Transforming Atrial Fibrillation Research to Integrate Social Determinants of Health: A National Heart, Lung, and Blood Institute Workshop Report.

Autor:	Benjamin EJ; Cardiovascular Medicine, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts.; Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts., Thomas KL; Division of Cardiology, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina., Go AS; Division of Research, Kaiser Permanente Northern California, Oakland.; Department of Epidemiology and Biostatistics, University of California, San Francisco.; Department of Medicine, Stanford University, Stanford, California.; Department of Medicine, University of California, San Francisco., Desvigne-Nickens P; Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland., Albert CM; Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California., Alonso A; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia., Chamberlain AM; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota.; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota., Essien UR; Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania., Hernandez I; Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego., Hills MT; StopAfib.org, American Foundation for Women's Health, Decatur, Texas., Kershaw KN; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois., Levy PD; Department of Emergency Medicine and Integrated Biosciences Center, Wayne State University, Detroit, Michigan., Magnani JW; Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania., Matlock DD; Division of Geriatrics, University of Colorado, Anschutz Medical Campus, Aurora.; VA Eastern Colorado Geriatric Research Education and Clinical Center, Denver., O'Brien EC; Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina., Rodriguez CJ; Division of Cardiovascular Medicine and Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, New York., Russo AM; Cooper Medical School of Rowan University, Camden, New Jersey., Soliman EZ; Section on Cardiovascular Medicine, Department of Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina., Cooper LS; Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland., Al-Khatib SM; Division of Cardiology, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina.
Jazyk:	angličtina
Zdroj:	JAMA cardiology [JAMA Cardiol] 2023 Feb 01; Vol. 8 (2), pp. 182-191.
DOI:	10.1001/jamacardio.2022.4091
Abstrakt:	Importance: Only modest attention has been paid to the contributions of social determinants of health to atrial fibrillation (AF) risk factors, diagnosis, symptoms, management, and outcomes. The diagnosis of AF provides unique challenges exacerbated by the arrhythmia's often paroxysmal nature and individuals' disparate access to health care and technologies that facilitate detection. Social determinants of health affect access to care and management decisions for AF, increasing the likelihood of adverse outcomes among individuals who experience systemic disadvantages. Developing effective approaches to address modifiable social determinants of health requires research to eliminate the substantive inequities in health care delivery and outcomes in AF. Observations: The National Heart, Lung, and Blood Institute convened an expert panel to identify major knowledge gaps and research opportunities in the field of social determinants of AF. The workshop addressed the following social determinants: (1) socioeconomic status and access to care; (2) health literacy; (3) race, ethnicity, and racism; (4) sex and gender; (5) shared decision-making in systemically disadvantaged populations; and (6) place, including rurality, neighborhood, and community. Many individuals with AF have multiple adverse social determinants, which may cluster in the individual and in systemically disadvantaged places (eg, rural locations, urban neighborhoods). Cumulative disadvantages may accumulate over the life course and contribute to inequities in the diagnosis, management, and outcomes in AF. Conclusions and Relevance: Workshop participants identified multiple critical research questions and approaches to catalyze social determinants of health research that address the distinctive aspects of AF. The long-term aspiration of this work is to eradicate the substantive inequities in AF diagnosis, management, and outcomes across populations.
Databáze:	MEDLINE
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