Social determinants of health and its impact on cardiovascular disease in underserved populations: A critical review

Padda, Inderbir; Fabian, Daniel; Farid, Meena; Mahtani, Arun; Sethi, Yashendra; Ralhan, Tushar; Das, Maumita; Chandi, Sonam; Johal, Gurpreet

doi:10.1016/j.cpcardiol.2024.102373

Cited by 5 publications

(1 citation statement)

References 44 publications

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“…The American Heart Association (AHA) forecasts that by the year 2030, an estimated 40.5% of the U.S. population will be affected 2 of 16 by cardiovascular diseases [3]. These projections underscore the importance of effective prevention strategies and public health interventions to manage the growing burden of CVD, particularly among underserved populations [4].…”

Section: Introductionmentioning

confidence: 99%

The Effects of Almond Consumption on Cardiovascular Health and Gut Microbiome: A Comprehensive Review

Singar,

Kadyan,

Patoine

et al. 2024

Nutrients

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The consumption of almonds has been associated with several health benefits, particularly concerning cardiovascular and intestinal health. In this comprehensive review, we compile and deliberate studies investigating the effects of almond consumption on cardiovascular disease (CVD) risk factors and gut health. Almonds are rich in monounsaturated fats, fiber, vitamins, minerals, and polyphenols, which contribute to their health-promoting properties. Regular intake of almonds has been shown to improve lipid profiles by reducing LDL cholesterol and enhancing HDL functionality. Additionally, almonds aid in glycemic control, blood pressure reduction, and chronic inflammation amelioration, which are critical for cardiovascular health. The antioxidant properties of almonds, primarily due to their high vitamin E content, help in reducing oxidative stress markers. Furthermore, almonds positively influence body composition by reducing body fat percentage and central adiposity and enhancing satiety, thus aiding in weight management. Herein, we also contemplate the emerging concept of the gut–heart axis, where almond consumption appears to modulate the gut microbiome, promoting the growth of beneficial bacteria and increasing short-chain fatty acid production, particularly butyrate. These effects collectively contribute to the anti-inflammatory and cardioprotective benefits of almonds. By encompassing these diverse aspects, we eventually provide a systematic and updated perspective on the multifaceted benefits of almond consumption for cardiovascular health and gut microbiome, corroborating their broader consideration in dietary guidelines and public health recommendations for CVD risk reduction.

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Section: Introductionmentioning

confidence: 99%

The Effects of Almond Consumption on Cardiovascular Health and Gut Microbiome: A Comprehensive Review

Singar,

Kadyan,

Patoine

et al. 2024

Nutrients

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Social Determinants of Health and US Health Care Expenditures by Insurer

Mohan,

Gaskin

2024

JAMA Netw Open

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ImportanceUS health expenditures have been growing at an unsustainable rate, while health inequities and poor outcomes persist. Targeting social determinants of health (SDOH) may contribute to identifying and controlling health care expenditures.ObjectiveTo determine whether SDOH are associated with US health care expenditures by Medicare, Medicaid, and private insurers.Design, Setting, and ParticipantsCross-sectional study of adults, representing the US civilian, noninstitutionalized population with Medicare, Medicaid, or private coverage, from the 2021 Medical Expenditure Panel SDOH Survey. Data analysis was conducted from October 2023 to April 2024.ExposureSDOH as individual-level, health-related social needs categorized by Healthy People 2030 domains: (1) educational access and quality, (2) health care access and quality, (3) neighborhood and built environment,(4) economic stability, and (5) social and community context.Main Outcomes and MeasuresThe primary outcome was health care expenditures (US dollars) by Medicare, Medicaid, and private insurers. A 2-part econometric model (probit regression model and generalized linear model with gamma distribution) was used.ResultsAmong the 14 918 insured adults in the analytic sample (mean [SD] age, 52.5 [17.9] years; 8471 female [56.8%]), the majority had middle to high family income (10 524 participants [70.5%]) and were privately insured (10 227 participants [68.5%]). Annual median (IQR) expenditure was $1648 ($389-$7126) for Medicaid, $3643 ($1321-$10 519) for Medicare, and $1369 ($456-$4078) for private insurers. Educational attainment and social isolation were associated with Medicaid expenditures. Medicaid beneficiaries with a high school diploma or general educational development certificate had on average (mean difference) $2245.39 lower annual Medicaid expenditures (95% CI, −$3700.97 to −$789.80) compared with beneficiaries with less than high school attainment. Compared with those who never felt isolated, Medicaid beneficiaries who often felt isolated had on average $2706.94 (95% CI, $1339.06-$4074.82) higher annual Medicaid expenditures. Health care access, built environment, and economic stability were associated with Medicare expenditures. Medicare beneficiaries living in neighborhoods with lower availability of parks had on average $5959.27 (95% CI, $1679.99 to $10 238.55) higher annual Medicare expenditures. Medicare beneficiaries who were very confident in covering unexpected expenses had on average $3743.98 lower annual Medicare expenditures (95% CI, −$6500.68 to −$987.28) compared with those who were not confident. Medical discrimination and economic stability were associated with private expenditures. Private insurance beneficiaries who experienced medical discrimination had on average $2599.93 (95% CI, $863.71-$4336.15) higher annual private expenditures compared with those who did not. Private beneficiaries who were contacted by debt collections in the past year had on average $2033.34 (95% CI, $896.82 to $3169.86) higher annual private expenditures compared with those who were not contacted.Conclusions and RelevanceIn this cross-sectional study of 14 918 insured adults, individual-level SDOH were significantly associated with US health care expenditures by Medicare, Medicaid, and private insurers. These findings may inform health insurers and policymakers to incorporate SDOH in their decision-making practices to identify and control health care expenditures, advancing health equity.

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Are the Cardiovascular Benefits and Potential Risks of Physical Activity and Exercise Dependent on Race, Ethnicity, or Sex?

Tardo,

Papadakis

2024

Canadian Journal of Cardiology

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Social determinants of health and its impact on cardiovascular disease in underserved populations: A critical review

Cited by 5 publications

References 44 publications

The Effects of Almond Consumption on Cardiovascular Health and Gut Microbiome: A Comprehensive Review

The Effects of Almond Consumption on Cardiovascular Health and Gut Microbiome: A Comprehensive Review

Social Determinants of Health and US Health Care Expenditures by Insurer

Are the Cardiovascular Benefits and Potential Risks of Physical Activity and Exercise Dependent on Race, Ethnicity, or Sex?

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