Discrepancies in Cardiovascular Disease Risk Perception Among African American Emerging Adults

Cardiovascular disease (CVD) disproportionately affects African Americans residing in the southern United States. While often diagnosed later in adulthood, CVD develops over time and risk factors emerge early in life. Perceptions of disease risk significantly influence health behaviors, yet young adults often underestimate their susceptibility.

This study compares CVD risk perception to actual CVD risk among African American emerging adults (AAEAs).

Using an explanatory sequential mixed methods approach guided by a situation-specific theory, we assessed CVD risk perception, objective CVD risk based on the American Heart Association's Life's Essential 8 metrics, and CVD knowledge in 28 AAEAs enrolled at a southeaster historically Black college/university. Descriptive statistics informed the selection of 16 participants for interviews to explore the reasons behind their perceptions and reactions to their objective risk assessment. These 16 participants were intentionally selected to reflect the distribution of participants across the perceived versus objective CVD risk categories represented in the full sample.

Most participants underestimated their cardiovascular disease (CVD) risk. Specifically, 16 of 28 participants (57.14%) perceived their risk to be low; however, only 4 of these 16 individuals (25%) accurately assessed their risk. Among those with a low perceived risk, 11 (68.8%) were found to have a moderate objective risk, and 1 participant (6.3%) was classified as having a high risk. Upon learning their actual CVD risk, participants' responses supported three primary themes: emotional awareness, personal analysis, and planned action.

Findings reflect a need to integrate personalized, culturally relevant CVD awareness and prevention strategies for AAEAs. Future research should involve larger cohorts to refine interventions that bridge the gap between perceived and actual CVD risk.