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. 2010 Aug-Sep;26 Suppl C(Suppl C):8C-13C.
doi: 10.1016/s0828-282x(10)71075-8.

The impact of social determinants on cardiovascular disease

Catherine Kreatsoulas  1 , Sonia S Anand
Affiliations

The impact of social determinants on cardiovascular disease

Catherine Kreatsoulas et al. Can J Cardiol. 2010 Aug-Sep.

Abstract
in English, French

Cardiovascular disease is the leading cause of death among high-income countries and is projected to be the leading cause of death worldwide by 2030. Much of the current research efforts have been aimed toward the identification, modification and treatment of individual-level risk factors. Despite significant advancements, gross inequalities continue to persist over space and time. Although increasing at different rates worldwide, the magnitude of increase in the prevalence of various cardiovascular risk factors has shifted research efforts to study the causes of the risk factors (ie, the 'causes of the causes'), which include the social determinants of health. The social determinants of health reflect the impact of the social environment on health among people sharing a particular community. Imbalances in the social determinants of health have been attributed to the inequities in health observed between and within countries. The present article reviews the role of the social determinants of health on a global level, describing the epidemiological transition and the persistent trend known as the 'inverse social gradient'. The impact of social determinants in Canada will also be examined, including data from ethnic and Aboriginal communities. Possible solutions and future directions to reduce the impact of social factors on cardiovascular health are proposed.

La maladie cardiovasculaire est la principale cause de mortalité dans les pays à revenus élevés et on s’attend à ce qu’elle devienne la principale cause de mortalité dans le monde d’ici 2030. Une bonne part de la recherche actuelle s’est attardée à la reconnaissance, à la modification et au traitement des facteurs de risque à l’échelon individuel. Or, malgré des progrès significatifs, d’importantes disparités persistent dans l’espace et le temps. Même si elle croît à un rythme différent selon les régions du monde, la prévalence de divers facteurs de risque cardiovasculaires force maintenant les chercheurs à étudier désormais l’origine des facteurs de risque eux-mêmes (c.à-d., « la cause des causes »), ce qui inclut les déterminants sociaux de la santé. Les déterminants sociaux de la santé témoignent de l’impact de l’environnement social sur la santé des personnes d’une communauté donnée. Les disparités quant aux déterminants sociaux de la santé ont été attribuées aux inégalités en matière de santé observées à l’intérieur des pays et entre eux. Le présent article fait le point sur le rôle des déterminants sociaux de la santé d’un point de vue mondial en décrivant l’évolution de l’épidémiologie et la tendance persistante connue sous le nom de « gradient social inverse ». L’impact des déterminants sociaux au Canada fera l’objet d’une analyse qui portera entre autres sur les données provenant des communautés ethniques et autochtones. On propose des solutions et des orientations qui pourraient éventuellement réduire l’impact des déterminants sociaux sur la santé cardiovasculaire.

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Figures

Figure 1)
Figure 1)
The epidemiological transition states of cardiovascular disease (CVD). CHD Coronary heart disease. Reproduced with permission from reference
Figure 2)
Figure 2)
Socioeconomic influences on cardiovascular disease (CVD) from a lifecourse perspective. Reproduced with permission from reference
Figure 3)
Figure 3)
Canadian poverty rates over time, 1984 to 2004. Reproduced with permission from reference
Figure 4)
Figure 4)
Socioeconomic gradient and cardiovascular disease (CVD) among Aboriginal Peoples and European descendants in Canada. Reproduced with permission from reference
Figure 5)
Figure 5)
Cardiovascular disease (CVD) risk factor prevalence and income among Aboriginal Peoples and European descendants in Canada. Reproduced with permission from reference
Figure 6)
Figure 6)
Risk of cardiovascular disease and social disadvantage. Reproduced with permission from reference
See this image and copyright information in PMC

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