As discussed in the July 4, 2023 issue of the Journal of the American Heart Association, cardiovascular disease (CVD) is the leading cause of mortality worldwide. Addressing social determinants of health (SDoH) may be the next forefront of reducing the enormous burden of CVD. SDoH can be defined as any social, economic, or environmental factor that influences a health outcome. An umbrella review sought to give a comprehensive overview of the role of SDoH in CVD. Four themes (economic circumstances, social/community context, early childhood development, and neighborhood/built environment) and health literacy in the health/health care theme were considered. Despite the quality of the included reviews being low or critically low, there was consistent evidence that factors relating to economic circumstances and early childhood development themes were associated with an increased risk of CVD and CVD mortality. Factors in the social/community context and neighborhood/built environment themes, such as social isolation, fewer social roles, loneliness, discrimination, ethnicity, neighborhood socioeconomic status, violence, and environmental attributes had a role in CVD.
Apart from clinical interventions, there is a need to strengthen nonmedical interventions that address multiple factors simultaneously. A possible way of doing so is addressed in the June 2023 issue of the journal The Milbank Quarterly is to expand the cadre of effective SDoH mitigation strategies. A practical, heuristic framework for policy makers, practitioners, and researchers is needed that serves as a roadmap for conceptualizing and targeting the key mechanisms of SDoH influence. A synthesis of the extant SDoH research into a heuristic framework addresses a scarcity of peer-reviewed organizing frameworks of SDoH mechanisms designed to inform practice. Development of such a framework represents a practical tool to facilitate the translation of scholarly SDoH work into evidence-based and targeted policy and programming. Tools designed to close the research-to-practice translation gap for effective SDoH mitigation are sorely needed.