Tufts MPH students are part of publishing research on how socioeconomic disadvantage shapes cardiovascular outcomes

Tufts Master of Public Health (MPH) students Somya Swarup, MPH26, and Marjorie Pradhan, MPH26, were part of a research team that produced a published systematic review addressing a critical public health issue: how socioeconomic disadvantage shapes outcomes for adults living with heart disease.

The research was completed as their Integrative Learning Experience (ILE), the MPH capstone that brings together students’ academic, research, and applied training.

The Research Question: When Heart Disease Meets Socioeconomic Disadvantage

The research focused on understanding whether social and structural conditions play a measurable role in outcomes for people living with heart disease. Drawing on existing literature, the team examined whether individuals facing socioeconomic disadvantage experience higher risks of mortality, hospitalization, or repeat cardiovascular events, even when clinical risk factors are accounted for.

As Swarup explains, the goal was to look beyond clinical care alone and better understand the broader forces shaping health outcomes:

“This paper looked at whether people with heart disease have worse outcomes when they also face socioeconomic disadvantages like lower income, lower education levels, or living in disadvantaged neighborhoods.”

The study, “Socioeconomic disadvantage and cardiovascular outcomes in patients with established heart disease: A systematic review,” was published ahead of print in The American Journal of Medicine.

Key Findings: Consistent Links to Worse Outcomes

Across the studies reviewed, the evidence pointed to a clear and consistent pattern: socioeconomic disadvantage was associated with worse cardiovascular outcomes. Individuals with lower income, limited educational attainment, or residence in disadvantaged neighborhoods were more likely to experience higher mortality, increased hospitalizations, and more frequent readmissions.

Swarup notes that these relationships persisted even after adjustment for traditional medical risk factors, reinforcing the importance of addressing social determinants alongside clinical care. 

Pradhan adds that the magnitude of the findings across the literature was striking. 

“We found that in our systematic review of 29 studies, low income, limited education, and neighborhood deprivation were consistently linked with 20–120% higher mortality and increased readmissions, independent of traditional risk factors,” she says.

From MPH Learning to Published Scholarship: The Integrative Learning Experience

For both students, the project represented a culmination of their MPH training. The Integrative Learning Experience (ILE) gave them the opportunity to synthesize skills developed across the curriculum, ranging from epidemiologic analysis to health systems thinking, and apply them to a complex, real‑world public health issue.

Swarup describes the ILE as a chance to step back and look critically at healthcare delivery systems and population‑level data.

“To me, an ILE is the chance to bring together different aspects of the MPH program and dig deeper into a public health topic,” she says.

Pradhan highlights how the project allowed her to apply core public health concepts in practice, including social determinants of health, structural violence, and epidemiologic interpretation. Together, the experience reinforced how MPH training prepares students to contribute meaningfully to research intended for public health and clinical audiences alike.

Partner Organizations and Mentorship

The students completed this work in collaboration with the Department of Internal Medicine at Kaiser Permanente in Santa Clara, California, and the Department of Cardiology at Tufts University School of Medicine and Tufts Medical Center in Boston. These partnerships provided students with mentorship and exposure to how public health research informs clinical decision‑making and health system improvement.

How Applied Practice Shaped the Work

Although the publication itself was completed as an ILE, both students emphasized that their Applied Practice Experience (APE) helped shape how they approached the research.

Through her APE with the Antimicrobial Stewardship Team at Tufts Medical Center, Swarup gained firsthand insight into how hospitals use data to inform policy, quality improvement, and systems‑level change, an approach that carried over into her research mindset.

Similarly, Pradhan drew on her APE at the Woman, Mother + Baby Research Institute, where she worked on initiatives aimed at improving provider and patient knowledge. That experience reinforced how gaps in information and access can directly influence health behaviors and outcomes, strengthening her perspective on the role of social and structural factors in patient care.

Why This Work Matters Now

Cardiovascular disease remains one of the leading causes of death in the United States and globally. At the same time, disparities in outcomes persist despite advances in medical treatment. The findings from this review underscore the growing recognition that improving health outcomes requires addressing not only clinical care, but also the social and economic conditions in which people live.

As Swarup explains, understanding these relationships is essential for designing more equitable health systems and policies. Pradhan echoes this sentiment, emphasizing the importance of recognizing patients’ lived experiences and social contexts when designing care that treats the whole person, not just their disease.

 “This topic is especially important now given that socioeconomic disparities continue to widen, shaping who gets sick and who receives adequate care,” she shares. “Recognizing that a person's lived experience and social context can influence health as much as—or even more than—genetics is critical for designing health systems that address the whole person, not just their disease.” 

Meet the Students 

Somya Swarup, MPH26

Somya Swarup is a Tufts MPH student in Health Management & Policy on the Boston campus. Her interest in public health developed through academic coursework and deepened through time spent working in clinical settings. After graduating in 2024, she spent time scribing and conducting research while preparing her medical school application. Experiences that highlighted how social and systemic factors shape patient care. She ultimately chose Tufts for its strong systems‑focused training and accelerated MPH format.

Marjorie Pradhan, MPH26

Marjorie Pradhan is a Tufts MPH student in Global Health Science & Practice on the Boston campus. With a background in global health, her interests center on addressing gender health inequities and the root causes of health disparities through research and community‑based approaches. Looking ahead, she plans to apply her public health training as she pursues a medical degree, integrating population‑level insights into clinical care.

Learn More About the Tufts MPH

Interested in graduate study that blends applied practice, rigorous methods, and real-world impact? Tufts MPH students build skills through coursework, the APE, and the ILE, often resulting in meaningful deliverables for public health audiences.

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