Overview: The HEART Initiative (Health Assessments and Rapid Transformation) has been launched in San Bernardino, Detroit and Nashville to reduce cardiovascular disease by collaborating with communities to develop sustainable solutions. The initiative will address high rates of hypertension, high cholesterol, and cardiovascular disease by connecting clinical care with community-based partners who will deliver strategies including prevention, education, and coordinated care. The initiative will utilise a model that addresses the root causes that keep communities from thriving, including social determinants of health.
Breanna Reeves
Adults living in the city of San Bernardino’s zip code 92401 have the highest prevalence of heart disease and stroke in the county at 7.7%, according to a 2025 Community Health Needs Assessment conducted by the Community Hospital of San Bernardino.
The HEART initiative (Health Assessments and Rapid Transformation) launched by Loma Linda University Health and the School of Global Health at Meharry Medical College, in partnership with community and national networks aims to change those outcomes. The HEART Initiative’s lead funding partner is Novartis, an advanced medicines’ company.
The HEART Initiative is a five-year effort designed to reduce cardiovascular disease in San Bernardino, Detroit and Nashville by collaborating with communities to develop solutions that are grounded by community, clinical evidence and are sustainable. Cardiovascular disease is a group of diseases that affect the heart and blood vessels.
The HEART Initiative’s work in San Bernardino will address high rates of hypertension, high cholesterol, and cardiovascular disease by connecting clinical care with community-based partners who will deliver strategies including prevention, education, and coordinated care.
“What we are clear on is that we’re going to start with churches, because we have a lot of trusted messengers in those churches,” said Dr. Juan Carolos Belliard, assistant vice president of community partnerships for Loma Linda University of Health.
During the height of the COVID-19 pandemic, public health and county partners relied on churches as trusted messengers in Black communities and in communities of color. Taking a similar approach, the HEART Initiative will present to churches and faith leaders, and work with them to connect with community members.
Some early community partners include Congregations Organized for Prophetic Engagement (C.O.P.E.), Inland Empire Concerned African American Churches, El Sol Neighborhood Educational Center, and Motivating Action Leadership Opportunity (MALO).
Part of the HEART Initiative’s approach to addressing cardiovascular disease rates in the city of San Bernardino is considering the role social determinants of health play in disparate health outcomes. Social determinants of health are the conditions in which people are born, live, work, learn and age that heavily impact their health outcomes and risks. The Initiative will utilize a model that addresses the root causes that keep communities from thriving.
“At the center of vital conditions is a sense of belonging and civic muscle. So even though you might be thinking, what does this have to do with cardiovascular health?” Dr. Belliard said. “Well, you can’t address a health issue without addressing the social drivers that cause those disparities and those health concerns.”
Oftentimes, health systems failed to come up with interventions that address all aspects of determinants of health such as those that are political. Political determinants create social conditions that restrict health equity, according to Daniel E. Dawes, JD, senior vice president of Global Health and founding dean of the School of Global Health at Meharry Medical College.
“What we’re doing is we’re going to work with these community members that have the highest rates of heart disease in America: San Bernardino, Detroit, Michigan, and in Nashville, Tennessee,” said Dawes. “[We’re] working with them to address the root causes, the structural conditions in which these community members find themselves… where they have no access to these vital resources that are needed in order to elevate health and life in our country.”
Cardiovascular disease is the leading cause of death in the U.S., responsible for nearly 1 in 3 deaths nationwide. One person dies every 34 seconds and approximately 80% of those deaths are preventable.
Most people miss the signs of cardiovascular disease and often mistake the symptoms as being something else, according to Dawes. Symptoms of cardiovascular disease include chest pain or discomfort, shortness of breath, nausea, irregular heartbeat, among others. Some key risk factors of cardiovascular disease are high blood pressure, high cholesterol, smoking, obesity and diabetes.
Dawes is no stranger to understanding the seriousness of cardiovascular disease, and neither is Dr. Belliard. Dawes has witnessed the devastating impacts of cardiovascular disease and other risk factors in his own family and community.
“I’m an individual who is living with high blood pressure. I live with high cholesterol. Thankfully, I’m able to access the medications that have been able to keep me alive today,” Daws shared. “What I experienced in my life, which really helped me to empathize and appreciate the struggle was something that I witnessed in my church, a largely African American church.”
Findings from the American Heart Association’s 2025 Statistical Update found that nearly 60% of Black adults aged 20 and older live with some form of cardiovascular disease including coronary heart disease, heart failure, stroke or hypertension, compared with roughly half of all U.S. adults.
Dr. Belliard also has a personal understanding of the risks that can lead to cardiovascular disease as someone living with high blood pressure.
“I’m somebody who exercises every day of the week. I either bike, swim or run, and I eat mostly a plant-based diet, and I still have to take medication for blood pressure,” Dr. Belliard said.
Dawes and Dr. Belliard know the importance of staying educated about their health risks, accessing nutritious foods, and accessing medication to treat their conditions. With the HEART Initiative, the goal is to ensure that communities most impacted are able to do the same by developing solutions in partnership with communities and other stakeholders like Loma Linda University Health and the School of Global Health at Meharry Medical College.
Dawes emphasized Meharry’s dedication to the initiative as well as Black communities and communities of color who have historically been harmed by the health care system. Meharry Medical College is a private historically Black medical school affiliated with the United Methodist Church and located in Nashville, Tennessee. Founded in 1876, as the Medical Department of Central Tennessee College, it was the first medical school for African Americans in the South.
“I think about other loved ones whose family members have also succumbed to heart disease. We are all taking this into the work, and we are committing to the communities that we’ll be working with, that you will have our undivided attention. You have our full support,” Dawes explained.
“We will make sure that these communities are given a fair shot at health and life — that is the commitment, and it is deeply personal. We recognize that none of this can be implemented without the support of community leaders, and that is why we are being intentional about bringing these leaders, bringing the politicians to this project so that we can sustain the project after the five years of funding is eliminated,” Dawes continued.