Going upstream to improve heart health in Philadelphia

Cardiovascular disease is the leading cause of death in the US, claiming one in four lives. Social factors such as living conditions, education and diet play a key role in determining a person’s heart health, which means cardiovascular disease typically hits vulnerable communities the hardest. Our three-year Closing the Gap initiative with the Jefferson Collaborative for Health Equity (established by Jefferson Health and Thomas Jefferson University) focuses on addressing the upstream social determinants of heart health in five vulnerable neighborhoods in Philadelphia with high rates of stroke and adverse outcomes related to heart disease.

Feb 01, 2023
Maggie Perez (standing, center), a health educator in Philadelphia
Maggie Perez (standing, center), a Jefferson health educator, meets members of the community in Philadelphia.

As part of the Closing the Gap initiative, dedicated clinical personnel, community health workers and health educators like Maggie provide health services outside corner stores and at other locations in Philadelphia. They also help with resources such as food, health education or housing, and connect people to trusted sources of care.

Back cover of the Annual Report 2022. Maggie Perez, a community health worker in Philadelphia, PA, checks the blood pressure of a local resident
Maggie Perez checks the blood pressure of a local resident in Philadelphia.

Approximately 40% of Philadelphia residents are Black or African American, according to research by the Pew Charitable Trusts. Risk factors behind cardiovascular disease are exacerbated by racial inequality, which can be defined as the unequal distribution of resources, power, and economic opportunity across race. According to the American Heart Association, heart disease accounts for nearly 40% of the disparity in life expectancy between Black and white Americans.

Tammy Ly (center), a community health worker in Philadelphia
Tammy Ly (center), a Jefferson community health worker, provides language interpretation at a health center, where she helps bridge different cultural traditions that could affect health and supports immigrant residents to access information about health services. Born in Vietnam, Tammy moved to Philadelphia in 1988 and has worked as a medical interpreter for more than 20 years.
An urban neighborhood in Philadelphia.
An urban neighborhood in Philadelphia.

Around 23% of people in Philadelphia live below the poverty line, according to Pew. While this has fallen from 28% in 2011, it is still one of the highest rates among major US cities. For people in Philadelphia’s most vulnerable neighborhoods, poverty, structural inequities and other factors such as access to healthcare and educational attainment mean their ZIP code can be a major determinant of their health.