Your zip code may be as critical to your heart health as your genetic code. A comprehensive review published in the Journal of the American Heart Association illuminates how social determinants of health—including economic stability, education, and neighborhood environment—fuel persistent racial disparities in cardiovascular outcomes. The authors assert that these inequities are the result of “deeply entrenched policies, practices, and views on racial inequality and social injustice.”
The disparities are stark and measurable. Research highlights that Black adults consistently exhibit diminished cardiovascular health compared to White adults. Specific findings reveal that Black patients with high-risk heart failure are less likely to receive life-saving ventricular assist devices and transplants than their White counterparts. In cases of peripheral artery disease, Black race was associated with a 37 percent higher risk of amputation. Furthermore, hypertension prevalence is notably higher among Black and Asian adults compared to White adults in the United States.
Biological mechanisms link these social factors to physical disease. The review explains that “chronic overactivation” of stress pathways in response to discrimination results in physiological wear and tear, increasing inflammation and dysregulating immune systems. For young Black adults with acute myocardial infarction, unemployment was specifically linked to lower quality of care.
To bridge these gaps, the authors argue that the historical model of focusing solely on individual behavioral changes is insufficient. Instead, they call for new models incorporating policymakers and housing administrators, noting that “policy measures that aim to improve those SDoHs that negatively affect health outcomes hold promise for improving cardiovascular outcomes.”
See: “Impact of Social Determinants of Health on Cardiovascular Disease” (March 4, 2025)
