Social Determinants of Health in Cardio-Oncology

JACC CardioOncology, Год журнала: 2024, Номер 6(3), С. 331 - 346

Опубликована: Май 7, 2024

Addressing the need for more equitable cardio-oncology care requires attention to existing disparities in cardio-oncologic disease prevention and outcomes. This is particularly important among those affected by adverse social determinants of health (SDOH). The intricate relationship SDOH, cancer diagnosis, outcomes from cardiotoxicities associated with oncologic therapies influenced sociopolitical, economic, cultural factors. Furthermore, mechanisms cell signaling epigenetic effects on gene expression link SDOH CVD-related complications therapies. To mitigate these disparities, a multifaceted strategy needed that includes access, policy, community engagement improved screening management. Interdisciplinary teams must also promote humility competency leverage new technology foster collaboration addressing impact

Язык: Английский

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Social and Environmental Determinants of Health and Cardio-Kidney-Metabolic Syndrome–Related Mortality

JAMA Network Open, Год журнала: 2024, Номер 7(9), С. e2435783 - e2435783

Опубликована: Сен. 26, 2024

Importance It is not well understood if and how various social environmental determinants of health (SEDoH) are associated with mortality rates related to cardio-kidney-metabolic syndrome (CKM) across the US. Objective To study magnitude association strength SEDoH CKM-related at county level Design, Setting, Participants This cross-sectional, retrospective, population-based used aggregate county-level data from US Centers for Disease Control Prevention Wide-Ranging Online Data Epidemiologic Research (WONDER) portal 2010-2019. analysis occurred September 2023 January 2024. Exposures A total 7 diverse were chosen, including median annual household income, percentage racial ethnic minority residents per county, fine particulate air pollution (PM 2.5 ) concentrations, high-school completion rate, primary care access, food insecurity, rurality rate. Main Outcomes Measures The outcome was age-adjusted rate (aaMR) attributable CKM. aaMR analyzed using geographically weighted models model coefficients each covariate studied. Results 3101 3243 counties (95.6%) analyzed. There substantial variation in between states counties. overall pooled (IQR) (2010-2019) 505.5 (441.3-578.9) 100 000 residents. Most lower half had much higher than (eg, Southern [IQR] aaMR, 537.3 [466.0-615.9] residents). positively insecurity (median β = 6.78 [2.78-11.56]) PM concentrations 5.52 [−11.06 19.70]), while it negatively income −0.002 [−0.003 −0.001]), −0.32 [−0.67 0.02]), high school −1.89 [−4.54 0.10]), −0.66 [−1.85 0.89]), access −0.18 [−0.35 0.07]). Conclusions Relevance In this cross-sectional US, there geographical differences aaMR. These findings may provide guidance deciding local policy.

Язык: Английский

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The Brain–Gut–Bone Axis in Neurodegenerative Diseases: Insights, Challenges, and Future Prospects

Advanced Science, Год журнала: 2024, Номер 11(38)

Опубликована: Авг. 9, 2024

Neurodegenerative diseases are global health challenges characterized by the progressive degeneration of nerve cells, leading to cognitive and motor impairments. The brain-gut-bone axis, a complex network that modulates multiple physiological systems, has gained increasing attention owing its profound effects on occurrence development neurodegenerative diseases. No comprehensive review been conducted clarify triangular relationship involving axis potential for innovative therapies disorders. In light this, new perspective is aimed propose interplay between brain, gut, bone highlighting their dynamic communication in diseases, as they modulate including nervous, immune, endocrine, metabolic systems. Therapeutic strategies maintaining balance brain regulation, intestinal microbiota improving skeletal health, also explored. intricate interactions within pose challenge effective treatments can comprehensively target this system. Furthermore, safety these requires further evaluation. This offers novel insights prevention treatment which have important implications clinical practice patient well-being.

Язык: Английский

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Health Equity Frameworks for Structural and Behavioral Change

Опубликована: Янв. 27, 2025

Abstract There is an ever-evolving language around health disparities and equity what considered a disparity. Though “disparity” used less often, are often conflated. This chapter assesses the various definitions of “health disparity” “equity.” And finally, how do social determinants give power privilege to some but not all? Identifying mechanisms grow will implicate changing structures as well stimulate individual-level behavioral change for people at placements along gradient. However, being able identify those requires understanding underlying theory or framework tell us where look problems. Mechanisms essential because they can intervene. summarizes frameworks that trainees scholars use describe justify factors explore in equity.

Язык: Английский

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Exposure to public housing reverses the association between neighborhood disadvantage and eosinophilic inflammation in patients with sickle cell disease

medRxiv (Cold Spring Harbor Laboratory), Год журнала: 2025, Номер unknown

Опубликована: Янв. 28, 2025

Abstract Sickle cell disease (SCD) is a single-gene illness characterized by chronic inflammation, decreased quality of life, and early mortality; however, outcomes are highly variable between individuals, suggesting substantial role social environmental factors in outcomes. Data suggest that individuals living with SCD have greater eosinophil counts activation, higher prevalence asthma wheezing than those without SCD, for eosinophilic inflammation SCD. In other diseases, has been linked to factors, particularly minoritized populations. To date, few human studies explored the pathophysiology exposures This study tested whether was related location-based measures disadvantage or public housing 79 diagnoses asthma, who were prospectively followed over one year. Home addresses geocoded matched principal-components derived, validated local neighborhood locations facilities. Serum peripheral eosinophils, IL-13 IL-5 measured every 8 weeks. fully-adjusted models, statistically significant, linear relationships observed degree level inflammation; direction relationship opposite patients live do not. For housing, associated increased inflammation. private progressively less These strong, somewhat unexpected, demonstrate subtle differences home environment differential effects on inflammatory profiles which may larger implications health, especially diseases such as understand mechanisms these require granular catalog many underlying

Язык: Английский

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Cardiometabolic deaths in black and white men: Tracing the risks from early- to mid-adulthood

Preventive Medicine Reports, Год журнала: 2025, Номер 51, С. 102997 - 102997

Опубликована: Фев. 7, 2025

This study aimed to estimate and compare cardiometabolic disease (CMD) mortality in U.S. Black White men during the transition from early adulthood middle age. Using 2022 National Vital Statistics System data standard period life table methods, we estimated risk of CMD death hypothetical cohorts age 25 45 years. We cumulative risk, excess mortality, years lost (YLL), proportion deaths due CMD, stratifying by metabolic cardiovascular disease. Of 325,134 aged initial cohort, before was one 63 individuals or 1.58 %. For men, risks were markedly lower. 1,185,384 158 0.63 The also found that 5141 expected 3090 60.10 % relative cohort. Additionally, all among 19.15 rising 6.02 at 38.00 45, compared with 11.10 increasing 4.57 19.79 45. YLL for averaged 6.72 months per person while 2.94 months. investigation shows profound racial disparities mid-adulthood.

Язык: Английский

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Associations of a Composite Stress Measurement Tool With Cardiovascular Risk Factors and Outcomes: Findings From the Dallas Heart Study

Journal of the American Heart Association, Год журнала: 2025, Номер unknown

Опубликована: Фев. 19, 2025

Background Most data linking chronic stress with cardiovascular disease (CVD) risk factors and outcomes have focused on single‐domain measurements. We evaluated the association between a novel composite measure of perceived CVD in diverse population. Methods Results Individual subcomponents (generalized stress, psychosocial, financial, neighborhood stress) were standardized integrated to create score (CSS). Participants from DHS (Dallas Heart Study) phase 2 (2007–2009) visit without prevalent who completed questionnaires included (n=2685). Associations CSS demographics, cardiac factors, health behaviors assessed multivariable analyses. Cox proportional hazards models adjusting for traditional used determine associations adjudicated atherosclerotic global (atherosclerotic CVD, heart failure, atrial fibrillation) outcomes. was higher among participants younger, women, Black or Hispanic individuals, lower income educational attainment ( P <0.0001 each). In regression age, sex, race ethnicity, education, associated hypertension, smoking, body mass index, hemoglobin A 1C , high‐sensitivity C‐reactive protein, sedentary time <0.01 Over median follow‐up 12.4 years, (adjusted hazard ratio [HR]. 1.22 per SD [95% CI, 1.01–1.47]) HR, 1.20 1.03–1.40]). No interactions seen CSS, demographic Conclusions Composite measures are vulnerable populations may help identify individuals at benefit enhanced prevention strategies.

Язык: Английский

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Associations between the neural-hematopoietic-inflammatory axis and DNA methylation of stress-related genes in human leukocytes: Data from the Washington, D.C. Cardiovascular Health and Needs Assessment

Brain Behavior & Immunity - Health, Год журнала: 2025, Номер unknown, С. 100976 - 100976

Опубликована: Март 1, 2025

Chronic stress is associated with cardiovascular disease (CVD) risk and elevated amygdala activity. Previous research suggests a plausible connection between activity, hematopoietic tissue events; however, the underlying biological mechanisms linking these relationships are incompletely understood. thought to modulate epigenomic modifications. Our investigation focused on associations activity (left (L), right (R), maximum (M), average (Av) AmygA), splenic (SpleenA), bone marrow (BMA) as determined by 18Fluorodeoxyglucose (FDG) Positron Emission Tomography/Computed Tomography (PET/CT) scans. Subsequently, we assessed how markers of chronic might relate DNA methylation stress-associated genes in community-based cohort African American individuals from Washington D.C. at for CVD. To assess AmgyA, SpleenA, BMA, methylation, linear regression models were run adjusted body mass index 10-year predicted atherosclerotic CVD risk. Among 60 participants (93.3% female, mean age 60.8), M-AmygA positively SpleenA (β = 0.29; p 0.001), but not BMA 0.01; 0.89). 0.37; 0.01 β 0.31; 0.02, respectively) 0.73; < 0.59; 0.005, both IL-1β TNFα. Decreased M-AmygA, IL-1β, TNFα NFκB1 cg07955720 STAT3 cg19438966. findings suggest potential association AmygA, pro-inflammatory cytokines setting stress, suggesting an adverse effect. Furthermore, reveal epigenetic NFκB JAK/STAT pathways linked stress.

Язык: Английский

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Intersectionality of individual and neighborhood‐level adverse social determinants of health in early pregnancy

Опубликована: Фев. 27, 2025

Abstract Introduction Individual‐ and neighborhood‐level social determinants of health (SDOH) have been assessed separately in pregnancy, but their relationship to one another remains uncertain. We investigated the intersectionality three SDOH measures with individual‐level measures. This was done examine concomitant experiences multiple pregnancy. Methods A secondary analysis data from Nulliparous Pregnancy Outcomes Study: Monitoring Mothers‐To‐Be. using geocoded participant home addresses first trimester at census‐tract level: (1) high socioeconomic disadvantage (in tertiles) by 2015 Area Deprivation Index, (2) inadequate food access USDA Food Access Research Atlas , (3) low walkability EPA National Walkability Score. measures: household income, lower educational attainment, Medicaid insurance. examined combinations these neighborhood individual graphical visualization statistical tests assess overall differences distribution Results Of 9588 nulliparous individuals, adverse [high (28%), (24%), (66%)] [low income (19%), attainment (23%), insurance (33%)] were common early Six percent individuals lived a community all those living least two measures, 23% areas walkability, 19% 1% access. Overall, no SDOH, among this group, 88% had SDOH. There significant based on whether (39%), (44%), (55%)], any (22%), (27%), (37%)], or only measure (14%), (17%), (27%)] ( p < 0.001 for all). Conclusion Among frequency generally higher when they communities more Future approaches that identify classify multifaceted multilevel nature structural as relate pregnancy outcomes are needed.

Язык: Английский

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Evolving Concepts in Cardiometabolic Risk: A Review of Recent Evidence

Research in Cardiovascular Medicine, Год журнала: 2025, Номер 14(1), С. 15 - 25

Опубликована: Янв. 1, 2025

Abstract Although traditional methods of assessing cardiometabolic risk have focused on a few factors, new research is showing the importance broader range factors. These include chronic inflammation, gut microbiome composition, and sleep disturbances, among others. In addition, environmental factors socioeconomic disparities play role. By incorporating both conventional emerging into personalized assessment, we can better understand address multifaceted nature risk. This approach will help improve individual community health outcomes. The development diagnostic tools, calculators, treatment plans an exciting step forward in our understanding embracing this expanded knowledge, work toward healthier future for everyone.

Язык: Английский

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