NameInstitutionDate IntroductionCardiovascular disease (CVD) is a class of diseases thatinvolve the heart orthe blood vessels.
Cardiovascular diseaseincludes coronary artery diseases (CAD) suchas angina and myocardial infarction (commonly knownas a heart attack) Other CVDs include stroke, heart failure, hypertensive heart disease, rheumatic heart disease, cardiomyopathy, heartarrhythmia and congenital heart disease. Cardiovasculardiseases are the leading cause of death globally. This is true in all areas ofthe world except Africa. Together they resulted in 17.9 million deaths (32.1%)in 2015, up from 12.3 million (25.
8%) in 1990. In the United States 11%of people between 20 and 40 have CVD, while 37% between 40 and 60, 71% ofpeople between 60 and 80, and 85% ofpeople over 80 have CVD. The average age of death from coronary arterydisease in the developed world is around 80 while it is around 68 in thedeveloping world. Disease onset is typically seven to ten years earlier inmen as compared to women. AbsractCardiovascular disease is the leading cause of death among high-incomecountries 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. Despitesignificant advancements, gross inequalities continue to persist over space andtime. Although increasing at different rates worldwide, the magnitude ofincrease in the prevalence of various cardiovascular risk factors has shiftedresearch efforts to study the causes of the risk factors (ie, the ’causes ofthe causes’), which include the social determinants of health.
The socialdeterminants of health reflect the impact of the social environment on healthamong people sharing a particular community. Imbalances in the socialdeterminants of health have been attributed to the inequities in healthobserved between and within countries. The present article reviews the role ofthe social determinants of health on a global level, describing theepidemiological transition and the persistent trend known as the ‘inversesocial gradient’. The impact of social determinants in Canada will also beexamined, including data from ethnic and Aboriginal communities. Possiblesolutions and future directions to reduce the impact of social factors oncardiovascular health are proposed.
1. How does money,power, and control matters in relating to the treatment of cardiovasculardisease?Social determinants elaborates on thehealth impact of the social environment on people living in a particularcommunity. Specifically, this involves the conditions in which people are born, grow, live, work and age, andare shaped by the distribution of money, power and resources at global,national and local grounds. The social determinants which involves health caresystem are mostly responsible for health inequities between and withincountries. Historical research has significantly established the impact ofeconomic development and social organization on heath.
it is necessary to focusefforts on understanding the role and impact of money and power to help bridge the current gap in equality. The greater one’sincome, the lower one’s likelihood of disease and premature death. Studies show that Americans at all incomelevels are less healthy than those with incomes higher than their own. For instance ,when analyzing CVD mortalityand risk factor prevalence rates according to income group, it is alarming torealize that despite affluence in Canada, individuals of lower socioeconomicstatus are more vulnerable to CVD than those of higher socioeconomicstatus . Income is a driving force behind the striking healthdisparities that many minorities experience.Evidence of the inverse social gradientand inequity gap reveals that mortality is highest among those in the poorestincome group and, as income increases, the mortality rate decreases. Notsurprisingly, these trends are also consistent with CVD risk factor prevalencerates in which individuals in a lower income group, especially in urban areas,have a greater exposure to risk factors which include smoking and atherosclerosis that manifest asobesity, diabetes, dyslipidemia and hypertension.
However, as the middle class expands andthe epidemiological transition spreads to a broader population, individualswith the lowest socioeconomic status tend to acquire the harmful risk factorslast, mostly due to their financial situation, power and the heavy physical activity usuallyassociated with their work. On the other hand the socioeconomically disadvantagedare also less likely to have access to advanced health services, treatments andinformation for risk factor modification and, as a result, CVD mortality rateswill take time to become miniminal and decline in this group.2. How doesthis affect communities with low income to get treatment for cardiovasculardisease? These answered in sentences included in the paper. Mainly focusing onAfrican American communities. Peoplewith lower socioeconomic status are much more likely to develop heart diseasethan those who are wealthier or better educated.
Studies also show that thisrisk persists even with long-term progress in addressing traditional riskfactors such as smoking, high blood pressure and other cardiovascular disease. Theresult of one being poor and having no power can be regarded as an extra risk whenassessing a patient’s chances of developing cardiovascular disease. People withlow socioeconomic status need to have their heart-disease indicators managed ina more aggressive manner.Usingdata from the Atherosclerosis Risk in Communities Studies indicate that more than 12,000 people aged 45 to 64 yearsliving in North Carolina, Mississippi, Minnesota and Maryland over the course of 10 years were periodicallyevaluated for heart-disease diagnoses and changes in their risk factors.Theresults indicated that people with lower socioeconomic status had a 50 percentgreater risk of developing heart disease than other study participants. peoplewith low socioeconomic status have a greater risk for developing heart diseaseand other health problems, the reason is often attributed to reducedhealth-care access or poor adherence to treatments such as smoking cessation ormedication. Social disadvantages andadversity in childhood may result in lasting adaptations to stress that take abigger toll on the heart.
Thesocial disadvantage index score was developed to incorporate social andeconomic exposures into a single continuous measure, and found that increasedsocial disadvantage is associated with an increased burden of some – but notall – cardiovascular risk factors independently associated with CVD.Specifically, social disadvantage was found to increase with age, was higheramong women than men and varied greatly according to ethnic group, in which thehighest risk for CVD Conclusion Because CVD is increasing globally, it iscrucial that we understand the social and economic forces that promote thedevelopment of risk factors affecting who is screened and who is treated. Thedissemination of knowledge and the application of effective strategies areessential.
The social determinants of health are tools to help illuminate howsocial processes interact with CVD health on a global, national and individuallevel. We suggest that low income is a neglected risk factor, and thatappropriate public action and policy intervention should be taken to reduceincome inequality.