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Cardiovascular Disease in the Nation’s Capital: How Policy and the Built Environment Contribute to Disparities in CVD Risk Factors in Washington, D.C.

  • Phillip Mauller
  • Lauren A. DoamekporEmail author
  • Crystal Reed
  • Kweisi Mfume
Article

Abstract

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.

Keywords

Cardiovascular disease Risk factors Built environment Policy Health disparities 

Notes

Funding Information

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.

Ethical Approval

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.

Disclaimer

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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Copyright information

© W. Montague Cobb-NMA Health Institute 2018

Authors and Affiliations

  • Phillip Mauller
    • 1
  • Lauren A. Doamekpor
    • 1
    Email author
  • Crystal Reed
    • 1
  • Kweisi Mfume
    • 1
  1. 1.Health Policy Research Consortium, A CTIS, Inc. ProgramGreenbeltUSA

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