Valley resident “Angela’s” anxiety over some chest pains is eased by Nurse Practitioner Amber Simpson at Valley Community Healthcare as part of a heart health screening.

In February, stores are filled with gifts and cards with bright red hearts for your Valentine. It’s a month to celebrate love with those who are special to you.

It’s also National Heart Health month, a time to love yourself by taking the time to check on your own heart health.

It’s startling to learn that about 647,000 people — that’s one in four across the country — die from heart disease each year. Heart disease is the leading cause of death for both men and women in the United States.

For Latinas, the statistics are even more alarming.

Nearly one in three Latinas have cardiovascular disease that can lead to heart attacks and strokes, according to the American Heart Association. The numbers of Latinas with heart disease are both increasing and are often undiagnosed.

“In our local community there are high rates of cardiovascular disease, with high rates of hypertension, circulation problems generally including heart circulation issues and extremity peripheral artery disease (PAD),” said David Luna, MD, Chief Medical Officer of Valley Community Healthcare.

“We are seeing higher rates of heart disease among Latinas and there are greater numbers of those who are undiagnosed,” the doctor said. “There are high rates of diabetes in our population which only exacerbates these kind of cardiovascular issues. We educate our clinicians about the risk factors the Latina population faces and [as they are identified] we see that those numbers are increasing.”

Another primary health issue is obesity, and the abundance of fast food restaurants that have put down roots in Latino communities and are described as “food deserts,” with too few places that offer healthier food.

“We have been looking at our data and our population has a higher body mass index, “Luna said. “We have to look at their weight and support their body image, and not engage in body shaming but strive to reduce their weight to restore their health.”

He said that Latinas are very receptive to the discussion, especially when it’s framed for the overall health of their family.

“We do a lot of education about preventive care, and give our patients tools to track their blood pressure and sugars so that they have that information for the doctor when they come in and have a partnership with our patients,” Luna said.

“We are developing programs that are culturally relevant with clinic hours [during]  evening and weekends for patients who can’t get off work during the weekday. We also have dietitians who offer information about nutrition and services that are culturally relevant to help them. When patients have high cholesterol or high blood pressure there are specific dietary restrictions that are very specific, and may be difficult for them to follow. ”

Despite their increased risk, many Latinas aren’t aware of the serious threat of heart disease. They can function with high blood pressure for years and not feel any symptoms although damage to arteries and the heart may be occurring.

Many Latinas may put off having regular physical exams — especially if there are financial pressures, and the responsibility of others depending on them. They may be unaware that there are health services available to them; and even if they are, they may still put off care choosing to take care of everyone else before themselves.

Latinas are often the nucleus of the family — many times working both outside and inside the home. Many Latinas, including those who are newly arrived immigrants, are among the working poor and are underemployed, which sets up a cycle of self-sacrifice and personal neglect.

In addition, they are nearly three times as likely as Caucasian women to be uninsured and — as a result — are less likely to seek care or have established primary care, which can compound their risk for heart disease.

Latinas often times are juggling a job and family, which can cause anxiety and stress and put them at greater risk for health issues. Latinas from every income level need to be aware that paying attention to heart health and health in general can make a tremendous difference to their quality of life and longevity.

As all women strive to higher positions or are primary wage earners with responsibilities for others, finding a balance to handle stress is crucial.

“We do quite a bit of screening for anxiety and stressors,” Luna said, adding that, “it’s their protocol at their clinics” that once a red flag is detected to route patients on the same day to practitioners who can offer services that address those needs.

“We see a large number of Latinas who have stress with job security, relationship security, and we try to link them with behavior health right away,” he said. “We do our best to train our staff to give our patients options to link them with someone who is going to help them.”

Luna said they offer classes on diabetes, and will soon be embarking on a partnership with Health Net to provide fitness programs for the whole family.

“There are also unique stressors that Latinas go through that can contribute to cardiovascular disease that other populations don’t go through,” he said.

Under the Trump Administration, there is a lot of uncertainty about whether to seek federally supported health care and whether it could jeopardize a patient’s immigration status. Patients have expressed fear about ICE coming into clinics as they seek care. While health professionals do their best to reassure patients, it is challenging as immigration policies and what is called the “public charge” rule is uncertain.

“Latinas have several stress factors that can include their immigration status,” Luna said. “We have an active membership service department to help patients who have questions about public charge and if they have to ‘dis-enroll’ from our clinic.

“We try to alleviate those fears and tell our patients about their options. Patients have expressed real fear of ICE coming into the clinics and demanding access to patients which has been a deterrent for them to get their health care in the past.”

“One of our goals is try to hire from within our community,” the doctor said. “We have a care coordinator program with health care practitioners who strive to be navigators for the patients and the community. A lot of them are from the area and they are anchored to the community and  know the community really well. They gain the patients trust which is really important.”

Valley Community Healthcare is based in North Hollywood, and also has a wellness center in North Hills next to Monroe High School and a student health center at Valley College. They primarily serve Medi-cal and Medicare patients and the uninsured.