Although minorities make up more than one-third of the U.S. population, they account for less than one-tenth of clinical trial participants. To correct this disparity, Bernadette Boden-Albala, founding dean of the planned School of Population & Public Health and director of UCI's Program in Public Health, suggests focusing on screening, the conversion from eligible to enrolled, and retention. Program in Public Health / UCI

With a $17.9 million grant from the National Institute on Minority Health and Health Disparities at the National Institutes of Health, a first of its kind center has been established to address health inequities that lead to cardiovascular diseases in low-income and minority groups within the greater Los Angeles and Orange County region. The center is a collaboration between the University of California, Los Angeles, and Irvine campuses, and for the next five years will study the factors that cause hypertension, diabetes, chronic kidney disease and other heart-related disease, in the highly diverse region of Southern California whose combined population is more than 13 million.

The center, called the UCLA-UCI Center for Eliminating Cardiometabolic Disparities in Multi-Ethnic Populations or UC END-DISPARITIES, will fill a gap in the current efforts to advance health equity through a community-academic, partnered approach, and will also prevent and reduce the harmful impact that cardiovascular disease has on minority communities.

“Latinx, Black, Asian, Pacific Islander and American Indian communities have some of the highest rates of cardiovascular disease and related deaths in the nation,” said Arleen Brown, MD, PhD, principal investigator and an internal medicine physician at UCLA Health. “To best understand why these communities are afflicted with these morbidities, we must closely examine and intervene at all levels of health, including the patient, their family, the healthcare system and community factors. And that’s exactly what this new center will do.”

The center will function through three integrated core groups (administrative, investigator development and community engagement) along with two research projects. The core groups will leverage existing synergies with key community, health system and academic partners with varying expertise in health equity research, biostatistics, implementation science and health information technology.

“This is an exciting and novel approach to using family networks to participate in both primary and secondary prevention of cardiovascular disease, which affects more than 121.5 million adults in the U.S per year,” said Bernadette Boden-Albala, MPH, DrPH, a multiple principal investigator and the director and founding dean of the UCI Program in Public Health. “To be able to partner with UCLA and collaboratively help these communities live healthier, longer lives is a seminal chapter in my research.”

Among the goals of the center, an infrastructure will be developed that supports and funds small innovative pilot projects to reduce cardiometabolic disparities, which local community organizations and early career investigators can apply for. To create a sustainable future for the center’s work and the institution’s ability to conduct disparities research, the project will also train and mentor a new generation of scientists who are focused on health equity. Underrepresented postdoctoral trainees and early career investigators will have the opportunity to participate in community-engaged health interventions and advance their own independent cardiometabolic disparities research.

UC-END Disparities is supporting two large five-year pilot projects with the goals of studying paradigm-shifting approaches to community health. The first, BP REACH or “Blood Pressure disparities Reduction, Equity and Access among safety net patients with Cardiovascular Health risk,” is a multilevel, culturally and linguistically tailored project at the Los Angeles County Department of Health Services. BP REACH will focus on health equity for vulnerable patients via a pharmacist-led medication management and community health worker education/outreach program.

The second project, SERVE OC or “Skills-based Educational strategies to Reduce Vascular Events in Orange County,” is community-based participatory research led by the UCI Program in Public Health. SERVE OC will focus on reducing cardiovascular risk factors within entire family units as well as understanding and intervening on structural barriers to behavioral change in Latina/o/x and Vietnamese families in Santa Ana through collaboration among researchers, community partners, and city officials.

The tracking of health data is a crucial part of the center’s research goals. Both projects will utilize non-invasive remote blood pressure monitoring technology that will allow both individual participants and researchers to easily track healthindicators.

“The center is the first step to understanding the health disparities that exist in our healthcare system, which must be approached from all levels of an individual’s network and must also engage the entire community. Only then will we be able to truly improve the health and well-being of our most vulnerable populations,” said Keith Norris, MD, PhD, a multiple principal investigator and professor of medicine at the David Geffen School of Medicine at UCLA.