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Reducing Cardiovascular Disparities Through Community-Engaged Implementation Research: A National Heart, Lung, and
George A Mensah1, Richard S Cooper2, Anna Maria Siega-Riz2
1From the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (G.A.M., L.N.P., M.C.G.P., B.J.N., R.A.R., M.M.E.); Loyola University Medical School, Department of Public Health Sciences, Chicago, IL (R.S.C.); University of Virginia School of Nursing, Charlottesville (A.M.S.-R.); Johns Hopkins School of Medicine, Department of Medicine, Baltimore, MD (L.A.C.); Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior, and Society, Baltimore, MD (L.A.C.); Center for Prevention Implementation Methodology (Ce-PIM), Northwestern University Feinberg School of Medicine, Chicago, IL (J.D.S., C.H.B.); Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora (J.M.W.); Morehouse School of Medicine, Department of Medicine, Atlanta, GA (E.O.O.); Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (S.A., C.R.N., N.R., M.L.A.-S., J.P.R., C.A.P., D.C.G.); University of Mississippi Medical Center, John D. Bower School of Population Health, Jackson (B.M.B.); University of North Carolina at Chapel Hill School of Nursing (J.L.B.); Michigan State University College of Human Medicine, Department of Epidemiology and Biostatistics, East Lansing (D.F.-H.); National Human Genome Research Institute, Bethesda, MD (S.Y.G.); School of Public Health, University of Illinois at Chicago (W.H.G., K.S.W.); Office of the Director, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD (R.S.J., E.J.P.-S.); Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (T.T.L.); Institute for Health Metrics and Evaluation, University of Washington, Seattle (A.H.M.); Department of Neurology, University of Louisville, KY (K.D.M.); Department of Population Health, Center for Healthful Behavior Change, New York University School of Medicine, New York (J.E.R.); Community-Campus Partnerships for Health, Raleigh, NC (A.R.); UK Medical Center, University of Kentucky, Department of Medical Behavioral Science, Lexington (N.E.S.); Department of Medicine, Jackson Heart Study, University of Mississippi Medical Center (M.S.); Office of Health Equity, Health Resources and Services Administration, Rockville, MD (G.K.S.); National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD (A.E.S.); and Social and Health Research Center, San Antonio, TX (R.P.T.). george.mensah@nih.gov.
Cardiovascular disparities persist across the US, with significant disease burden concentrated in certain regions and demographics. Few large-scale studies address these inequities, highlighting a need for targeted interventions.
Area of Science:
- Public Health
- Cardiovascular Medicine
- Health Disparities Research
Background:
- Cardiovascular disease (CVD) mortality rates have declined overall but disparities persist based on sex, race, ethnicity, socioeconomic status, and geography.
- High CVD burden is noted in the southeastern US and Appalachia, yet large-scale intervention studies in these areas are scarce.
- Existing data reveal significant variations in CVD mortality across states and counties.
Purpose of the Study:
- To summarize the current knowledge on cardiovascular disparities.
- To propose intervention strategies to reduce or eliminate these disparities.
- To align proposed interventions with the National Heart, Lung, and Blood Institute (NHLBI) mission.
Main Methods:
- Convened experts from diverse scientific backgrounds (biomedical, behavioral, environmental, implementation, social sciences).
- Reviewed current state of knowledge on cardiovascular disease disparities.
- Discussed challenges, opportunities, and resources for intervention.
Main Results:
- Identified persistent disparities in cardiovascular disease burden across various demographic groups.
- Highlighted geographical variations in CVD mortality, with higher rates in specific US regions.
- Acknowledged a lack of large-scale intervention studies in high-burden populations.
Conclusions:
- There is a critical need for large-scale intervention studies to address persistent cardiovascular disparities.
- Multidisciplinary expertise is essential for developing effective strategies to reduce CVD inequities.
- Recommended actions and resources were identified to guide future research and interventions.
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