TY - JOUR
T1 - COVID-19, Social Determinants of Health, and Opportunities for Preventing Cardiovascular Disease
T2 - A Conceptual Framework
AU - Russo, Rienna G.
AU - Li, Yan
AU - Ðoàn, Lan N.
AU - Ali, Shahmir H.
AU - Siscovick, David
AU - Kwon, Simona C.
AU - Yi, Stella S.
N1 - Funding Information:
This publication is supported in part by the National Institutes of Health National Institute on Minority Health and Health Disparities Award Number U54MD000538, National Heart, Lung, and Blood Institute Award Number R01HL141427, US Department of Health and Human Services, Centers for Disease Control and Prevention (CDC) Award Number NU38OT2020001477, CFDA number 93.421. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health or the Centers for Disease Control and Prevention.
Publisher Copyright:
© 2021 The Authors.
PY - 2021/12/21
Y1 - 2021/12/21
N2 - The COVID-19 pandemic has disrupted the social, economic, and health care systems in the United States and shined a spotlight on the burden of disease associated with social determinants of health (SDOH). Addressing SDOH, while a challenge, provides important opportunities to mitigate cardiovascular disease incidence, morbidity, and mortality. We pre-sent a conceptual framework to examine the differential effects of the COVID-19 pandemic on SDOH across demographically diverse populations, focusing on the short-and long-term development of cardiovascular disease, as well as future research opportunities for cardiovascular disease prevention. The COVID-19 pandemic exerted negative shifts in SDOH and cardiovascular risk factors (ie, smoking, body mass index, physical activity, dietary behavior, cholesterol, blood pressure, and blood sugar). For example, evidence suggests that unemployment and food insecurity have increased, whereas health care access and income have decreased; changes to SDOH have resulted in increases in loneliness and processed food consumption, as well as decreases in physical activity and hypertension management. We found that policy measures enacted to mitigate economic, social, and health issues inadequately protected populations. Low-income and racial and ethnic minority com-munities, historically underserved populations, were not only disproportionately adversely affected by the pandemic but also less likely to receive assistance, likely attributable in part to the deep structural inequities pervasive in our society. Effective and culturally appropriate interventions are needed to mitigate the negative health impacts of historical systems, policies, and programs that created and maintain structural racism, especially for immigrants, racial and ethnic minorities, and populations experiencing social disadvantage.
AB - The COVID-19 pandemic has disrupted the social, economic, and health care systems in the United States and shined a spotlight on the burden of disease associated with social determinants of health (SDOH). Addressing SDOH, while a challenge, provides important opportunities to mitigate cardiovascular disease incidence, morbidity, and mortality. We pre-sent a conceptual framework to examine the differential effects of the COVID-19 pandemic on SDOH across demographically diverse populations, focusing on the short-and long-term development of cardiovascular disease, as well as future research opportunities for cardiovascular disease prevention. The COVID-19 pandemic exerted negative shifts in SDOH and cardiovascular risk factors (ie, smoking, body mass index, physical activity, dietary behavior, cholesterol, blood pressure, and blood sugar). For example, evidence suggests that unemployment and food insecurity have increased, whereas health care access and income have decreased; changes to SDOH have resulted in increases in loneliness and processed food consumption, as well as decreases in physical activity and hypertension management. We found that policy measures enacted to mitigate economic, social, and health issues inadequately protected populations. Low-income and racial and ethnic minority com-munities, historically underserved populations, were not only disproportionately adversely affected by the pandemic but also less likely to receive assistance, likely attributable in part to the deep structural inequities pervasive in our society. Effective and culturally appropriate interventions are needed to mitigate the negative health impacts of historical systems, policies, and programs that created and maintain structural racism, especially for immigrants, racial and ethnic minorities, and populations experiencing social disadvantage.
KW - COVID-19 pandemic
KW - Cardiovascular disease
KW - Health disparities
KW - Social determinants of health
UR - http://www.scopus.com/inward/record.url?scp=85122903592&partnerID=8YFLogxK
U2 - 10.1161/JAHA.121.022721
DO - 10.1161/JAHA.121.022721
M3 - Review article
C2 - 34889110
AN - SCOPUS:85122903592
SN - 2047-9980
VL - 10
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 24
M1 - e022721
ER -