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

Publication ,  Journal Article
Benjamin, EJ; Thomas, KL; Go, AS; Desvigne-Nickens, P; Albert, CM; Alonso, A; Chamberlain, AM; Essien, UR; Hernandez, I; Hills, MT; Kershaw, KN ...
Published in: JAMA Cardiol
February 1, 2023

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.

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Published In

JAMA Cardiol

DOI

EISSN

2380-6591

Publication Date

February 1, 2023

Volume

8

Issue

2

Start / End Page

182 / 191

Location

United States

Related Subject Headings

  • United States
  • Social Determinants of Health
  • Social Class
  • National Heart, Lung, and Blood Institute (U.S.)
  • Male
  • Humans
  • Female
  • Ethnicity
  • Atrial Fibrillation
  • 3201 Cardiovascular medicine and haematology
 

Citation

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Benjamin, E. J., Thomas, K. L., Go, A. S., Desvigne-Nickens, P., Albert, C. M., Alonso, A., … Al-Khatib, S. M. (2023). Transforming Atrial Fibrillation Research to Integrate Social Determinants of Health: A National Heart, Lung, and Blood Institute Workshop Report. JAMA Cardiol, 8(2), 182–191. https://doi.org/10.1001/jamacardio.2022.4091
Benjamin, Emelia J., Kevin L. Thomas, Alan S. Go, Patrice Desvigne-Nickens, Christine M. Albert, Alvaro Alonso, Alanna M. Chamberlain, et al. “Transforming Atrial Fibrillation Research to Integrate Social Determinants of Health: A National Heart, Lung, and Blood Institute Workshop Report.JAMA Cardiol 8, no. 2 (February 1, 2023): 182–91. https://doi.org/10.1001/jamacardio.2022.4091.
Benjamin EJ, Thomas KL, Go AS, Desvigne-Nickens P, Albert CM, Alonso A, et al. Transforming Atrial Fibrillation Research to Integrate Social Determinants of Health: A National Heart, Lung, and Blood Institute Workshop Report. JAMA Cardiol. 2023 Feb 1;8(2):182–91.
Benjamin, Emelia J., et al. “Transforming Atrial Fibrillation Research to Integrate Social Determinants of Health: A National Heart, Lung, and Blood Institute Workshop Report.JAMA Cardiol, vol. 8, no. 2, Feb. 2023, pp. 182–91. Pubmed, doi:10.1001/jamacardio.2022.4091.
Benjamin EJ, Thomas KL, Go AS, Desvigne-Nickens P, Albert CM, Alonso A, Chamberlain AM, Essien UR, Hernandez I, Hills MT, Kershaw KN, Levy PD, Magnani JW, Matlock DD, O’Brien EC, Rodriguez CJ, Russo AM, Soliman EZ, Cooper LS, Al-Khatib SM. Transforming Atrial Fibrillation Research to Integrate Social Determinants of Health: A National Heart, Lung, and Blood Institute Workshop Report. JAMA Cardiol. 2023 Feb 1;8(2):182–191.

Published In

JAMA Cardiol

DOI

EISSN

2380-6591

Publication Date

February 1, 2023

Volume

8

Issue

2

Start / End Page

182 / 191

Location

United States

Related Subject Headings

  • United States
  • Social Determinants of Health
  • Social Class
  • National Heart, Lung, and Blood Institute (U.S.)
  • Male
  • Humans
  • Female
  • Ethnicity
  • Atrial Fibrillation
  • 3201 Cardiovascular medicine and haematology