Social determinants of health across the lifecourse and chronic disease risk: available data and seminal findings from the Atherosclerosis Risk in Communities (ARIC) Study

This review article provides a summary of findings on the social determinants of chronic disease prevalence, incidence, and mortality from the Atherosclerosis Risk in Communities (ARIC) Study, a community surveillance of coronary heart disease conducted in 4 geographically distinct US communities from 1987 through 2014 and an ongoing longitudinal cohort of 15 792 men and women recruited from those communities. The ARIC Community Surveillance Study documented the contribution of poor neighborhood socioeconomic status to trends in heart disease and to disparities in associated medical care. Data from members of the ARIC Study cohort provide evidence on the importance of neighborhood- and individual-level social determinants to the prevalence of cardiovascular risk factors and to the burden of cardiovascular disease and mortality, dementia, and kidney disease. Findings from the unique ARIC Lifecourse Socioeconomic Study conducted within the ARIC cohort underscore the importance of socioeconomic exposures across the lifecourse to the prevention of chronic disease. The rich ARIC data on neighborhood deprivation, environmental exposures, physical and built environments, and racial and economic segregation provide a foundation for innovative methodological approaches that integrate demographic, socioeconomic, behavioral, and clinical risk factors-enabling researchers to identify optimal targets for effective chronic disease prevention.