[Socioeconomic status and coronary disease: theories, research methods, epidemiological evidence and the results of Italian studies]

Abstract

This review covers the most important theoretic contributions and results of epidemiological research on the relationship between socio-economic status (SES) and coronary heart disease (CHD). Two major approaches have been identified: those of the British and American schools. In spite of differences in method, most of published contributions have shown social inequalities in the outcome of most degenerative disorders. Similar patterns have been detected for the CHD: the time trend declines documented in recent years in most industrialized countries has not filled in the gap of SES difference in the incidence and mortality for CHD, which even seems to have increased in the lower social classes. Moreover, an apparent paradox has been described: even though CHD is typical of welfare societies, its impact is higher in the lower social classes. Recent results of Italian studies are reported which investigated the relationship between CHD risk factors and SES in representative samples. The findings suggest the presence, in Italy, too, of social discrepancies in the prevalence of major risk factors, in both gender groups. This should be taken in consideration when preventive programmes are planned in populations or in work settings.