content/uploads/2021/10/Hello_Heart-Savings-2021- Final.pdf. Published October 2021. Accessed October 19, 2022. (This analysis was commissioned by Hello Heart, which provided a summary report of self-fundedemployer client medical claims data for 203 Hello Heart users and 200 non-users from 2017-2020. Findings have not been subjected to peer review.)
