The impact of social determinants on cardiovascular disease

doi:10.1016/S0828-282X(10)71075-8

Canadian Journal of Cardiology

Volume 26, Supplement C, August–September 2010, Pages 8C-13C

https://doi.org/10.1016/S0828-282X(10)71075-8 Get rights and content

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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The impact of social determinants on cardiovascular diseaseImpact des déterminants sociaux sur la maladie cardiovasculaire

Lancet

Lancet

Lancet

Lancet

J Am Coll Cardiol

Lancet

Lancet

Soc Sci Med

Soc Sci Med

Soc Sci Med

Reducing the global burden of cardiovascular disease: The role of risk factors

Prev Cardiol

Environmental and societal influences acting on cardiovascular risk factors and disease at a population level: A review

Int J Epidemiol

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Eur J Epidemiol

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Global Burden of Cardiovascular Diseases: Part I: General considerations, the epidemiologic transition, risk factors, and impact of urbanization

Circulation

Projections of global mortality and burden of disease from 2002 to 2030

PLoS Med

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N Engl J Med