RESEARCH FOCUS

Social Determinants of Health

My research primarily centers on understanding the social determinants of health (SDOH) - the conditions in the environments where individuals are born, live, learn, work, play, worship, and age. These factors significantly influence a wide array of health outcomes, functioning, and overall quality of life. Social determinants of health play a pivotal role in shaping people's health, well-being, and overall quality of life. Examples of these determinants include secure housing and neighborhoods, access to nutritious foods and opportunities for physical activity, experiences of racism, discrimination, and violence, educational attainment, job opportunities, income levels, environmental factors like air and water quality, as well as language and literacy skills. Studying these elements helps us comprehend their profound impact on individuals' health and guides efforts to create healthier and more equitable communities.


Selected publications:

Parekh T, Xue H, Wadhera RK, Cheskin LJ, Cuellar AE. From Policy to Practice: Assessing the State Innovation Models Initiative's Early Success in Incorporating Social Determinants of Health in ASCVD Hospitalizations in the United States. Am J Epidemiol. Published online August 27, 2024. doi:10.1093/aje/kwae313. PMID: 39191660

Mszar R, Hagan K, Lahan S, Parekh T. Cost and non-cost factors associated with delays in receiving medical care in adults with atherosclerotic cardiovascular disease. J R Coll Physicians Edinb. Published online May 28, 2024:14782715241256693. PMID: 38804568

Nwana N, Makram OM, Nicolas JC, Gullapelli R, Parekh T, et al. Neighborhood Walkability Is Associated With Lower Burden of Cardiovascular Risk Factors Among Cancer Patients. JACC CardioOncology. Published online May 7, 2024. doi:10.1016/j.jaccao.2024.03.009

Parekh T, Xue H, Al-Kindi S, Nasir K, Cheskin LJ, Cuellar AE. Food Environment Quality and Cardiovascular Disease Mortality in the United States: a County-Level Analysis from 2017 to 2019. J Gen Intern Med. 2023 Jul 28. DOI: 10.1007/s11606-023-08335-9. Epub ahead of print. PMID: 37507552.

Makram OM, Nwana N, Nicolas JC, Gullapelli R, Pan A, Bose B, Parekh T, Al-Kindi S, Yahya T, Hagan K, Javed Z, Patel K, Sharma G, Jones SL, Cainzos-Achirica M, Maddock JE, Nasir K. Favorable Neighborhood Walkability is Associated with Lower Burden of Cardiovascular Risk Factors Among Patients Within an Integrated Health System: The Houston Methodist Learning Health System Outpatient Registry. Curr Probl Cardiol. 2023 Feb 10;101642.

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.

Chronic Diseases and Health Disparities

Chronic diseases encompass a wide range of conditions persisting for a year or more, necessitating ongoing medical attention or restricting daily activities. Notably, ailments like heart disease, cancer, and diabetes stand as the primary causes of mortality and disability in the United States, concurrently driving the nation's annual healthcare expenditure of $3.8 trillion. Although public health initiatives have made strides in identifying and addressing chronic disease risk factors, a pressing need exists to delve deeper into their impact on existing disparities. Beyond conventional risk factors, the field of public health must extend its reach further upstream by tackling social and institutional factors contributing to inequities. Factors such as race, sexual orientation, education, income, residential segregation, and healthcare access disparities offer a clear pathway for public health to explore. By scrutinizing these aspects, public health can assess and enhance health policies, programs, and infrastructures, thereby fostering a more comprehensive and equitable approach to chronic disease management.

Selected Publications


Nguyen RT, Jain V, Acquah I, Khan SU, Parekh T, Taha M, Virani SS, Blaha MJ, Nasir K, Javed Z. Association of cardiovascular risk profile with premature all-cause and cardiovascular mortality in US adults: findings from a national study. BMC Cardiovasc Disord. 2024 Feb 6;24(1):91. PMID: 38321396; PMCID: PMC10845615.

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 encompass a range of interlinked conditions arising from the consumption of substances that alter mind and behavior, resulting in adverse health and behavioral consequences. The complexity of this issue is exacerbated by societal attitudes as well as political and legal responses toward alcohol and illicit drug use, making it a multifaceted challenge in public health. Debates persist regarding whether abuse and misuse stem from biological or genetic factors or are merely personal choices shaped by social values.

In contrast, addiction shares similarities with other diseases, such as heart disease. Both conditions disrupt the normal, healthy functioning of bodily organs, leading to severe and detrimental effects. Importantly, both can often be prevented and treated. If left unaddressed, they can persist throughout a person's lifetime and, in the worst cases, result in fatal outcomes. Recognizing addiction as a disease highlights the urgency of intervention, emphasizing the significance of prevention, treatment, and support mechanisms in mitigating its long-term impact.

Selected publications 

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 firmly believe that within every extended family, there exists at least one individual coping with a disability, a reality mirrored in my own family experience. This personal connection serves as my driving force, inspiring my ongoing dedication to researching this underserved population. While traditional health policies acknowledge racial and ethnic disparities in healthcare and outcomes, a parallel recognition is sorely lacking in the realm of disability-related research and policies. Individuals with disabilities consistently face significant challenges in various health metrics, enduring higher rates of chronic diseases from an early age. Despite recent attempts to shed light on their plight, our society has yet to elevate their health and quality of life to a paramount position in public health priorities. This gap underscores the pressing need for a paradigm shift, where we prioritize the well-being of people with disabilities and integrate their concerns into the heart of public health initiatives. 


Selected publications

Orji A F, Gimm G, Desai A, Parekh T. (2023). The Association of Cervical Cancer Screening with Disability Type among U.S. Women (25-64 years). American Journal of Preventive Medicine. https://doi.org/10.1016/j.amepre.2023.08.010

Gimm G, Parekh T, Kitsantas P. Assessing the Prevalence and Risk Factors of Marijuana Use in Adults with Disabilities. Addict Behav. 2023 Mar 1;138:107559. 

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.

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