Dr. Pandey’s team included UT Southwestern colleagues Shreya Rao, M.D., M.P.H., and Sandeep Das, M.D., M.P.H., M.B.A.; and Matthew W. Segar, M.D., M.S., of the Texas Heart Institute in Houston. Their project, Impact of Social and Structural Determinants of Health on Hospital Length of Stay among Heart Failure Patients according to Race, focused on correlations between hospital length of stay for patients with heart failure and ZIP codes, using data from the American Heart Association’s Get With The Guidelines® – Heart Failure registry to examine Black versus non-Black populations and geographic areas across the country.
“It is well-established that Black individuals have a disproportionately higher burden of heart failure and worse access to care outside of the hospital, and that social determinants of health are important drivers of these disparities,” said Dr. Pandey, a general cardiologist with interest in heart failure research. “In this study, we focused on how neighborhood-level measures of social determinants of health impact length of stay for heart failure hospitalization among patients who self-report as Black and contrasted it with patients of other races.” The social determinants of health included neighborhood-level measures of income, education, housing stability, social support, access to transportation, rural vs. urban location, and proportion of individuals who were foreign-born with limited English proficiency in the community.
The American Heart Association, the leading voluntary organization devoted to longer, healthier lives, recognizes social determinants of health, including structural racism, as a major cause of poor health and premature death from heart disease and stroke.[1]
“Improving our understanding of how social determinants of health impact certain populations in order to develop consequential targeted solutions requires harmonization of different types of data,” said Michelle A. Albert, M.D., M.P.H., president of the American Heart Association and immediate past president of the Association of Black Cardiologists.
The team used the American Heart Association’s Precision Medicine Platform to investigate key questions around socioeconomic disparities and heart failure outcomes. The Precision Medicine Platform is an easy-to-use research interface that allows researchers to collaborate from anywhere in the world in a secure, cloud-based environment. With artificial intelligence and deep machine-learning capabilities, the Precision Medicine Platform gives researchers the power and speed to bring their data together collaboratively and accelerate their findings into impactful discoveries for patients faster than ever before.
Dr. Pandey pointed to the need to invest in improving access to care in socioeconomically disadvantaged neighborhoods as a strategy to alleviate the existing disparities.
[1] Churchwell K, Elkind MSV, Benjamin RM, et al. Call to action: structural racism as a fundamental driver of health disparities: a presidential advisory from the American Heart Association. Circulation. 2020;142(24).