How racism hurts the heart


New Center for Chronic Disease Reduction and Equity Promotion across Minnesota aims to address stark disparities in cardiovascular health

Minnesota is one of the healthiest places to live—if you’re white. But Minnesotans who are Indigenous or people of color have a much different experience, one characterized by some of the country’s largest disparities in heart health outcomes.

“Native Americans in Minnesota are nearly four times as likely to die from heart disease compared with white people of the same age,” says Michele Allen, M.D., M.S., director of the University of Minnesota Medical School’s Program in Health Disparities Research. “And Black adults die from heart disease at nearly twice the rate of their white counterparts.”  

The new Center for Chronic Disease Reduction and Equity Promotion Across Minnesota (C2DREAM), co-led by the U of M, Mayo Clinic, Hennepin Healthcare, and other statewide partners, aims to address these stark disparities and dismantle racism’s impact on cardiovascular health.

Fueled by a $19 million grant from the National Institute on Minority Health and Health Disparities, C2DREAM will assess how racism on a structural level (like a lack of high-quality medical facilities in certain communities) and an interpersonal level (like a doctor’s unintentional dismissal of a Black patient’s concerns, for example) contributes to heart disease and other chronic conditions like diabetes and obesity.

“I believe improving public health is a form of social justice,” says Sandra Japuntich, Ph.D., a clinical psychologist at Hennepin Healthcare and C2DREAM collaborator. “C2DREAM brings together not only the best academic minds in the field of health equity but also community partners who have been doing this work. We will be able to learn from them about what works in their community to form sustainable solutions to improving health equity in cardiovascular disease.”

Researchers are already working on projects to make smoking cessation programs more culturally relevant for Indigenous people and people of color, develop healthy eating and exercise programs specifically for Native Americans, and establish best practices for preventing cardiovascular disease in Somali and Latinx communities. More than 40 other pilot studies are planned for the next five years.

“Racism is a fundamental cause of health inequities in Minnesota,” says Rachel Hardeman, Ph.D., M.P.H., the Blue Cross Endowed Professor of Health and Racial Equity in the U’s School of Public Health. “Working together, C2DREAM will study and confront the multidimensional ways racism impacts chronic disease for BIPOC communities.”