Striving for Equity in Health Care

By Jane Farrell

Where you live shouldn’t determine how well or how long you live, but it does. The American Heart Association recognizes that medical care alone is insufficient to ensure better health and well-being: about 80% of a person’s health is determined by factors other than access and quality of clinical care. When people don’t have stable homes, nutritious food, good schools or clean air or water, their health suffers. The American Heart Association, the leading voluntary organization devoted to longer, healthier lives for all, has awarded a $675,000 medical research grant to Greg Roth, M.D., M.P.H, associate professor of medicine/cardiology from the Division of Cardiology at the University of Washington and the Institute for Health Metrics and Evaluation in Seattle, Washington, to evaluate how cardiovascular health risks and outcomes are impacted by social determinants of health, focusing on evaluation of the Association’s Social Impact Fund.

Roth will lead the project Cardiovascular Health Metrics for Community-based Programs – Framework for Evaluation of the American Heart Association Social Impact Fund, which will receive $225,000 per year over three years.

The American Heart Association established its Social Impact Fund to target sustainable solutions focused on access to health care, housing, and affordable and healthy food; economic empowerment; or closing the educational achievement gap in under-resourced communities.

It is widely recognized that health disparities are largely influenced by social determinants. Social determinants of health are the structural determinants and conditions in which people are born, grow, live, work, and age that affect health, functioning, and quality of life. There are currently five main domains of social determinants of health, including economic stability, neighborhood and built environment, education, social, and community context, and health and health care. Each of these domains may have relevance at the individual, neighborhood and environmental level.

Given that social factors represent the base for how health is experienced, data about social determinants of health have been generally assessed and addressed in isolation of one another, leading to widely disparate forms of data and data collection strategies. The absence of a standard approach to collecting these data is a potential barrier to the ability to compare, extrapolate, and apply evidence-based findings to larger populations.

The American Heart Association believes the establishment of a common language and standard set of metrics in this field is critical to furthering the ability to combine data from multiple studies, measure impact and improve our understanding of social and environmental variables that impact quality-of-life related risks and outcomes.

To address these goals for commonalities in data, the grant includes an Amazon Web Services (AWS) credit for $50,000 per year for use on the American Heart Association Precision Medicine Platform. The Precision Medicine Platform, powered by AWS, is a central hub for the cardiovascular and stroke research community to access vast and diverse datasets and cloud-based workspaces. These datasets and workspaces enable state-of-the-art, high-performance computing, analytics and collaboration to accelerate scientific discovery. The Precision Medicine Platform provides streamlined data access and cloud-based workspaces, removing traditional barriers researchers often face when approaching challenging scientific questions.

“At the American Heart Association, equity and science are at the center of everything we do. Addressing the connection between cardiovascular health risks and social determinants of health is key to closing the healthy equity gap,” said Jennifer Hall, Ph.D., chief of data science for the American Heart Association. “By using the Association’s Precision Medicine Platform, researchers can come together to help us better understand how we can break down social and economic barriers to health equity.”