Second annual special issue spotlights disparities research, impact on health equity

Issue Highlights:

• The American Heart Association’s flagship scientific journal Circulation today published its second annual special issue focused on disparities in cardiovascular medicine, in a quest to better understand the impact of these disparities on equitable delivery of cardiovascular care for all.
• This year, the special disparities issue features new clinical trial research, state-of-the-art reviews and scientific perspectives that explore how social, cultural and structural determinants of health are driving disparities in cardiovascular disease incidence and outcomes.
• The new Equity, Diversity and Inclusion (EDI) Editorial Board of the AHA’s scientific journals shared an editorial, published in Circulation, detailing its focused efforts to facilitate more and better science in the health equity and diversity space and increase diverse representation throughout the editorial, author and reviewer pool.

For Immediate Release at 1 p.m. CT/2 p.m. ET, Monday, July 18, 2022

DALLAS, July 18, 2022 — The American Heart Association’s flagship journal Circulation published today its second annual issue devoted to disparities in cardiovascular medicine. The special issue is a complementary collection of On My Mind commentaries, Original Research Articles and Research Letters that evaluate the multiple ways in which disparities impact cardiovascular health equity.

“We are proud to assemble this second annual issue to feature research and insights that can help us understand the layered and complex factors that drive health disparities,” noted the editors of the special issue, Circulation Associate Editors Mercedes R. Carnethon, Ph.D., FAHA, Karol E. Watson, M.D., Ph.D., and Fatima Rodriguez, M.D., M.P.H. “Cardiovascular health disparities are apparent across multiple domains defined by individual and structural indicators of socioeconomic position, age, ethnicity, ability status, nativity, sexual orientation, and gender identity. A shared characteristic of these domains is that social, cultural and structural determinants of health are driving disparities in cardiovascular disease incidence and outcomes. Understanding these interdependent factors is the first step to developing and implementing changes that can make a difference.”

The themed issue is highlighted in the journal’s weekly podcast series, Circulation on the Run. The podcast, posted simultaneously with the publication of the issue, features a discussion with researchers Drs. Kyalwazi and Wadhera, who discuss insights from their paper on disparities in cardiovascular mortality over a 20-year timeframe between Black and white adults.

“Research on health disparities is critical to our ability to dismantle the many barriers to achieving health equity for all,” said Circulation Editor-in-Chief Joseph A. Hill, M.D., Ph.D., a professor of internal medicine and molecular biology and chief of cardiology at UT Southwestern Medical Center and director of the Harry S. Moss Heart Center in Dallas. “Our editorial team remains steadfast in our commitment to providing an open and inclusive forum for disparities research that will help inform and hopefully improve health care quality, access and equity.”

The featured manuscripts can be accessed in full here and include:

Editor’s Page: Toward a Broader Conceptualization of Disparities and Solutions –Mercedes R. Carnethon, Fatima Rodriguez, Karol E. Watson

On My Mind:

• Far Apart, but Close at Heart: The Importance of Understanding Patient Barriers to Telehealth and Potential Solutions – Leslie Eiland and Andjela Drincic
• Broadening the Pool of Mentors for Historically Underrepresented Trainees and Faculty in Cardiology – Mercedes R. Carnethon and Philip Greenland
• Achieving Health Equities in Indigenous Peoples in Canada: Learnings Adaptable for Diverse Populations – Peter P. Liu; Malcolm King; Alexandra King
• Leaving the Social Vacuum: Expanding Cardiovascular Guidelines to Embrace Equity – Jared W. Magnani and LaPrincess C. Brewer

Original Research:

• Association of Neighborhood-Level Material Deprivation With Atrial Fibrillation Care in a Single-Payer Health Care System: A Population-Based Cohort Study – Husam Abdel-Qadir et al.
  

  • Editorial: Whose Streets? Neighborhood-Level Determinants of Atrial Fibrillation Care – Utibe R. Essien et al.

• Community-Based, Cluster-Randomized Pilot Trial of a Cardiovascular Mobile Health Intervention: Preliminary Findings of the FAITH! Trial – LaPrincess C. Brewer et al.
• Differences in Comorbidities Explain Black–White Disparities in Outcomes After Femoropopliteal Endovascular Intervention – Anna K. Krawisz et al.
• Associations of Clinical and Social Risk Factors With Racial Differences in Premature Cardiovascular Disease – Nilay S. Shah et al.
• Disparities in Cardiovascular Mortality Between Black and White Adults in the United States, 1999 to 2019: Cardiovascular Mortality for Black and White Women and Men – Ashley N. Kyalwazi et al.
• Racial and Ethnic Differences in All-Cause and Cardiovascular Disease Mortality: The MESA Study – Wendy S. Post et al.
• Socioeconomic Deprivation: An Important, Largely Unrecognized Risk Factor in Primary Prevention of Cardiovascular Disease – Dorien M. Kimenai et al.
• Association of Extreme Heat and Cardiovascular Mortality in the United States: A County-Level Longitudinal Analysis From 2008 to 2017 – Sameed Ahmed M. Khatana et al.

Research Letters:

• Evolving Trends and Widening Racial Disparities in Children Listed for Heart Transplantation in the United States – M. Mujeeb Zubair et al.
  

  • Race and Ethnicity Stratification for Polygenic Risk Score Analyses May Mask Disparities in Hispanics – Shoa L. Clarke et al.

Authors’ disclosures and funding sources for each article are listed in the individual manuscripts.

The American Heart Association continues to invest in understanding and addressing disparities to improve health equity for all. In a November 2020 Presidential Advisory, “Call to Action: Structural Racism as a Fundamental Driver of Health Disparities,” the Association declared structural racism a major cause for poor health and premature death from heart disease and stroke. The Association’s 2024 Impact Goal states that “every person deserves the opportunity for a full, healthy life. As champions for health equity, by 2024, the AHA will advance cardiovascular health for all, including identifying and removing barriers to health care access and quality.” The Association has also pledged to invest more than $230 million to address the social determinants of health and the barriers to achieving health equity for all, including grant funding for focused research opportunities for underrepresented racial and ethnic groups.

The Association’s unwavering support for scientific research focused on disparities, anti-racism, health equity and community-based participation is realized in the Association’s suite of 14 peer-reviewed scientific journals including Circulation. The new Equity, Diversity and Inclusion (EDI) Editorial Board’s commentary, “Creation of the American Heart Association Journals’ Equity, Diversity, and Inclusion Editorial Board: The Next Step to Achieving the 2024 Impact Goal,” was published today in Circulation. The EDI Editorial Board’s role is to facilitate more and better science in the health equity and diversity space and increase representation throughout the editorial, author and reviewer pool. With input from the Editors-in-Chief, the EDI Editorial Board has met regularly over the past year to develop a workflow, standardize nomenclature for published manuscripts and minimize the effect on length of review for manuscript submissions. The strategies and tactics implemented will evolve, acknowledging that “increasing overall diversity and improving health equity for all is challenging work involving a multitude of stakeholders, but it is important, essential and urgent.”

The demographic information report for all of the Association’s journals, in aggregate, is posted here publicly and will be updated annually. This report catalogs the composition of editorial boards, invited authors and invited reviewers by gender, racial and ethnic diversity via the optional self-reported demographic data that users provide in the journals’ manuscript tracking system. And, in early 2021, the Association’s journals adopted new guiding principles and detailed standards for publishing disparities research outlined in “The Groundwater of Racial and Ethnic Disparities Research: A Statement from Circulation: Cardiovascular Quality and Outcomes.” These tenets challenge the scientific research community to recognize the historical foundation of race as a social not a biological construct that was designed to separate one population from another – and to avoid perpetuating racism.

Additional Resources:

Studies published in the American Heart Association’s scientific journals are peer-reviewed. The statements and conclusions in each manuscript are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers and the Association’s overall financial information are available here. 

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public’s health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.  

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