Barriers, Opportunities, and Challenges in Addressing Disparities in Diet-Related Cardiovascular Disease in the United States

J Am Heart Assoc. 2020 Apr 7;9(7):e014433. doi: 10.1161/JAHA.119.014433. Epub 2020 Mar 23.


In the United States, cardiovascular disease (CVD) is the leading cause of death and disability. Suboptimal diet quality is responsible for a greater percentage of CVD-related morbidity and mortality than any other modifiable risk factor. Further troubling are the stark racial/ethnic and socioeconomic disparities in diet quality. This represents a major public health concern that urgently requires a coordinated effort to better characterize the barriers to healthy dietary practices in population groups disproportionally affected by CVD and poor diet quality to inform multifaceted approaches at the government (policy), community environment, sociocultural, and individual levels. This paper reviews the barriers, opportunities, and challenges involved in shifting population behaviors, especially in underserved populations, toward healthy dietary practices. It is imperative that public health policies address the social determinants of nutrition more intensively than previously in order to significantly decrease CVD on a population-wide basis.

Keywords: cardiovascular disease prevention; cardiovascular disease risk factors; diet; disparities; nutrition; social determinants.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Cardiovascular Diseases / ethnology
  • Cardiovascular Diseases / mortality
  • Cardiovascular Diseases / prevention & control*
  • Diet / adverse effects*
  • Diet / ethnology
  • Diet, Healthy* / ethnology
  • Female
  • Food Assistance
  • Health Behavior
  • Health Status Disparities*
  • Humans
  • Male
  • Middle Aged
  • Nutritive Value
  • Protective Factors
  • Race Factors
  • Risk Assessment
  • Risk Factors
  • Risk Reduction Behavior*
  • Social Determinants of Health*
  • Socioeconomic Factors
  • United States / epidemiology
  • Young Adult