Cardiovascular outcomes related to nutrition policies among socioeconomically disadvantaged populations

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PROJECT SUMMARY/ABSTRACT CANDIDATE: Eric J. Brandt, MD, MHS is a health services researcher, preventive cardiologist, and lipidologist. His personal story of loss from cardiovascular disease (CVD) and clinical experience motivates his research at the intersection of CVD outcomes, nutrition policy, and health equity. His goal is to become an independent clinician investigator and leading cardiovascular health services researcher who influences policy changes to reduce health disparities in CVD among disadvantaged populations. RESEARCH CONTEXT: Poor diet is the leading contributor to premature death from CVD in the U.S. Racial, ethnic, and socioeconomically disadvantaged groups have lower-quality diets and a higher burden of CVD. The Supplemental Nutrition Assistance Program (SNAP) seeks to equitably improve nutrition security and disproportionately serves racial-ethnic minority individuals. SNAP decreases food insecurity, however, existing data are unclear about SNAP participants’ diet quality, how SNAP participants handle competing nutrition and medical needs, and if SNAP participation influences health outcomes and use of medical services. The projects in this proposal seek to fill critical knowledge gaps at the intersection of social determinants of health (SDOH), minority health disparities, medical care, and CVD outcomes. SPECIFIC AIMS: 1) To define dietary patterns among SNAP participants with CVD or CVD risk factors and to correlate these with CVD mortality; 2) To identify how SNAP participants with CVD navigate the intersection of nutrition, medical care, and health outcomes; and 3) To assess how SNAP participation drives the use of medical care and how CVD events impact food purchases. RESEARCH PLAN: To accomplish these aims, Dr. Brandt will study dietary patterns and CVD mortality of SNAP participants in the National Health and Nutrition Examination Survey; collect qualitative data to assess the interplay between food and health among diverse individuals with CVD; and use linked SNAP enrollment, Medicaid claims, and grocery data to study SNAP participant interactions with medical care. All projects will assess underlying SDOH that explain differential outcomes across race-ethnicity. CAREER DEVELOPMENT PLAN: Dr. Brandt will build upon prior training with courses or workshops in SDOH, policy, nutritional epidemiology, causal inference analytics, and qualitative and mixed methods. Through strong mentorship, scientific meetings, early-career faculty workgroups, manuscript publication, and R01 workshops he will transition to independence and emerge as a leading cardiovascular health services researcher. ENVIRONMENT: Dr. Brandt has full support from his Department and Division. He will leverage the ideal training environment at the University of Michigan, including strong, collaborative mentorship and access to a vast range of courses, workshops, and professional development resources.