Social determinants of cardiovascular disease risk over the life course

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PROJECT SUMMARY Over the last several decades, cardiovascular disease (CVD) incidence and the prevalence of CVD risk factors have steadily increased in the Central American region, in contrast to other countries of the Americas where CVD is no longer increasing or on the decline. The rise of CVD in the region has occurred in tandem with increases in urbanization and widening social inequities, and poses a growing, untenable burden for its limited public health and health care systems. While research in high income countries highlights interventions on social determinants of health as levers to prevent cardiovascular disease, less is known about the specific, intervenable social determinants that can help prevent CVD in Central America. Training and mentoring of the local workforce in identifying relevant research questions, in the use of appropriate research methods, and in the dissemination of results to the scientific community, the public, and policy makers is critical to identify and develop interventions to prevent CVD in the region. To this end, researchers from Drexel University and the Institute for Nutrition of Central America and Panama (INCAP) have partnered to establish a training program focused on developing the research capabilities of trainees and local capacity building in the conduct of policy- relevant research on the influence of social determinants and place-based factors on CVD risk across the lifespan. Key elements include: (1) a focus on factors at multiple levels (from cities, to neighborhoods, to persons) and over the lifecourse, (2) the use of rigorous state-of-the-art methods; (3) an emphasis on the value of interdisciplinary approaches; and (4) dissemination and translation of research findings into policy actions. The program leverages the SALURBAL Study, a unique multidisciplinary collaboration focused on the region. Training activities will include (1) training of up to 3 PhD students or up to 5 Masters students; (2) support for up to 4 postdoctoral fellows and 11 visiting faculty fellows promoting the development of junior and mid-career faculty; (3) annual workshops and periodic webinars and journal clubs on social determinants of health, CVD and lifecourse epidemiology, and research methods; (4) support for the development of data management and analytical capacity on site; and (5) enhanced south-south collaborations in mentorship and research. As a result of the program we expect to see an increase in the number researchers with Masters or Doctoral degrees at INCAP, an increase in the number of publications and grant proposals submitted by local researchers, larger numbers of mentoring relationships, publications, and grant proposals involving collaborations between INCAP and other countries in the region, greater capacity for data management/analysis at INCAP, and greater engagement of local investigators in CVD research and dissemination activities, including policy translation in the region. We also expect to see a continuation proposal to this training program submitted by INCAP as lead at the end of the this initial phase of the program.