Cardiovascular Impact of Race and Ethnicity in Patients With Diabetes and Obesity

Associations of Cardiometabolic Multimorbidity With All-Cause and Coronary Heart Disease Mortality Among Black Adults in the Jackson Heart Study

“…One pillar of equity-based interventions is to address multiple levels of the socioecological model, including through community-engaged and community-based participatory research centered on equity to advance cardiometabolic health equity. 5,36 More ideal levels of American Heart Association's Life's Simple 7 are associated with lower risk of diabetes, heart disease, and stroke. [37][38][39] Unfortunately, community-based participatory research to improve all components of Life's Simple 7 in US Black populations are lacking.…”

“…The multiplicative increased risk of all-cause and CHD mortality seen in this US Black population is a call to action to prevent the development of cardiometabolic disease and advance the treatment of care of those with known cardiometabolic morbidities. 4 Over 30 years since the Heckler report, 30 and 20 years since the Unequal Treatment report, 31 we are still grappling as a society and medical community with how best to address racial and ethnic disparities in chronic disease and life expectancy. Much of the discussion on prevention revolves around individual lifestyle change, but appreciating that individual lifestyle change occurs in the environment and context of a person's living situation and is impacted by the social determinants of health (SDOH) is critical to addressing inequities.…”

“…2 Structural inequities lead to a higher prevalence of many cardiometabolic diseases in Black populations. [3][4][5] For instance, the total diabetes prevalence is 17.4% in Black populations, compared with 13.6% in White populations. 6 Although age-adjusted stroke death rates declined by 7% or more among all racial and ethnic groups between 2008 and 2018, rates remained higher in Black populations (52.3 deaths per 100 000 population; change since 2008, −12.7%) compared with White populations (35.9 deaths per 100 000 population; change since 2008, −11.4%).…”

“…), are urgently needed to advance cardiometabolic health equity. Policy approaches to eradicate structural inequities in historically marginalized communities would catalyze further gains toward eliminating health disparities,[3][4][5]32 as evidenced by the Moving to Opportunity study, 45 in which women using housing vouchers to move to a low-poverty census track had lower rates of class II and III obesity and HbA 1c levels more than 10 years later.45 Strengths of our study include a large, community-based, socioeconomically diverse, contemporaneous Black cohort with more than 15 years of follow-up to assess mortality. We used validated questionnaires to assess risk factors and a comprehensive documentation of diabetes over time, including fasting glucose, HbA 1c , medication use, and self-reported physician diabetes diagnosis.…”

Community-Based Participatory Research to Improve Cardiovascular Health Among US Racial and Ethnic Minority Groups

“…Additionally, socioeconomic and racial/ethnic disparities in cardiovascular risk factors and mortality persist despite skyrocketing national healthcare expenditures, which have tripled over the past 20 years to $4.1 trillion/year in 2020 [ 8 ]. Thus, although evidence demonstrates longstanding racial/ethnic and socioeconomic disparities in CVH, interventions at the population level have lagged [ 9 ]. The solutions to address these disparities include prevention, community engagement, and policy change.…”