Tackling heart disease and poverty

Abstract

Cardiovascular disease is the leading cause of death worldwide, with a projected increase in incidence in developed and developing countries. This paper will review the literature on the role of poverty and socioeconomic deprivation in cardiovascular disease and outline ways to tackle poverty. The literature acknowledges the individual risk factors for cardiovascular disease, but highlights the negative effects of neighborhood deprivation on the incidence of cardiovascular disease and its mortality rates. The studies show that equitable access to health care is not evident and those in less affluent neighborhoods have greater disease incidence and increased mortality and morbidity rates, particularly for angina, myocardial infarction, and heart failure. The approach to reducing disease rates needs to be conducted from an individual level to the societal level and needs to prevent and treat heart disease (particularly in deprived neighborhoods). Nurses and health professionals must drive health policy so that progress can be achieved in reducing the disease rates.

Socioeconomic inequality in the prevalence of noncommunicable diseases in low- and middle-income countries: Results from the World Health Survey

“…These findings are in accordance with previous reports from a variety of settings, which also reported inverse associations between socioeconomic position and prevalence of angina [10,11,56], arthritis [12,13,15,16], asthma [57,58], and depression [23,24,59-62]. Previously, European data (including eight higher-income countries) from the 1990s demonstrated education-related inequality in 14 of 17 studied NCDs, most notably stroke, diseases of the nervous system and diabetes.…”

“…For example, a study of 52 countries at all stages of development found a trend for increased angina in poorer populations, although associations with individual- or societal-level socioeconomic markers were not analyzed [10]. A literature review reported elevated angina-related mortality and morbidity in less-affluent neighbourhoods, based on literature from several world regions [11]. Although few multinational studies of LMICs have examined the role of socioeconomic inequality in arthritis prevalence, preliminary research from the United States supported an association of low individual socioeconomic status with greater likelihood of arthritis in less-developed settings, and a potential role for community social determinants [12].…”

Atrial fibrillation in the elderly – Not a benign condition

“…From an emergency perspective, where possible, it would be beneficial to screen patients for undiagnosed AF, regardless of presenting complaint in those over 65 years and in those with diagnosed AF, to improve treatment and monitoring in those with sub-optimally managed AF. Although the role of poverty in cardiovascular disease is well known, the impact on AF is less established (Lee and Carrington, 2007). As well as primary care settings, the ED appears to be suitable and appropriate for these tasks given that many elderly people requiring hospitalisation present to the ED.…”

Effect of Community Affluence on the Association Between Individual Socioeconomic Status and Cardiovascular Disease Risk Factors, Colorado, 2007–2008

“…Several recent studies have explored the association between neighborhood deprivation and risk factors and chronic disease incidence and mortality (3-6). Whereas prevention efforts that focus on individual characteristics that control behavior are important, environmental and social elements also affect personal choices, are modifiable risk factors (7,8), and deserve attention. The objective of this study was to assess how community affluence, as measured by median household income, modifies the association between individual SES and 6 CVD risk factors.…”