Top Things to Know: Implementation of Prevention Science to Eliminate Healthcare Inequities
Prepared by Katherine A. Sheehan, PhD, Science and Medicine Advisor
- The American Heart Association is a leader in promoting ideal cardiovascular (CV) health leading to the Life’s Essential 8 metrics, and the 2024 Impact Goal which aims to advance cardiovascular health for all, including identifying and removing barriers to health care access and quality.
- Prevention of cardiovascular and related diseases is foundational to attaining ideal cardiovascular health and is focused on reducing risk factors through evidence-based strategies.
- The purpose of this scientific statement is to examine barriers to ideal CV health and its related conditions and outline ways to use existing healthcare resources to reduce inequities related to social determinants of health (SDoH) and improve the equitable delivery of CV health care.
- The statement systematically discusses interventions across health care environments involving direct patient care, ways to leverage health care technology, optimization of multispecialty and multi professional collaborations and interventions, ways to engage local communities, and health-related government policies that will improve the community environment to achieve equitable healthcare.
- Core SDoH as defined by the World Health Organization and how they impact CV health are detailed, including public health literacy, neighborhoods and the built environment, access to health care, economic stability, and social and community context such as racial and ethnic inequalities.
- Specific interventions to improve health equity are described, including educating members of the health care team, increasing diversity within health care settings, use of language that promotes health equity, and improving health literacy at the patient care level.
- Health care technology can be leveraged towards greater equity through improvements in electronic medical records (EMRs), delivery of care via telehealth, and technology used by patients such as smart watches, that can better serve patients.
- Multidisciplinary and collaborative approaches to care can help reduce health care inequities such as empowering the patient and fostering a sense of shared responsibility among team members. These may include primary care clinicians, nurses, dieticians, pharmacists, case managers, social workers, and community health workers.
- In summary, this scientific statement outlines a broad approach and practical strategies to using existing resources to improve health care equity. These include use of technology, collaborative approaches to patient clinical care, and community engagement through stakeholders and local governments.
- Coordination of conscious and meaningful efforts in a multilayer approach to improve healthcare policy and community engagement are important initial steps to mitigate and eliminate health inequities.
Citation
Agarwala A, Patel J, Stephens J, Roberson S, Scott J, Beckie T, Jackson EA; on behalf of the American Heart Association Prevention Science Committee of the Council on Epidemiology and Prevention and Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Lifestyle and Cardiometabolic Health; Council on Peripheral Vascular Disease; Council on Quality of Care and Outcomes Research; and Stroke Council. Implementation of prevention science to eliminate health care inequities in achieving cardiovascular health: a scientific statement from the American Heart Association [published online ahead of print September12, 2023]. Circulation. doi: 10.1161/CIR.0000000000001171