The goal of HEAT Heart Health is to learn more about how stress, the social environment, and inherited (genetic) factors related to family history may affect the risk of heart disease among African Americans in Tallahassee. In addition, the information we collect will guide the development of community outreach programs for heart disease prevention, and it may help to develop new approaches to reducing racial inequities in health.

HEAT Heart Health is funded by the National Science Foundation (NSF). NSF is an independent federal agency created by Congress in 1950 "to promote the progress of science; to advance the national health, prosperity, and welfare; to secure the national defense…" Our work is funded by two grants to the University of Florida from the Cultural and Physical Anthropology Programs at NSF.

The study was initiated by researchers at the University of Florida who have been collaborating with community members since 2007. These researchers are Drs. Lance Gravlee, Christopher McCarty, and Connie Mulligan. In 2010, we formed a Steering Committee to oversee the project. The Steering Committee includes UF researchers, local policymakers, community-based organizations, and concerned citizens from Tallahassee.

The steering committee consults on all of the major project decisions. The research team developed the specific goals and hypotheses of the project, which were vetted by an Institutional Review Board (IRB) and determined to have scientific merit by the National Science Foundation, which funds the study. The steering committee helps decide how the research gets done. Their role is to guide the research team and ensure that the data collection process is carried out in a compassionate and culturally appropriate manner. As members of the community themselves, they will help to ensure that the research benefits the residents of Tallahassee.

African Americans suffer disproportionately from heart disease and related conditions. Nationwide, hypertension, or chronic high blood pressure, is about 50% more common among African Americans than it is among whites. This gap contributes more than any other cause to racial inequalities in life expectancy. Of course, not all African Americans have high blood pressure. We are trying to identify differences within the African American community that may affect the risk of heart disease. The results could identify new approaches to eliminating racial inequalities in health.

There are two main reasons.

1. Tallahassee is home to a large and diverse African American community. According to the 2010 Census, about a third of Tallahassee residents identify as Black or African American, as compared to 16.1% in Florida and 12.9% in the country as a whole. This community is also diverse in terms of socioeconomic conditions. Roughly one-quarter of African Americans in Tallahassee live below the federal poverty level, but there are also more African Americans with advanced degrees in Tallahassee than in any other part of the state. That makes it possible to capture a wide range of variation in social contexts that matter for health.
2. There is local interest in advancing health equity. Tallahassee has a legacy of civil rights activism stretching back to the 1956 bus boycott. Today, the spirit of civil rights activism lives on in local efforts to eliminate social inequities in health. HEAT Heart Health benefits from and contributes to the work of local activists who seek greater equity in health.

We envision three kinds of potential benefits for the community:

1. We are committed to hiring people from the community whenever possible. We will hire 10-12 people for the community survey in 2011-2012. Our policy of hiring locally means that we provide some small economic stimulus to the community and invest in building community capacity.
2. We will disseminate the results of our study in ways that are meaningful to the community. A key role of the Steering Committee is to ensure that we report back to the community in a timely and accessible manner. We expect to host community forums, town hall meetings, and other events to report our findings. These events will help to raise awareness about heart disease prevention in Tallahassee.
3. We will engage policy makers. We want the results of our study to inform local heart disease prevention strategies. One way we will pursue this goal is to share with local policy makers what we learn about how modifiable aspects of the social environment are related to health. In the future, we will also work with HEAT partners to seek funding that would directly support intervention programs and prevention strategies.

We will conduct a survey of about 350 African Americans in Tallahassee. We will select people at random (like the toss of a coin) to make the results representative of all African Americans in Tallahassee. We will ask people to participate in two interviews in their homes. The interview will involve questions about people's health status, social relationships, stress, and other life experiences. A trained interviewer will take people's blood pressure and collect saliva and a few drops of blood for genetic analyses and to assess risk factors for heart disease and other conditions. All information will be kept strictly confidential. No personal information about participants will ever be revealed or used for other purposes.