Race, Racism, and Cardiovascular Health: Applying a Social Determinants of Health Framework to Racial/Ethnic Disparities in Cardiovascular Disease

Zulqarnain Javed, Muhammad Haisum Maqsood, Tamer Yahya, Zahir Amin, Isaac Acquah, Javier Valero-Elizondo, Julia Andrieni, Prachi Dubey, Ryane K. Jackson, Mary A. Daffin, Miguel Cainzos-Achirica, Adnan A. Hyder, Khurram Nasir

Research output: Contribution to journalReview articlepeer-review

Abstract

Health care in the United States has seen many great innovations and successes in the past decades. However, to this day, the color of a person's skin determines-to a considerable degree-his/her prospects of wellness; risk of disease, and death; and the quality of care received. Disparities in cardiovascular disease (CVD)-the leading cause of morbidity and mortality globally-are one of the starkest reminders of social injustices, and racial inequities, which continue to plague our society. People of color-including Black, Hispanic, American Indian, Asian, and others-experience varying degrees of social disadvantage that puts these groups at increased risk of CVD and poor disease outcomes, including mortality. Racial/ethnic disparities in CVD, while documented extensively, have not been examined from a broad, upstream, social determinants of health lens. In this review, we apply a comprehensive social determinants of health framework to better understand how structural racism increases individual and cumulative social determinants of health burden for historically underserved racial and ethnic groups, and increases their risk of CVD. We analyze the link between race, racism, and CVD, including major pathways and structural barriers to cardiovascular health, using 5 distinct social determinants of health domains: economic stability; neighborhood and physical environment; education; community and social context; and healthcare system. We conclude with a set of research and policy recommendations to inform future work in the field, and move a step closer to health equity.

Original languageEnglish (US)
Pages (from-to)e007917
JournalCirculation. Cardiovascular quality and outcomes
Volume15
Issue number1
DOIs
StatePublished - Jan 1 2022

Keywords

  • cardiovascular disease
  • ethnicity
  • morbidity
  • quality of care
  • racism

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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