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Intervening on the social determinants of cardiovascular disease and diabetes
Leandris C Liburd1, Leonard Jack, Sheree Williams
1Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA. lel1@cdc.gov
Insights
Greater research into social determinants is needed to reduce chronic disease disparities in racial and ethnic communities. Addressing social, policy, and historic contexts is crucial for effective interventions against heart disease and type 2 diabetes.
Area of Science:
- Public Health
- Health Disparities Research
- Social Epidemiology
Background:
- Heart disease, cerebrovascular diseases, and type 2 diabetes are leading causes of death and disability in the U.S.
- Racial and ethnic minority communities disproportionately experience these chronic conditions.
- Traditional behavior change strategies show limited effectiveness in eliminating population-level health disparities.
Purpose of the Study:
- To advocate for increased intervention research focused on the social determinants of cardiovascular disease and diabetes.
- To call for novel research questions and designs to understand the context of health disparities.
- To highlight successful programs addressing racial and ethnic health disparities.
Main Methods:
- Commentary and synthesis of existing research on chronic diseases and health disparities.
- Review of intervention strategies and their impact on social determinants.
- Highlighting programs from the Centers for Disease Control and Prevention (CDC).
Main Results:
- Current strategies are insufficient to eliminate health disparities.
- Greater focus on social, policy, and historical contexts is necessary.
- Specific CDC programs show promise in addressing these disparities.
Conclusions:
- Intervention research must target social determinants to reverse chronic disease trends in minority communities.
- Understanding the social and historical context is a prerequisite for developing effective interventions.
- Continued support and evaluation of programs like REACH 2010 are vital.
Abstract:
Heart disease, cerebrovascular diseases, and type 2 diabetes ranked first, third, and sixth, respectively, among the leading causes of death and disability in the United States in 2000. Racial and ethnic communities (i.e., African Americans, Hispanic-Latino Americans, Native Americans and Alaska Natives, and Asian Americans and Pacific Islanders) disproportionately suffer from these chronic conditions. Traditional behavior change strategies have had some positive, but limited effects and will not likely be sufficient to eliminate these health disparities at the population level. In this commentary, the authors argue for greater intervention research directed at the social determinants of cardiovascular disease and diabetes if we are to reverse current trends in chronic disease prevalence in communities of color. The authors also call for new research questions and study designs that will increase our understanding of the social, policy, and historic context in which disparities are created as a necessary first step in developing interventions aimed at social-contextual and psychosocial risk factors. Promising programs supported by the Centers for Disease Control and Prevention's Racial and Ethnic Approaches to Community Health (REACH 2010) program and the Division of Diabetes Translation are highlighted.
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