The Cardiovascular Health Inequities (CHI) Laboratory, led by Diana A. Chirinos, Ph.D., is dedicated to understanding the role of psychosocial factors as determinants of cardiovascular health in vulnerable populations. Specifically, we are interested in (1) characterizing the cardiovascular risk profile of vulnerable populations, (2) identifying the psychosocial factors most closely linked to cardiovascular disease (CVD), and (3) elucidating the bio-behavioral pathways underlying these relationships. A better understanding of these mechanisms will lead to targeted and more effective prevention and intervention efforts. Our long-term goal is to design targeted behavioral interventions to reduce CVD burden and promote health equity among vulnerable populations.
Our conceptual framework for understanding illness progression incorporates theoretical models from the behavioral and social sciences, psychoneuroimmunology, and basic physiology. Three theoretical models in particular, the Reserve Capacity Model,1 the Lifespan Biopsychosocial Model of Cumulative Vulnerability and Minority Health,2 and the Stage Model of Stress and Disease,3 have informed our conceptualization of the impact of socio-demographic and psychosocial factors on health. The model depicted in Figure 1 describes this conceptualization and serves as a roadmap to develop our research questions and as a theoretical framework in which to base the design of potential interventions. In this model, chronic stress, prompted by stressful life events and/or environmental demands, is associated with risk factors and disease progression via behavioral and biological pathways. Within this framework, emotion regulation and reserve capacity serve as important mediator and potential moderators of some of these relationships, and socio-demographic/ contextual factors are all-encompassing, impacting every other component in the model, from stressful life events to disease incidence and progression.
References
- Gallo LC and Matthews KA. Understanding the association between socioeconomic status and physical health: do negative emotions play a role? Psychol Bull. 2003;129:10-51.
- Myers HF. Ethnicity- and socio-economic status-related stresses in context: an integrative review and conceptual model. Journal of Behavioral Medicine. 2009;32:9-19.
- Cohen S, Gianaros PJ and Manuck SB. A Stage Model of Stress and Disease. Perspect Psychol Sci. 2016;11:456-63.