College of Nursing
58 Assessing Healthcare Disparities for Midlife Hispanic Women
Margaret Dalseth and Lisa Taylor-Swanson
Faculty Mentor: Lisa Taylor-Swanson (Nursing, University of Utah)
Vasomotor symptoms (VMS) such as hot flashes, night sweats, and palpitations manifest during pre-, peri-, and post-menopausal stages.1 According to the Study of Women Across the Nation (SWAN) Hispanic women report more negative experiences compared to other ethnic groups including VMS-related and depressive symptoms.2 SWAN is a multi-site longitudinal study examining the health of midlife women focusing on their biological, psychological, and social changes during this life period.3 Below, Graph A depicts the percent of the ethnic population that reports experiencing VMS for greater than 6 days and Graph B shows the percentage of specific populations that experience VMS in the preceding two weeks.2 Here, Hispanic women experience the greatest percentage of symptoms compared to other ethnicities during pre-menopause and the second highest experience of symptoms during perimenopause.2 More specifically, 45% of Hispanic women experience VMS during pre-menopause compared to 25% of White women.2 Many factors contribute to the increase in VMS experienced by Hispanic women such as nutritional risk factors and acculturation. To decrease the severity and frequency of VMS, Hispanic women may consider the increased inclusion of isoflavones which bind to estrogen receptors.4 Soy is rich in isoflavones, and studies show that soy supplementation reduces menopausal hot flashes.4 Since soy consumption is less a common part of Hispanic communities’ diets, messaging on soy consumption may aid in lowering VMS.5
Graph A. Percent of Women Presenting Vasomotor Symptoms for 6+ Days by Menopausal Status and Race/Ethnicity
Graph B. Percent of Women Presenting Vasomotor Symptoms for Greater than 2 weeks by Menopausal Status and Race/Ethnicity
One explanation for this disparity in symptoms is due to BMI.1 High BMI is specifically related to the increased prevalence of hot flashes, night sweats, and palpitations.1 SWAN reported that Hispanic women had one of the highest average BMIs which may contribute to their increase in experience of VMS.1 Similarly, high blood pressure is associated with the overactivity of the sympathetic nervous system (SNS) which stimulates adrenaline and sweat glands, contributing to the VMS experience.1 The US Hispanic population has similar prevalence of hypertension compared to White and Asian Americans but received an average of 7% less treatment compared to White Americans.6 The unmanaged potential for sympathetic nervous system overactivity places the Hispanic population at risk for VMS.
Not only are Hispanic women disproportionately affected by VMS but also major health risks associated with the onset of menopause.7 Cardiovascular disease (CVD) is the leading cause of death for menopausal and Hispanic women.8 Countless disparities exist relating to cardiov