John Manirakiza, a local farmer in Prince George’s County, Maryland, was unsuspecting of any looming health issues as he tirelessly worked in his greenhouse amid a heat wave in July 2021. While routine doctor visits were not Manirakiza’s common practice as long as he felt up to par, the startling onset of a stroke amid his drive home became the clarion call to take control of his health.
“I would joke with a close friend of mine that in my prayers, I was asking for a breakthrough, but I didn’t necessarily expect for it to be this painful,” Manirakiza said as he recounted the moments that led to the cerebrovascular episode.
Toughing through a migraine in the scorching heat, Manirakiza pushed to finish his workload despite growing symptoms signaling a more serious issue. During his drive home from a long day’s work, he was just two lights away from his house when he developed blurred vision, quickly leading to the slip of his motor skills as he continuously missed the turn to his street.
It wasn’t long before he blacked out in the driver seat of his car, not yet realizing that he was having a stroke.
While cardiovascular disease (CVD) is the leading cause of death across the United States, according to the National Library of Medicine, “the prevalence of diagnosed and undiagnosed hypertension among African American men (42.4%) greater than 20 years of age in the U.S. is among the highest in the world.”
The higher prevalence of CVD risk factors, and hypertension among African Americans, contributes to stark disparities in stroke, peripheral artery disease, and heart failure.
Manirakazi, a former semi-professional soccer player who kept physically active and maintained a moderately balanced diet, was not the common candidate for CVD, as he did not drink or smoke, was a healthy weight, and was only 48 years old at the time. However, the almost fatal moment encouraged him to address pressing health concerns; namely his levels of stress and high blood pressure that led to that scary 2021 day.
What Lies Beneath Heart Disease
Before his stroke, Manirakiza had not considered mental health and his life experiences as stress factors. However, having spent time in a refugee camp and being a main source of financial support to his family even after migrating to the United States, constant pressures along with unresolved PTSD were fueling an increasingly dangerous cocktail for disaster.
“In our community, we burden ourselves too much. Being brought up in a communitarian type of society, you think of others too much and you don’t do what you call ‘self-care’,” said Manirakiza. “I felt like I was a mother moving from crisis to crisis, to crisis to crisis, and not having a moment to care for [myself]. I [had to learn] how to care for myself instead of [having to depend] on medication.”
Having treated many Black men in the D.C. area, Dr. Quinn Capers, noted many Black men disregard their health due to stress, poor lifestyle habits, and lack of access to resources.
“Black men have the shortest life expectancy in the United States of all the major race groups in the United States, and much of that is due to cardiovascular disease,” Capers explained to The Informer. “Black men in particular tend to have more what we call risk factors, things that put you at risk for heart disease; untreated high blood pressure, untreated high cholesterol, cigarette smoking, not enough exercise, too much stress in their lives.”
Capers emphasized the complexity of health disparities among Black men as a legacy of racism, particularly in housing segregation, which can lead to people residing in unhealthy parts of towns with restricted access to fresh fruits and vegetables, clean air and water, and green space.
“As a cardiologist, I’m always telling my patients, go for a 20 to 30 minute walk every day. Well, some of them, because of what was at one point legal racial segregation and housing, they live in neighborhoods where they don’t feel it’s safe to go for a walk. There’s no green space, the air is polluted, the water may be polluted,” Capers said. “I would point out particularly with minority communities, it’s not just that people are making bad choices that impact their health and therefore they’re dying earlier. There is the legacy of racism in minority communities where they don’t have a choice. There is a societal issue, and we call some of these things, the social determinants of health that often are outside of an individual’s control.”
Unlearning Old Habits
Almost three years after his stroke, Manirakiza prioritizes his peace of mind, strategically cutting stressors out of his life as much as possible and unlearning the social culture that does not encourage Black men to seek medical care.
He told The Informer he continues to visit different medical specialists to learn the impact of high blood pressure and underlying factors contributing to high stress, which he highlights as a newer lifestyle habit that did not always come naturally.
“If you grew up not seeing doctors or having access to healthcare on a regular basis, it becomes training to not see a doctor for routine check-ups, but rather medical emergencies,” Manirakiza said. “A part of me was creating this impression that I am superman but I’m not, and breaking down this counter-stereotypic narrative has been an important step for me.”
