Social determinants of incidence, outcomes, and interventions of cardiovascular disease risk factors in American Indians and Alaska Natives

Abstract

AbstractCardiovascular disease (CVD) is the leading cause of death among American Indians and Alaska Natives (AIANs). Despite copious research on CVD incidence and outcome discrepancies, a social determinants of health (SDOH) focused framework on CVD risk factors and health outcomes in AIAN populations has not been undertaken. This paper presents the following: (1) a review of the literature on SDOH and CVD in AIAN populations, (2) a summary on intersectionality as it relates to SDOH and CVD, (3) a framework for conceptualizing CVD risks, interventions, structural determinants, and health equity, (4) a summary of potential interventions to address CVD in AIANs, and (5) a discussion about future work. Common SDOH themes across the CVD risk factors in AIANs are income‐related obstacles, healthcare access, structural racism, discrimination, and failed colonial policies. Colonization of AIAN populations has resulted in social, political, and economic disadvantages, manifesting as systemic socioeconomic disadvantage and unequal access through elevated poverty rates, lower educational attainment, mental health challenges, and decreased healthcare access. These extensive social factors have a multifactorial effect across several CVD risk factors; all ultimately result in elevated CVD morbidity and mortality. Addressing SDOH and diminishing disparities is essential to facilitating improved CVD outcomes for AIANs.