Social Determinants of Cardiovascular Disease.
Social Determinants of Cardiovascular Disease.
复制标题
DOI：
10.1161/circresaha.121.319811
复制
发表时间：
2022-03-04
影响因子：
20.1
通讯作者：
Wallen GR
中科院分区：
文献类型：
--
作者：
Powell-Wiley TM;Baumer Y;Baah FO;Baez AS;Farmer N;Mahlobo CT;Pita MA;Potharaju KA;Tamura K;Wallen GR
健康的社会决定因素（SDoH），包括影响健康的经济，社会，环境和心理社会因素，在心血管疾病（CVD）风险因素以及CVD发病率和死亡率的发展中起着重要作用。COVID-19大流行和当前由乔治弗洛伊德之死引发的社会正义运动暴露了我们社会中长期存在的由SDoH驱动的卫生不平等。尽管最近关注这些健康差异的结构性驱动因素，但SDoH对心血管健康和CVD结局的影响仍然没有得到充分研究和完全理解。为了进一步研究连接SDoH和CVD的机制，并最终设计有针对性的和有效的干预措施，重要的是要促进跨学科的努力，将翻译，流行病学和临床研究纳入检查SDoH-CVD的关系。本次审查旨在促进研究协调和干预措施的发展，提供一个基于证据的框架，SDoH植根于边缘化人群的生活经验。我们的框架强调了与CVD最密切相关的关键结构/社会经济，环境和心理社会因素，并探讨了将SDoH与CVD发病机制联系起来的几种潜在生物学机制，包括过度应激激素，炎症，免疫细胞功能和细胞衰老。我们提出了具有里程碑意义的研究和最近的研究结果SDoH在我们的框架，仔细考虑的结构和措施。最后，我们提供了一个路线图，未来SDoH研究的重点是个人，临床和政策的方法，旨在发展多层次的社区参与的干预措施，以促进心血管健康。
Social determinants of health (SDoH), which encompass the economic, social, environmental, and psychosocial factors that influence health, play a significant role in the development of cardiovascular disease (CVD) risk factors as well as CVD morbidity and mortality. The COVID-19 pandemic and the current social justice movement sparked by the death of George Floyd have laid bare long-existing health inequities in our society driven by SDoH. Despite a recent focus on these structural drivers of health disparities, the impact of SDoH on cardiovascular health and CVD outcomes remains understudied and incompletely understood. To further investigate the mechanisms connecting SDoH and CVD, and ultimately design targeted and effective interventions, it is important to foster interdisciplinary efforts that incorporate translational, epidemiological, and clinical research in examining SDoH-CVD relationships. This review aims to facilitate research coordination and intervention development by providing an evidence-based framework for SDoH rooted in the lived experiences of marginalized populations. Our framework highlights critical structural/socioeconomic, environmental, and psychosocial factors most strongly associated with CVD and explores several of the underlying biologic mechanisms connecting SDoH to CVD pathogenesis, including excess stress hormones, inflammation, immune cell function, and cellular aging. We present landmark studies and recent findings about SDoH in our framework, with careful consideration of the constructs and measures utilized. Finally, we provide a roadmap for future SDoH research focused on individual, clinical, and policy approaches directed towards developing multilevel community-engaged interventions to promote cardiovascular health.
影响因子：
1.7
作者：
Tamura K;Curlin K;Neally SJ;Vijayakumar NP;Mitchell VM;Collins BS;Gutierrez-Huerta C;Troendle JF;Baumer Y;Osei Baah F;Turner BS;Gray V;Tirado BA;Ortiz-Chaparro E;Berrigan D;Mehta NN;Vaccarino V;Zenk SN;Powell-Wiley TM
通讯作者：
Powell-Wiley TM