Jackson Heart Study Brings Science and Community Together

Newswise — Can the rigors of scientific research learn from the wisdom of the community? As researchers across the country struggle to find answers to the disproportionate burdens of disease, disability, and premature death suffered by minority populations, The Jackson Heart Study (JHS) is making strides in developing a novel, community-based approach to reducing cardiovascular disease among African Americans.

A special supplement of Ethnicity & Disease released today presents key findings on methods used in The Jackson Heart Study to achieve the federal mandate to reduce disparities in cardiovascular health among American populations. A single, underlying theme has guided the work of the researchers: the solution to health problems within a community may be found through the wisdom of the community residents and applied to the precision of scientific study.

Science and the community. The Jackson (Mississippi) Heart Study (JHS) began enrolling participants in 2000 and takes place in a state known for the highest rates of cardiovascular disease (CVD) (Table 1)(1) and in a city with the largest percentage of African Americans (36.3%) in the United States.

In this setting, JHS researchers joined with community residents to overcome traditional barriers of the often-strained relationship between African Americans, academic institutions, and research. They have built trust among participants and researchers to find ways to weave community/lay input into science designed to provide solutions for better CVD health outcomes.

Study participants. Participants in the JHS were recruited from urban and rural areas of the three counties (Hinds, Madison, and Rankin) that make up the Jackson, Miss, metropolitan statistical area (MSA). In all, 5302 residents participated and comprise nearly 7% of all African-American Jackson MSA residents aged 35-84 years (N=76,426, US Census 2000).2 Of these participants, obesity, hypertension, and diabetes were very prevalent: 40% of the men and 60% of the women were obese; 60% of the men and 63% of the women had hypertension; and 17% of the men and 20% of the women had diabetes. (see Table 2).

"The scientific questions and the population on which the JHS focuses make it a study for our time," stated Herman A. Taylor, Jr., MD, MPH, principal investigator of the study and professor of medicine at the University of Mississippi Medical Center. In addition to the community focus, the key study aspects include capacity building for research in the minority community and training for young minority researchers. "We believe our approach will serve as a model for community-centered research into pubic health problems," Dr. Taylor added.

Study delivers methods for scientific rigor. Given the complexity and novel approaches of the study, the Ethnicity & Disease supplement presents a detailed accounting of the methods used by researchers of the Jackson Heart Study for: recruitment; determination of genetic influence on CVD; psychosocial and sociocultural determinants in ethnic disparities; diet and physical activity; survey instruments and data analysis; and preparing young researchers to participate in higher-level medical learning. The reports published in the supplement provide evidence that these methods can successfully blend the goals of a large observational study of common diseases with a program of community health activism and academic infrastructure building.

Jackson Heart Study long-term goals. The study elements released in this edition of Ethnicity & Disease lay the groundwork for this long-term study expected to be completed in several years. "The enormous risk factor burden in the Mississippi population at-large, plus the continuing disparity between Blacks and Whites justifies a rigorous scientific study, which will result in a better understanding of heart disease in the African-American population," said Charles L. Curry, MD, president of ISHIB (the International Society on Hypertension in Blacks), the publisher of Ethnicity & Disease. "We recognize the need to advance research endeavors such as the Jackson Heart Study to expand our nation's capacity to prepare scientists for future study and to assist in achieving our mutual goal of eliminating heart disease disparities," Dr Curry continued.

At the study's completion, the researchers expect to have a dataset important to minority populations and comparable to the famed Framingham Heart Study that led to groundbreaking solutions for heart health. The JHS research component combines baseline data regarding economic, sociocultural, behavioral, dietary, and physical activity measures, and an array of physical, biochemical, and genetic attributes to produce a dataset of uncommon richness. This data will be a resource to the scientific community and will be accessed by many scientists through mechanisms that protect and serve the interests of the metropolitan Jackson African-American community.

Institutions behind the research. While the in-depth community involvement is key to the success of the study, three academic settings support the study by hosting various centers for study efforts: Jackson State University, a public institution, hosts the JHS Coordinating Center; Tougaloo College, a private undergraduate institution is home for the JHS Undergraduate Training Center; and the University of Mississippi Medical Center, the state's only medical university, is the host of the JHS Examination Center. In addition, the JHS is supported by the National Heart, Lung, and Blood Institute (NHLBI) and the National Center for Minority Health and Health Disparities of the National Institutes of Health.

Ethnicity & Disease. This quarterly, peer-reviewed journal provides a comprehensive source of information on causal relationships in the etiology of common illnesses through the study of ethnic patterns of disease. Ethn Dis is published by ISHIB (The International Society on Hypertension in Blacks) and includes articles on such topics as ethnic differentials in disease rates, the impact of migration on health status, social and ethnic factors related to healthcare access, and metabolic epidemiology. Ethn Dis is indexed on MEDLINE and in other scientific databases. ISHIB, founded in 1986, is a unique nonprofit medical membership society devoted to improving the health and life expectancy of ethnic minority populations.

References1. Centers for Disease Control and Prevention. Mortality for 1999-2002 with ICD 10 codes. Available at: http://wonder.cdc.gov. Accessed on: 8/16/05.2. US Bureau of the Census. Summary file 3 (SF 3) - sample data. Available at: http://factfinder.census.gov. Accessed on: 7/27/05.