The Social Determinants of Cardiovascular Health

Social epidemiology “proposes to identify societal characteristics that affect the pattern of disease and health distribution in a society and to understand its mechanisms.” [1]

At AHA EPI|Lifestyle Scientific Sessions this year, the conference theme was “Genes,  Behavior, and Environment: Putting the Pieces Together,” as I discussed in my blog post in early March. [Read the post]

Both within and between the ideas of genes, behavior, and environment was the thread of health disparities and social epidemiology. Oral abstract sessions included Epidemiology of Major Cardiovascular Disease, where Dr. Ben King discussed the burden of CVD among homeless persons in Austin, Texas; Dr. Gail Daumit highlighted interventions to reduce CV risk factor burden among those with serious mental illness; and Dr. Catherine Tcheandjieu called for more inclusion of non-European descent populations in polygenic risk studies.

In the Social Determinants of Cardiometabolic Disease, social determinants of health (SDOH) came to the forefront, as would be expected. From Dr. Emily D’Agostino presenting results comparing use of different poverty measures, to Dr Marialaura Bonaccio highlighting the effect of cumulative socioeconomic disadvantage across the lifespan on heart failure hospitalizations, we in the audience learned not only how to measure and evaluate these measures of social determinants of health, but saw how they quantifiably and undeniably affect CV health and outcomes.

Caption: A key Healthy People 2020 goal is to “create social and physical environments that promote good health for all”. You can learn more [here]. Image Source: https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health

Caption: A key Healthy People 2020 goal is to “create social and physical environments that promote good health for all”. You can learn more [here]. Image Source: https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health


In the Lifecourse Epidemiology session, presenters summarized and argued for the importance of diet quality, smoking prevention, access to green spaces, and healthy diet patterns beginning in childhood to attenuate CVD risk in adulthood. Research from the Lifestyle Council naturally focuses on healthy lifestyle behaviors that are typically found in more affluent groups and likely contribute to the widening health disparities in chronic disease we’ve observed over the past decade, at least. [2]

In Dr. Leslie Lytle’s frank discussion of the lack of NIH funding towards intervention studies [3] to address not only these disparities but the lag in CV Health overall, I’m reminded of the session at #AHA17 “Closing the Gap on Disparities: Practical Strategies and Implementation,” when Dr. Michelle Albert called for epidemiologists to move from describing associations to implementing and evaluating interventions. [Read the post]

I encourage you to think of your research in the framework of social determinants of health. You can learn more about SDOHs, access data sources, and learn how to put SDOH research in action at the CDC Social Determinants page.



  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2723602/ Social epidemiology: Definition, history, and research examples. 
  2. https://www.cdc.gov/nchs/data/hus/hus15.pdf Health, United States, 2015, With Special Feature on Racial and Ethnic Health Disparities
  3. https://www.ncbi.nlm.nih.gov/pubmed/30458950 NIH Primary and Secondary Prevention Research in Humans During 2012-2017