Abstract for: A Model of Cardiovascular Disease Disparities with Illustrative Policy Analysis
Socioeconomic factors often lead to disparities in health outcomes, including cardiovascular disease (CVD). Even well-intended interventions may worsen health disparities, because the socially disadvantaged face higher barriers to change. We adapted an existing SD model of CVD risk and disaggregated it by three levels of a new Social Risk Index based on income, race, and education. This three-way classification was supported by a county-level statistical analysis across the 64 counties of Colorado. We simulated expansion of an effective diabetes prevention program with scenarios that differed by the extent to which the intervention was targeted to those with the highest social risk and lowered barriers for them. Absent targeting, the model produces the greatest total benefit (reduction of diabetes prevalence and CVD events) but also an increase in disparity. With full targeting, there is some loss of total benefit (more so for diabetes than for CVD), but a significant reduction in disparity. We plan to conduct additional tradeoff analyses to find an optimal strategy to address CVD disparities in Colorado.