July 15, 2022 — The American Heart Association, the leading voluntary organization devoted to longer, healthier lives, recognizes structural racism as a major cause of poor health and premature death from heart disease and stroke. Areas in the U.S. with more social vulnerabilities have higher premature mortality from cardiovascular disease. The American Heart Association, and the Association of Black Cardiologists hosted a six-month data challenge in which researchers tested the relationships between heart failure and health disparities, social determinants of health and structural determinants of health. The results were evaluated by a peer review group of nearly 30 experts in the field. Four teams of researchers are winners.
“Congratulations to these researchers for their exceptional work in the heart failure data challenge,” said Michelle A. Albert, M.D., M.P.H., past president of the Association of Black Cardiologists and president of the American Heart Association. “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. These teams must be commended for their efforts at addressing health equity, one of the most pressing areas in healthcare.”
The Winners Are:
Ambarish Pandey, M.D. (University of Texas Southwestern Medical Center, Dallas) led the study “Impact of Social and Structural Determinants of Health on Hospital Length of Stay among Heart Failure Patients according to Race,” with his team Matthew W. Segar, M.D., M.S. (Texas Heart Institute, Houston), Shreya Rao, M.D., M.P.H. (University of Texas Southwestern Medical Center, Dallas), Sandeep Das, M.D., M.P.H., M.B.A. (University of Texas Southwestern Medical Center, Dallas).
The study leveraged the American Heart Association’s Get With The Guidelines® – Heart Failure registry data to identify key ZIP code level social determinants of health parameters that are significantly associated with prolonged length of stay following heart failure hospitalization.
Gargya Malla, M.D., M.P.H., Ph.D. (University of Alabama at Birmingham) led the project “Neighborhood Disadvantage and Risk of Heart Failure Among Black and White Adults: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study.” Her team included researchers from University of Alabama at Birmingham; Weill Cornell Medicine, New York; East Carolina University, Greenville, North Carolina, and Drexel University, Philadelphia. The study investigated incident heart failure risk associated with living in disadvantageous neighborhoods and if this association was different for white and Black adults in the US.
Third Place (tie):
Jeffrey Tran, M.D. and Nancy Sweitzer, M.D., Ph.D. (University of Arizona Sarver Heart Center, Tucson, Arizona) led the study “The Effect of Socioeconomic Determinants of Health on the Prescription of Angiotensin Receptor Blocker/Neprilysin Inhibitors at Discharge from the Hospital,” which investigated how socioeconomic determinants of health impact the odds of being prescribed angiotensin receptor blocker/neprilysin inhibitors in patients experiencing heart failure with reduced ejection fraction being discharged from the hospital. The study leveraged multilevel multiple imputation to handle missing data and use existing data to the fullest extent possible.
Vishal Rao, M.D., M.P.H. (Duke University Medical Center, Durham, North Carolina) and Melissa Caughey, Ph.D. (University of North Carolina – Chapel Hill, North Carolina) led the project “In-Hospital Outcome Differences in Patients Hospitalized for Heart Failure Across Neighborhood Socioeconomic Disadvantage in the American Heart Association Get With The Guidelines - Heart Failure Registry.” The team explored the association between socioeconomic status disadvantage and in-hospital heart failure outcomes in patients from diverse neighborhoods in the Get With The Guidelines - Heart Failure Registry.
The research findings from all the winning studies are currently under consideration for publication in peer-reviewed scientific journals and are not yet publicly available.
“These types of data challenge projects provide much-needed insights into the relationships between heart failure and social determinants of health. Data challenges bring in top level scientists that provide novel and effective solutions,” said Jennifer Hall, Ph.D., chief of data science for the American Heart Association.
Health disparities include environmental threats, individual and behavioral factors, inadequate access to health care, poverty and educational inequalities. Social determinants of health include resources such as food supply, housing, economic and social relationships, education and health care. Structural determinants of health include economic, governing and social policies that affect pay, working conditions, housing and education.
Researchers had access to the American Heart Association’s Get With The Guidelines – Heart Failure registry data on the American Heart Association’s Precision Medicine Platform to conduct their analyses. 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.
For more information: www.heart.org
 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).
 Khan SU, Javed Z, Lone AN, et al. Social vulnerability and premature cardiovascular mortality among us counties, 2014 to 2018. Circulation. 2021;144(16):1272-1279.