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Review
. 2023 Apr 11;81(14):1368-1385.
doi: 10.1016/j.jacc.2023.01.042.

Assessing and Addressing Social Determinants of Cardiovascular Health: JACC State-of-the-Art Review

Eric J Brandt  1 , Kardie Tobb  2 , Julia C Cambron  3 , Keith Ferdinand  4 , Paul Douglass  5 , Patricia K Nguyen  6 , Krishnaswami Vijayaraghavan  7 , Sabrina Islam  8 , Ritu Thamman  9 , Shahid Rahman  10 , Akshay Pendyal  11 , Nishtha Sareen  12 , Celina Yong  6 , Latha Palaniappan  13 , Uzoma Ibebuogu  14 , Andrew Tran  15 , Adrian M Bacong  13 , Gina Lundberg  16 , Karol Watson  17
Affiliations
Review

Assessing and Addressing Social Determinants of Cardiovascular Health: JACC State-of-the-Art Review

Eric J Brandt et al. J Am Coll Cardiol. .

Abstract

Social determinants of health (SDOH) are the social conditions in which people are born, live, and work. SDOH offers a more inclusive view of how environment, geographic location, neighborhoods, access to health care, nutrition, socioeconomics, and so on are critical in cardiovascular morbidity and mortality. SDOH will continue to increase in relevance and integration of patient management, thus, applying the information herein to clinical and health systems will become increasingly commonplace. This state-of-the-art review covers the 5 domains of SDOH, including economic stability, education, health care access and quality, social and community context, and neighborhood and built environment. Recognizing and addressing SDOH is an important step toward achieving equity in cardiovascular care. We discuss each SDOH within the context of cardiovascular disease, how they can be assessed by clinicians and within health care systems, and key strategies for clinicians and health care systems to address these SDOH. Summaries of these tools and key strategies are provided.

Keywords: built environment; community; economic stability; education; health care access; social environment.

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Conflict of interest statement

Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

CENTRAL ILLUSTRATION
CENTRAL ILLUSTRATION. Impact of Social Determinants of Health on Health Through Health Care Providers and Systems
The U.S. Department of Health and Human Services’ Health People 2030 recognizes 5 domains of social determinants of health, including economic stability, education, health care access and quality, social and community context, and neighborhood and built environment. The World Health Organization framework of social determinants of health recognizes that these social determinants of health directly and indirectly impact health and well-being as well as health outcomes. Both health care providers and the health system can act as indirect modifiers for how these social determinants of health impact health, well-being, and health outcomes.
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