The impact of social determinants on cardiovascular disease
The impact of social determinants on cardiovascular disease
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DOI：
10.1016/s0828-282x(10)71075-8
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发表时间：
2010-08-01
影响因子：
6.2
通讯作者：
Anand, Sonia S.
中科院分区：
文献类型：
--
作者：
Kreatsoulas, Catherine;Anand, Sonia S.
心血管疾病是高收入国家的主要死亡原因，预计到2030年将成为全世界的主要死亡原因。目前的许多研究工作都是针对个人层面的风险因素的识别、修改和治疗。尽管取得了重大进展，但严重的不平等在时间和空间上仍然存在。尽管在世界范围内以不同的速度增加，但各种心血管危险因素流行率的增加幅度已使研究工作转向研究危险因素的原因（即“原因的原因”），其中包括健康的社会决定因素。健康的社会决定因素反映了社会环境对同一社区人民健康的影响。健康的社会决定因素的不平衡归因于国家之间和国家内部观察到的健康不平等。本文回顾了在全球层面上健康的社会决定因素的作用，描述了流行病学的转变和被称为“反社会梯度”的持续趋势。还将审查加拿大社会决定因素的影响，包括来自少数民族和土著社区的数据。提出了减少社会因素对心血管健康影响的可能解决方案和未来发展方向。
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.