From the Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (G.A.M., L.N.P., M.C.G.P., B.J.N., R.A.R., M.M.E.); Loyola University Medical School, Department of Public Health Sciences, Chicago, IL (R.S.C.); University of Virginia School of Nursing, Charlottesville (A.M.S.-R.); Johns Hopkins School of Medicine, Department of Medicine, Baltimore, MD (L.A.C.); Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior, and Society, Baltimore, MD (L.A.C.); Center for Prevention Implementation Methodology (Ce-PIM), Northwestern University Feinberg School of Medicine, Chicago, IL (J.D.S., C.H.B.); Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora (J.M.W.); Morehouse School of Medicine, Department of Medicine, Atlanta, GA (E.O.O.); Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (S.A., C.R.N., N.R., M.L.A.-S., J.P.R., C.A.P., D.C.G.); University of Mississippi Medical Center, John D. Bower School of Population Health, Jackson (B.M.B.); University of North Carolina at Chapel Hill School of Nursing (J.L.B.); Michigan State University College of Human Medicine, Department of Epidemiology and Biostatistics, East Lansing (D.F.-H.); National Human Genome Research Institute, Bethesda, MD (S.Y.G.); School of Public Health, University of Illinois at Chicago (W.H.G., K.S.W.); Office of the Director, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD (R.S.J., E.J.P.-S.); Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA (T.T.L.); Institute for Health Metrics and Evaluation, University of Washington, Seattle (A.H.M.); Department of Neurology, University of Louisville, KY (K.D.M.); Department of Population Health, Center for Healthful Behavior Change, New York University School of Medicine, New York (J.E.R.); Community-Campus Partnerships for Health, Raleigh, NC (A.R.); UK Medical Center, University of Kentucky, Department of Medical Behavioral Science, Lexington (N.E.S.); Department of Medicine, Jackson Heart Study, University of Mississippi Medical Center (M.S.); Office of Health Equity, Health Resources and Services Administration, Rockville, MD (G.K.S.); National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD (A.E.S.); and Social and Health Research Center, San Antonio, TX (R.P.T.).
Circ Res. 2018 Jan 19;122(2):213-230. doi: 10.1161/CIRCRESAHA.117.312243.
Cardiovascular disparities remain pervasive in the United States. Unequal disease burden is evident among population groups based on sex, race, ethnicity, socioeconomic status, educational attainment, nativity, or geography. Despite the significant declines in cardiovascular disease mortality rates in all demographic groups during the last 50 years, large disparities remain by sex, race, ethnicity, and geography. Recent data from modeling studies, linked micromap plots, and small-area analyses also demonstrate prominent variation in cardiovascular disease mortality rates across states and counties, with an especially high disease burden in the southeastern United States and Appalachia. Despite these continued disparities, few large-scale intervention studies have been conducted in these high-burden populations to examine the feasibility of reducing or eliminating cardiovascular disparities. To address this challenge, on June 22 and 23, 2017, the National Heart, Lung, and Blood Institute convened experts from a broad range of biomedical, behavioral, environmental, implementation, and social science backgrounds to summarize the current state of knowledge of cardiovascular disease disparities and propose intervention strategies aligned with the National Heart, Lung, and Blood Institute mission. This report presents the themes, challenges, opportunities, available resources, and recommended actions discussed at the workshop.
心血管疾病的差异在美国仍然普遍存在。根据性别、种族、民族、社会经济地位、教育程度、出生地或地理位置，不同人群的疾病负担不平等。尽管在过去 50 年中，所有人群的心血管疾病死亡率都显著下降，但性别、种族、民族和地理位置方面仍然存在很大差异。最近的建模研究、关联微地图和小区域分析数据也表明，各州和县的心血管疾病死亡率存在明显差异，美国东南部和阿巴拉契亚地区的疾病负担尤其沉重。尽管存在这些持续存在的差异，但在这些高负担人群中很少进行大规模的干预研究，以研究减少或消除心血管差异的可行性。为了应对这一挑战，2017 年 6 月 22 日至 23 日，美国国家心肺血液研究所召集了来自广泛的生物医学、行为、环境、实施和社会科学背景的专家，总结了目前心血管疾病差异的知识状况，并提出了与该研究所使命一致的干预策略。本报告介绍了研讨会讨论的主题、挑战、机遇、现有资源和建议的行动。
