Abstract
Extensive epidemiological evidence has demonstrated the socioeconomic gradient in cardiovascular health, with the most disadvantaged individuals at greatest risk of developing and dying from cardiovascular disease (CVD). Large-scale studies, beginning in the 1960s, reported significant associations between coronary mortality and occupation grade, income, and education. Individuals with low socioeconomic status (SES) additionally have a poorer prognosis post-myocardial infarction. Explanatory mechanisms explored here include differential access to medical care, differences in risk factor profiles, health literacy, and psychological and environmental factors. The influence of neighborhood SES is examined, beyond individual socioeconomic profile, as well as SES trajectory throughout life, and the relative importance of childhood versus adult SES in the development of CVD. Finally methodological factors are considered, examining the limitations of SES research, measurement issues, and risk prediction. It is proposed that SES should be considered in cardiovascular risk assessment, and that policy changes have the potential to minimize socioeconomic inequalities in cardiovascular health.
Original language | English |
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Title of host publication | Interdisciplinary Concepts in Cardiovascular Health |
Subtitle of host publication | Volume I: Primary Risk Factors |
Publisher | Springer-Verlag Wien |
Pages | 187-203 |
Number of pages | 17 |
ISBN (Electronic) | 9783709113349 |
ISBN (Print) | 9783709113332 |
DOIs | |
State | Published - 1 Jan 2013 |
Keywords
- Cardiovascular disease
- Epidemiology
- Mortality
- Myocardial infarction
- Prognosis
- Risk prediction
- Socioeconomic status