Social Determinants of Health

My research is primarily focused on the social determinants of health (SDOH) - the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. SDOH have a major impact on people’s health, well-being, and quality of life. Examples of SDOH include:

Safe housing and neighborhoods - Housing Security

Access to nutritious foods and physical activity opportunities - Food Security

Racism, discrimination, and violence

Education, job opportunities, and income

Polluted air and water

Language and literacy skills

Selected publications:

Parekh T, Xue H, Cheskin L, Cuellar AE. Food insecurity and housing instability as determinants of cardiovascular health outcomes: A systematic review. Nutr Metab Cardiovasc Dis. Published online April 1, 2022. doi:10.1016/j.numecd.2022.03.025

Parekh T. Age-standardized prevalence of social determinants of health and associated race-ethnic disparities in stroke survivors. Eur J Prev Cardiol. 2021; 28 (zwab061.210).

Parekh T, Desai R, Pemmasani S, Cuellar A. Impact of Social Determinants of Health on Cardiovascular Diseases. Journal of the American College of Cardiology. 2020;75(11 Supplement 2):1989.

Parekh T, Desai A. Demographic and Socioeconomic Disparities Among Cancer Survivors in Clinical Trials Participation, USA, 2016-2018. J Cancer Educ. 2020 Jun 11;1–3.

Desai R, Patel U, Parekh T, Hanna B, Sitammagari K, Fong HK, Lodhi MU, Varma Y, Damarlapally N, Doshi R, Savani S, Kumar G, Sachdeva R. Nationwide Trends in Prevalent Cardiovascular Risk Factors and Diseases in Young Adults: Differences by Sex and Race and In-Hospital Outcomes. Southern Medical Journal. 2020;113(6):311–319.

Chronic Diseases and Health Disparities

Chronic diseases are defined broadly as conditions that last 1 year or more and require ongoing medical attention or limit activities of daily living or both. Chronic diseases such as heart disease, cancer, and diabetes are the leading causes of death and disability in the United States. They are also leading drivers of the nation’s $3.8 trillion in annual healthcare costs.

While public health efforts continue to move upstream in evaluating and addressing chronic disease risk factors, there is a stronger need to go further and look at their impact on existing disparities as well. In addition to addressing traditional risk factors, the field of public health can move further upstream by addressing social and institutional factors that drive inequities. For instance, differences in health outcomes by the interaction of race, sexual orientation, education, income, residential segregation, and access to care - are a clear path for public health to go further upstream and to evaluate health policies, programs, and infrastructures.

Selected Publications

Desai A, Sachdeva S, Parekh T, Desai R. COVID-19 and Cancer: Lessons From a Pooled Meta-Analysis. JCO Global Oncology. 2020;(6):557–559.

Desai R, Singh S, Parekh T, Sachdeva S, Sachdeva R, Kumar G. COVID-19 and diabetes mellitus: A need for prudence in elderly patients from a pooled analysis. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2020;14(4):683–685.

Fong HK, Desai R, Faisaluddin M, Parekh T, Mahmood A, Shah V, et al. Sex disparities in cardiovascular disease outcomes among geriatric patients with prediabetes. Prim Care Diabetes. 2021 Feb 1;15(1):95–100.

Hanna B, Desai R, Parekh T, Guirguis E, Kumar G, Sachdeva R. Psychiatric disorders in the U.S. transgender population. Annals of Epidemiology. 2019;39:1-7.e1.

Substance Use and Addiction

Substance abuse and misuse refer to a set of related conditions associated with the consumption of mind- and behavior-altering substances that have negative behavioral and health outcomes. Social attitudes and political and legal responses to the consumption of alcohol and illicit drugs make substance abuse/misuse one of the most complex public health issues. While there is an ongoing discussion about social values - whether abuse/misuse is a disease with biological/genetic foundations or just a personal preference.

In contrast, addiction is a lot like other diseases, such as heart disease. Both disrupt the normal, healthy functioning of an organ in the body, both have serious harmful effects, and both are, in many cases, preventable and treatable. If left untreated, they can last a lifetime and may lead to death.

Selected publications

Gimm G, Parekh T, Kitsantas P. Assessing the Prevalence and Risk Factors of Marijuana Use in Adults with Disabilities. Addict Behav. 2022 Nov 25;107559.

Parekh T, Cuellar AE, Farina-Morse M, Spencer N, Sutter RE. Where It Really Counts: Feasibility and Potential of the Peer Engaged Empowered Recovery Program for Substance-Dependent Jail Inmates. J Addict Nurs. United States; 2022 Sep 1;33(3):137–143. PMID: 36041157

Parekh T, Fahim F. Building Risk Prediction Models for Daily Use of Marijuana Using Machine Learning Techniques. Drug Alcohol Depend. 2021 May 28;108789.

Parekh T, Desai R. A Comparative Analysis of E-cigarette Users in The United States Between 2017 and 2018. Cureus. 2021; 12(12): e12079.

Parekh T, Pemmasani S, Desai R. Marijuana Use Among Young Adults (18–44 Years of Age) and Risk of Stroke. Stroke. 2020;51(1):308–310.

Parekh T, Pemmasani S, Desai R. Risk of Stroke With E-Cigarette and Combustible Cigarette Use in Young Adults. American Journal of Preventive Medicine. 2020;58(3):446–452.

Parekh T, Owens C, Fay K, Phillips J, Kitsantas P. Use of e-Cigarettes and Development of Respiratory Conditions in Women of Childbearing Age. Southern Medical Journal. 2020;113(10):488–494.

Disability and Healthcare Disparities

I believe that in every extended family, there will be at least one person with some type of disability, as it does in my case - the source of inspiration to continue my research efforts for this disparity population.

In traditional health policies, race/ethnic health differences are well recognized as inequities in health care and health outcomes. However, similar recognition is lacking for disability-related research and policies. On virtually all measures of health outcomes, People with disabilities experience fare poorly. Moreover, they face more chronic diseases and conditions and experience them at earlier ages. While the recent efforts to make the poor health of people with disabilities more visible, the recognition has not yet reached a level where we put forward health and quality of life at the front of public health priorities.

Selected publications

Gimm G, Parekh T, Rossheim M. Prevalence of E-cigarette Use among Adults with Disabilities. Disability and Health. Disabil Health J. 2021; 14(2):101048