The parishioners at St. Albans Church of God in Christ used to help themselves to plates of fried chicken at church dinners. These days the menu is more likely to offer baked chicken. Greens are no longer cooked with ham hocks. The church has even purchased blood pressure monitors — and a defibrillator in case someone were to go into cardiac arrest.
All of these changes are thanks to a Minnesota doctor who's been taking her message of healthy hearts to Black churches in hopes of saving lives.
"That woman is rare," said the Rev. William Land, pastor of the St. Paul church. "She's the real deal. Just genuine."
That woman is Dr. LaPrincess Brewer, a preventive cardiologist and assistant professor at Mayo Clinic. The program she launched, FAITH! (Fostering African American Improvement in Total Health) works with underserved communities to promote cardiovascular health. Brewer has spent years showing up in Minnesota churches, listening to community members about what they need to live healthier lives.
Her mission was shaped early in life.
"I was brought up in the Black church, and I was able to witness so many people dying prematurely from uncontrolled cardiovascular risk factors," she said. "They were family to me. I carried that with me on my journey to become a cardiologist."
While COVID-19 has been getting most of the attention for its growing death toll, heart disease is still the leading cause of death in the United States. Minnesota has one of the lowest age-adjusted heart disease mortality rates in the nation, but state data show that African Americans ages 35 to 64 die from cardiovascular disease at nearly twice the rate of their white counterparts.
When Brewer arrived in Minnesota a decade ago from Baltimore, she was taken aback by the state's glowing report card for health and well-being — and what she observed firsthand.
"Minnesota has been consistently designated as one of the healthiest states in the U.S. But when I actually looked at my community here, the patients from these underserved racial and ethnic minority populations, I said, 'Well, they aren't the healthiest,' " she said. "I wanted to look beyond the façade and explore if there were disparities among African Americans in Minnesota."
And look she did. Have I mentioned that Brewer is also a physician-scientist who conducts research? She recently co-authored a study that found a much higher prevalence of cardiovascular disease among Black Minnesotans than previously documented.
Health workers surveyed African Americans at churches, barbershops, gyms and clinics and discovered 19% of people in this community-based sampling had cardiovascular disease, compared with the rate of 4% cited by a previous Minnesota study.
Her supporters say she and her Mayo Clinic colleagues have helped build a faith-based movement toward stronger hearts across the state. Churches like Land's have developed a culture of health within their congregations, inviting nutritionists and doctors as guest speakers on Sunday mornings.
Converting skeptics
But when Brewer first started visiting Black churches here while donning her research hat, some questioned her intentions.
Years ago, when she stopped by Christ's Church of the Jesus Hour in Rochester, congregant Jackie Johnson's knee-jerk reaction was: Here we go again.
"Initially I thought here's another Mayo program, they just want to come in and get our opinion about health, and then we won't see them anymore," said Johnson, a retired Mayo medical social worker. "But she was different."
Brewer articulated why the research was needed. The data, she reasoned, could influence health policies and increase access to care within the African American community. Not only did Brewer refuse to bail, but she came back again and again to share the findings with the churches she had partnered with.
She also ran with an idea to develop a mobile app — a suggestion that came straight from participants. Community members helped design the app, which offers pointers on how to live healthier lives and allows users to interact with others on the same journey. In a pilot study, the research found that those who used the app saw a reduction in blood pressure, started to eat healthier foods and doubled their amount of physical activity, Brewer said.
"It just really shows how innovative the community is if you listen," she said. "They can tell you what they need."
Although Brewer is focused on real-time interventions, she recognizes all the factors that happen upstream to make African Americans more vulnerable to heart disease. Those influences run the gamut from a lack of affordable housing and employment opportunities to food deserts — the dearth of grocery stores in many impoverished areas.
Even the origins of soul food can be traced back to slavery, when African Americans were denied access to nutritious diets. "They had to eat the leftovers, the thrown-out stuff," said Johnson, the Rochester retiree. "Some of it became a delicacy, like chitlins — that's the gut of the pig. Our ancestors were so clever that they prepared it in a way that was so, so good. It went down from generation to generation."
Johnson underwent her first heart valve replacement surgery in 1984. Recently she has upended old habits and begun life anew. She credits Brewer with teaching her how to check for sodium on food labels and getting her into a regimen of walking and doing YouTube senior fitness videos. Over the past two years, Johnson has shed so many pounds that she had to size down from a 12 to an 8.
"It's not a good thing because I can't even wear my clothes anymore," she said with a laugh.
But she hopes these changes will extend her life.
And what about Dr. Brewer, whom Johnson initially suspected would flee once her research at her church was complete?
"She was there from the start, and she's still there," Johnson said. "That's the basis of my trust with her. She gives so much of herself and gets nothing in return. Her main purpose is to get African Americans in better health."