Understanding the impact of racism—a social determinant of health—on the scope of the co-occurrence of mental health and cardiometabolic challenges in high-disparity racial/ethnic minority populations

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This diversity supplement will build upon my training as a social epidemiologist to connect the dots between the epidemiologic research that seeks to understand the complex drivers and mechanisms of disparities in outcomes related to comorbid cardiometabolic and mental health conditions, implementation science and social determinants. Cardiometabolic syndrome (CMetS) and anxiety are highly prevalent and complicate management of each other when they co-occur, leading to greater disability and healthcare utilization and costs. Such multi- comorbidity becomes even more challenging when it intersects with racial inequities and social determinants of health culminating in amplified risk of adverse outcomes. Successful disease management that works at the intersection of the individual and the community must be implemented to mitigate disparities and optimal treatment must address aspects of both CMetS and mental health disorders in a culturally relevant intervention. The overall goal of this diversity supplement is to identify strategies to enhance the systems science map of the parent project by utilizing community survey data, and to guide the development of antiracism interventions and implementation strategies in the domain of comorbid mental health and cardiovascular/metabolic conditions. Training goals and Research Aims to address the overall objective are as follows: Training Goal 1 (TG1): Develop expertise in integrating “big data” and community-based studies for the identification of and social determinants for comorbid mental health and Cardiovascular/ Metabolic conditions Training Goal 2 (TG2): Gain mastery in the ORBIT model of intervention development to translate basic behavioral and social science into new antiracism interventions and implementation strategies to address triple complexities of social, behavioral, and clinical challenges. Training Goal 3 (TG3): Obtain training in computational simulation modeling (e.g systemic dynamic modeling) to study the effects of potential intervention strategies on a complex system (eg. Primary care) Primary Research Aim: Understand community member perspectives on barriers and facilitators to successful disease management of comorbid cardiometabolic and mental health conditions among underserved ethnic minorities in the Southern United States including antiracism and other social determinants of health. Research Aim 1a (RA1a). Use a community based participatory research (CBPR) approach to conduct focus groups to address community concerns and incorporate community perspectives into future large scale community survey development and design to guide the assessment process. Research Aim 1b (RA1b). Conduct a pilot community survey to identify barriers and facilitators to successful disease management of comorbid cardiovascular/metabolic and mental health conditions and to accessing health care services.