![Credit: Pixabay/CC0 Public Domain Heart Health](https://scx1.b-cdn.net/csz/news/800a/2023/heart-health.jpg)
Credit: Pixabay/CC0 Public Domain
Researchers from the Mayo Clinic and the University of Minnesota Clinical and Translational Science Journaloffers a new framework to explain how racism impacts the heart health of people of color in Minnesota, as researchers focus on reversing these disparities.
“This framework will help scientists study and measure how chronic exposure to racism, rather than race, affects health outcomes,” said Dr. Sean Phelan, a health services researcher at Mayo Clinic and senior author of the paper. “This will enable researchers to address the root causes of these disparities and design interventions to improve the heart health of people of color around the world.”
The researchers are part of the Center for Chronic Disease Reduction and Advancing Equity in Minnesota (C2DREAM), which works with community leaders and community health organizations across Minnesota to reduce cardiovascular health disparities.
Taking a broader perspective to reduce inequality
Historically, research on racism and health has focused on interpersonal racism. The C2DREAM framework takes a broader perspective and considers how oppressive systems of power, structural and institutional racism, and interpersonal racism work together to affect social determinants of health and health outcomes. Social determinants of health are non-medical factors that affect health. The U.S. Centers for Disease Control and Prevention describes these as “the conditions in which people are born, grow, work, live, and age.”
“Our social structures and policies deny or allow access to opportunities in ways that impact health throughout a person’s life,” says Kene Orakwe, lead author of the study and a predoctoral student in health services research, policy and management at the University of Minnesota School of Public Health. “I believe that in order to reduce inequalities, we need to be intentional about examining these social structures.”
People who experience chronic racism may be affected by factors such as intergenerational trauma, reduced access to health care, discriminatory treatment in medical settings, and psychological distress — all of which can negatively impact heart health with cumulative effects over the course of a lifetime.
Promoting research to combat racial discrimination
C2DREAM’s goal is to find ways to disrupt the impact of racism on heart health, and the C2DREAM framework provides a roadmap for researchers, including a common set of measures for different types of racism.
“To change something, you have to be able to measure it,” said Felicity Enders, PhD, associate director of the Mayo Clinic Center for Clinical and Translational Science and co-investigator on C2DREAM.
The C2DREAM framework guides critical thinking, illuminates the multidimensional relationship between racism and heart health, and shows researchers how to measure the impact of racism at different levels. In doing so, the framework also shows researchers how to measure the actual impact of interventions.
For example, Enders says, studies with immigrant communities might look at structural barriers to heart health, such as access to culturally appropriate healthy foods, institutional barriers, such as the availability of interpreters during telehealth visits, and interpersonal barriers, such as cultural understanding between doctors and patients.
C2DREAM researchers are already using this framework to guide their work. All C2DREAM studies collect common indicators of inequality, such as residential segregation and income disparity. This makes it easier to compare, share, and combine data across studies. It also leads to a more comprehensive understanding of how racism impacts heart health across Minnesota, and how to stop that impact.
Improving racial discrimination measures
The researchers view the C2DREAM framework as merely a starting point, and future research will focus on refining measures of structural, institutional, and interpersonal racism, and expanding the framework to include the effects of cultural and internalized racism.
C2DREAM is a regional, statewide effort across Minnesota that includes Mayo Clinic and Mayo Clinic Health System, the University of Minnesota, Hennepin Healthcare, Native American Community Clinics and the RAND Corporation, bringing together researchers and community stakeholders from a range of disciplines to leverage evidence-based medicine expertise and local and cultural knowledge.
2024 Mayo Clinic News Network. Distributed by Tribune Content Agency, LLC.
Quote: Reversing the impact of racism on heart health (July 5, 2024) Retrieved July 5, 2024, from https://medicalxpress.com/news/2024-07-reversing-racism-toll-heart-health.html
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