Social Determinants of Cardiovascular Diseases

Abstract

Social determinants of health can be understood as the social conditions in which individuals live and work; conditions that are shaped by the distribution of power, income and resources, as much on a global and national level as on a local level. Social determinants of cardiovascular diseases are found largely outside the healthcare and preventative healthcare systems; but it is important to think in terms of chains of cause and effect, which enable us to see these determinants at work within the system of curative and preventative care, including the management of traditional risk factors. Taking a dynamic perspective on these social determinants of health, and in particular viewing them in a biological and epidemiological context, emphasizes the fact that intervention as early in life as possible is desirable in order to prevent cardiovascular diseases. It is important to act early, before childhood adversities in these critical periods are permanently or irrevocably recorded in the body. In terms of behaviour, focussing health education on adults runs counter to the fact that, with age, it is increasingly difficult to change our behaviour and to overcome biological damage already inflicted. In an area where attention has long been focussed on individual risk factors, underlining the fact that these factors act from infancy allows us to highlight the collective influences on the development of these diseases. Reflecting on health determinants in this way suggests that perhaps the population strategy proposed by Geoffrey Rose may lead to an increase in social inequalities if the modest decrease in risk factors, for example in terms of nutrition, involves the population categories initially most privileged.

Review on Cardiovascular Risk Prediction

“…Although the effects of the downstream determinants (genes, personality) on CVD risk factors are clearly evident, the effects of the upstream determinants (policies, societal factors) are less clear [91]. Following are the two main approaches available for the prevention of the cardiovascular diseases.…”

Trends in Socioeconomic Inequalities in Ischemic Heart Disease Mortality in Small Areas of Nine Spanish Cities from 1996 to 2007 Using Smoothed ANOVA

“…52 On the other hand, numerous studies have found differences in diagnosis and in treatment strategies depending on patient characteristics such as sex, age, and socioeconomic level. 22 Specifically, it has been observed that women are subject to fewer diagnostic tests, are examined less, and receive fewer explanations and less advice from their doctors than men. 53 It is probable that this situation is aggravated if in addition the woman has a lower socioeconomic level.…”

“…may have a relationship with IHD mortality, independently of the individual characteristics of the deceased. 3,[14][15][16][17][18][19][20][21][22] In western European countries, specifically in Spain, a clear decline in IHD mortality has been observed in recent decades. 2,23 This decline is mainly attributed to reductions in the majority of risk factors, such as smoking, hypertension, and hypercholesterolemia, as well as improvements in medical diagnosis and treatment.…”

A Study on Anthropometric Measurements, Blood Pressure, Blood Sugar and Food Intakes Among Different Social Status and Ethnicities

“…Social factors are defined as social life and work conditions, these conditions could be affected by distribution of wealth and power, global and national income (7). A study in China showed the higher risk of metabolic syndrome in women with lower education and monthly income, but male subjects did not reveal this relationship (8).…”