Cardiovascular Disease in the Nation’s Capital: How Policy and the Built Environment Contribute to Disparities in CVD Risk Factors in Washington, D.C.
On average, Washington D.C. residents experience low levels of cardiovascular disease (CVD) behavioral risk factors compared to the rest of the country. Despite presenting as a city of low risk, CVD mortality is higher than the national average. Driving this inconsistency are vast racial disparities as Black D.C. residents die from CVD at a much higher rate than their White counterparts. A closer examination of the data also reveals significant disparities between White and Black populations with regard to behavioral risk factors. Segregation and the built environments of sections of the city with large Black populations may be contributing to risk factor disparities. We examine factors in those built environments that contribute to disparities and assess the intentionality and effectiveness of policies focused on food access, physical activity, and tobacco use implemented between 2003 and 2014. We found that D.C. enacted few policies intentionally designed to reduce barriers in the physical environment that contributed to disparate outcomes, and the few that were implemented showed mixed results in their levels of effectiveness. Our findings demonstrated that both racial and geographical disparities have persisted for more than a decade and half. It is possible that the formation of intentional policies may help reduce barriers in the physical environment and disparate CVD outcomes.
KeywordsCardiovascular disease Risk factors Built environment Policy Health disparities
This work was supported by the National Institute on Minority Health and Health Disparities of the National Institute of Health under award number 5U54MD00860802.
Compliance with Ethical Standards
The authors have complied with the Principles of the Ethical Practice of Public Health of APHA. This manuscript has not been published nor is it under consideration for publication elsewhere.
This article does not contain any studies with human participants performed by any of the authors.
Conflict of Interest
The authors declare that they have no conflicts of interest.
The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Health or the National Institute on Minority Health and Health Disparities.
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