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The Journal of Heart and Lung Transplantation
International Society for Heart and Lung Transplantation.

Sociodemographic indices in pediatric heart failure: Maximizing data to influence future social determinants of health interventions

Published:November 06, 2022DOI:https://doi.org/10.1016/j.healun.2022.10.027
      In November of 2020, the American Heart Association published their “Call to Action” on Structural Racism as a Fundamental Driver of U.S. Health Disparities, recognizing it as a fundamental cause of poor health outcomes and disparities in cardiovascular disease.
      • Churchwell K
      • Elkind M
      • Benjamin R
      • et al.
      Call to action: structural racism as a fundamental driver of health disparities: a presidential advisory from the American Heart Association.
      In this document, structural racism was defined as “the normalization and legitimization of an array of dynamics–historical, cultural, institutional, and interpersonal–that routinely advantage White people while producing cumulative and chronic adverse outcomes for people of color” leading to “differential access to goods, services, and opportunities”.
      • Churchwell K
      • Elkind M
      • Benjamin R
      • et al.
      Call to action: structural racism as a fundamental driver of health disparities: a presidential advisory from the American Heart Association.
      The results of structural racism are evident in unequal social determinants of health (SDOH- the conditions in which people live, grow, work, play, etc.), which ultimately result in differences in health outcomes, or health disparities.

      Healthy people 2030. Social determinants of health 2020; Available at: https://health.gov/healthypeople/priority-areas/social-determinants-health. Accessed October 17, 2022.

      These disparities have also been well described when assessing differential outcomes in cardiac transplantation and heart failure in adults. Recent studies have demonstrated that adult Black patients were less likely to undergo transplantation, had a higher risk of posttransplant death, and had a 2.6-fold higher heart failure mortality rate compared to White patients.
      • Glynn P
      • Lloyd-Jones D
      • Feinstein M
      • et al.
      Disparities in cardiovascular mortality related to heart failure in the United States.
      ,
      • Breathett K
      • Knapp S
      • Carnes M
      • et al.
      Imbalance in heart transplant to heart failure mortality ratio among African American, Hispanic, and White Patients.

      Abbreviations:

      SDOH (Social Determinants of Health), DCI (Distressed Communities Index), COI (Childhood Opportunity Index)
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