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VCU Health Takes Health Disparities to Heart

Advancing health equity for cardiovascular disease begins in our communities. In Richmond, Virginia, VCU Health takes working with the community for better health to the next level — especially when it comes to the heart health of the most at-risk populations.

Aerial image of VCU Health downtown campus

VCU Health, located in downtown Richmond, is working to understand the risk factors that contribute to cardiovascular disease in the community. Here’s how the health system takes every resident’s cardiovascular health to heart.

Cardiovascular disease is impacted by an individual’s social determinants: the conditions in which they live, work, and play. “These factors have a significant impact on health outcomes,” explains Sheryl Garland, Chief of Health Impact of the VCU Center on Society and Health and Executive Director of the VCU Office of Health Equity. The five main social determinants are economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social and community context.

Richmond is one of 28 communities participating in a nationwide initiative called the Accountable Health Communities. The federal pilot program studies how meeting health-related needs for Medicare and Medicaid populations impacts health care cost and utilization. Data from Health Quality Innovators (HQI) indicates that the top three needs facing Richmond are food insecurity, housing instability, and transportation.

Advancing health equity begins with providing the community with information and resources. Acutely aware of the health disparities facing its city’s residents, VCU Health is passionate about making a tangible difference beyond its own walls. “We want to raise awareness. And be a friend — a trustworthy source of information based on data that folks in the community can rely on,” says Greg Hundley, M.D., Chair of the Division of Cardiology and Director of the VCU Health Pauley Heart Center. “We’re interested in raising awareness and developing solutions to prevent these adverse cardiovascular events.”

Richmond: A city interested in understanding health disparities

VCU Health uses data to inform how to meet the tangible needs of our community, as well as inspiring a patient-centric approach to care. Finding evidence-based ways to meet those needs is an essential conversation within the health care system.

“Within areas of central Virginia, several communities possess high-concentration areas of poverty, that often are largely minority — primarily Black, non-Hispanic residents — experiencing these poor health outcomes, and few opportunities for help…. Those places are not places where it’s easy for residents to be healthy, because of some of those structural constraints,” explains Derek Chapman, Ph.D., Interim Director of the VCU Center on Society and Health.

The Center on Society and Health documented the history behind these disparities in a recent report. The numbers are stark. In 2015, one in four Richmond residents lived in poverty, making the city’s poverty rate the second highest in the state.

But not all of Richmond sits in poverty. “Neighborhoods themselves can be risk factors for these health outcomes,” Chapman explains. While communities in the East End like Fairmount and Gilpin have lower life expectancies of 67 years and 63 years, respectively, individuals in neighborhoods like Westover Hills and the Museum District — both located in the West End — can boast longer life expectancies of 83 years and 77 years, respectively. Only seven miles apart, Westover Hills and Gilpin have a 20-year life disparity.

Health disparities facing those with cardiovascular disease

So, when it comes to preventing heart disease in Richmond, addressing social determinants matter. A person’s job can impact their ability to visit a cardiologist, and their access to transportation may affect their ability to pick up medications at the pharmacy. If someone faces barriers like these, says Dr. Hundley, their stress levels are higher, as is their blood pressure — both of which contribute to heart disease.

While adopting a healthier lifestyle often cuts the relative risk of heart disease in half, many individuals in Richmond face socioeconomic barriers that make it difficult not only to adopt but even consider making these changes. Research suggests eating more fruits and vegetables will combat heart disease; but that can be challenging if someone doesn’t have the means to purchase nutrient-rich foods. If someone lives in a high-crime neighborhood, or even one without sidewalks, it’s difficult to exercise safely outside and meet the recommended 150 minutes of moderate exercise per week.

VCU Health is addressing health disparities — one patient at a time.

Because cardiovascular disease is one of the major causes of death within the community, VCU Health collaborates with community partners, like local school systems, to educate younger generations about heart disease and the importance of healthy lifestyle choices. Libraries also partner with VCU Health, offering community groups that can help alleviate social pressures on family caregivers, such as childcare services.

Food deserts, or areas with limited food access, occur most often in urban communities such as the East End of Richmond, so that’s exactly where VCU Health helped about the need to open a community-driven, affordable grocery store, called the Market at 25th to help meet the area’s need for healthy foods. Next door sits VCU Health Hub at 25th, a wellness center that provides health education and mental wellness resources to East End residents, including various health screenings, behavioral health assessments, social service referrals, counseling services, medication management, free fitness classes, nutrition education, and art therapy. Programs are provided by VCU faculty and students, as well as community-based organizations and most are free to the public. Both at the Health Hub and designated units in the health system, outreach workers connect patients to community resources like these to address the social determinants that challenge them.

Advances like these are all part of the VCU Health Equity Initiative, a strategic effort launched in 2016 to expand the health equity goals of both the university and the health system. And in September 2021, VCU opened its Office of Health Equity, which Garland leads. In attempting to engage and meet the needs of our most economically and socially challenged populations, VCU Health seeks to work and partner with local communities and their leaders to combat cardiovascular disease, reduce mortality, and improve health-related quality of life for all citizens in Virginia.

To learn more about the work VCU Health is doing to advance health equity in the community, visit the VCU Office of Health Equity. You can find the health system’s DEI statement here.