How ‘to health’ at scale: Reflections in the post-pandemic era
Vasan S. Ramachandran, MD, FACC, FAHA
Founding Dean | School of Public Health |
University of Texas
WHERE: In-Person | 2001 ³ÉÈËVRÊÓƵ College, Rm 1140
NOTE: Social with Faculty & Students Rm 1147 2:30-3:00 pm
Abstract
- Health is influenced by hierarchical interdependencies between built & socio-cultural environments (macro level), personal behaviors (meso level), & molecular and physiological factors (micro level)
- Health disparities are driven by health inequities, i.e., resource-poor social environments & the policies, programs & economic arrangements that shape such environments
- Public health problems are ‘wicked problems’, best tackled with complex systems thinking, collaboration, dialogue, and shared understanding
- Achieving health equity at scale requires a systems approach that targets the social determinants of health and shifts the distribution of power, money, and resources
- Effective health promotion and illness prevention require multifaceted, multisectoral population-wide approaches to reshape the environments in which people live and in which they make choices via a combination of legislative, policy, and legal responses
- ‘To health’ at scale requires us ‘to citizen’ at scale
Learning Objectives
- To understand concepts of structural and social determinants of health and their relations to health inequities and health disparities and the importance of structural competence
- To understand commercial and legal determinants of health and their relations to health inequities and disparities
- To describe how to integrate social determinants of health into healthcare
Speaker Bio
I am a cardiologist with subspecialty training in echocardiography and cardiovascular epidemiology, and have a long-standing commitment to clinical epidemiological research. I am the Founding Dean of the School of Public Health in San Antonio, Texas, and a Professor Medicine and Population Health at the University of Texas Health Science Center in San Antonio, Texas. Previously, I served as the Chief in the Section of Preventive Medicine and Epidemiology in the Department of Medicine and Professor of Medicine and Epidemiology at Boston University Schools of Medicine (BUSM) and Public Health (BUSPH). I also served as m the Principal Investigator of the Framingham Heart Study (FHS, the oldest running epidemiology study in the US) between 2014 to 2022. I am the Principal Investigator of the Risk Underlying Rural Areas Longitudinal (RURAL) Study (one of the youngest cohort studies in the US). I also direct the FHS echocardiography-vascular imaging laboratory. I have been an Associate Editor for Circulation, the flagship journal of the American Heart Association, from 2002-2016, and I was the founding editor-in-chief for its daughter journal, Circulation Cardiovascular Genetics from 2008-2018. I am a trained mentor and served as the PI of a Post-doc T32 program in ‘Interdisciplinary Training in Cardiovascular Epidemiology’ (from 2016-2022), and the PI of BU’s R38 program (Stimulating Access to Research in residency) from 2020-2022, which is focused on training medical residents in research.
My own research is focused on: A) The epidemiology and novel risk markers of heart failure (HF), with a focus on HFpEF, including evaluating the role of LV and vascular remodeling and ventricular-vascular coupling; B) Population-based echocardiography and arterial stiffness, including identifying biological, environmental, and genetic determinants, normative standards and prognostic implications; C) Population-based exercise testing, with a current focus on cardiopulmonary exercise testing with metabolite profiling; D) Detailed assessment of novel biomarkers of CVD risk, risk prediction, subclinical atherosclerosis and genomics of CVD traits, including metabolomics, proteomics and the microbiome.