Social Determinants of Cardiovascular Diseases

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Questions and Answers

The study of Social Determinants of Health (SDH) is focused on understanding the effects of social context on health, while ignoring the mechanisms by which these determinants act on health.

False

The Ottawa Charter for Health Promotion emphasizes that the prerequisites for health include peace, shelter, education, food, income, a stable ecosystem, sustainable resources, social injustices, and equality.

False

The materialist hypothesis in health believes that socioeconomic disadvantages influence an individual's health behavior.

True

The term 'stress' in work-related stress is considered a precise and unambiguous concept.

False Signup and view all the answers

Studies have consistently shown that social isolation increases the risk of death due to myocardial infarction, with men experiencing this phenomenon more than women.

True Signup and view all the answers

Geographical location has been shown to be unrelated to atmospheric pollution, as the distribution of populations regarding pollution is random.

False Signup and view all the answers

The socioeconomic gradient in health can only be partially explained by traditional risk factors, such as smoking, obesity, and an unhealthy diet.

True Signup and view all the answers

The study by Geoffrey Rose focused solely on individuals, examining the factors contributing to their illnesses.

False Signup and view all the answers

Adverse childhood experiences (ACEs) have been linked to alterations in brain structure and neurobiological stress-response systems, but these changes are not associated with consequences for health and emotional well-being.

False Signup and view all the answers

The interaction between patients and their general practitioner (GP) is a constant factor across diverse healthcare settings and does not vary based on patient characteristics.

False Signup and view all the answers

The study of socioeconomic inequalities in health has shown that implementing preventive strategies against traditional risk factors alone in disadvantaged groups effectively reduces health inequalities.

False Signup and view all the answers

Including healthcare systems as a social determinant of health is a common perspective in epidemiological research.

False Signup and view all the answers

Clinical decision rules that use traditional cardiovascular risk models are designed to mitigate social inequalities in access to healthcare.

False Signup and view all the answers

The 'Inequalities by Omission' concept in healthcare refers to systemic failures resulting from the exclusion of social determinants in daily care processes.

True Signup and view all the answers

The role of the healthcare system in addressing social inequalities is primarily evident in hospital settings, where there appears to be a more equitable provision of care compared to ambulatory settings.

False Signup and view all the answers

In the context of the patient-physician interaction, older patients generally have a higher education level than younger patients, leading to increased concordance between medical professionals and patients.

False Signup and view all the answers

The decision-making process concerning CVD management involving patients is typically influenced by the patient's socioeconomic status, age, and education level, but not by their coping style.

False Signup and view all the answers

Studies have suggested that healthcare professionals often underestimate the health of patients with a lower level of education, potentially leading to inadequate health advice and treatment.

True Signup and view all the answers

The cumulative effect of socioeconomic disadvantages during childhood and adolescence has been shown to predict future ill health, but only in a cross-sectional manner.

False Signup and view all the answers

The hypothesis by Anders Forsdahl regarding the correlation between living conditions and later mortality from arteriosclerotic disease is now widely accepted, but it has been challenged and is still controversial.

False Signup and view all the answers

The study by Barker et al. suggested that adverse influences experienced in childhood due to poor living standards can increase individuals' susceptibility to other influences encountered later in life, potentially adding to their risk of developing chronic diseases.

True Signup and view all the answers

The Dutch Famine cohort studies, which assessed individuals born in Amsterdam during the famine, have shown that exposure to famine in early gestation is significantly linked to a higher prevalence of coronary heart disease (CHD) in adulthood, regardless of other contributing factors.

True Signup and view all the answers

The social environment can influence gene expression but has not been shown to have any impact on the social epidemiology landscape.

False Signup and view all the answers

The population strategy in disease prevention, as proposed by Geoffrey Rose, aims to achieve individual benefit by targeting high-risk individuals, but not by shifting the distribution curve of risk factors.

False Signup and view all the answers

The recent trend in the use of population prevention strategies for disease has proven to significantly exacerbate social inequalities, particularly in terms of nutrition.

True Signup and view all the answers

Which of the following is NOT included as a prerequisite for health in the Ottawa Charter for Health Promotion?

Competition Signup and view all the answers

What is the term used to describe the situation where social determinants are not included in daily care procedures, potentially leading to a perpetuation of health disparities?

Inequalities by Omission Signup and view all the answers

Name the British epidemiologist who introduced a double level of reflection between individuals and populations, focusing on the factors that explain why a certain individual is sick and why a population is sick?

Geoffrey Rose Signup and view all the answers

Which specific social factor has been shown to contribute to a higher prevalence of heart disease among individuals who experienced famine exposure in early gestation?

Famine exposure in early gestation Signup and view all the answers

What is the term used for the social and personal experiences that a person encounters during childhood that can have long-term consequences for their health and well-being?

Adverse Childhood Experiences (ACEs) Signup and view all the answers

Which two social factors are particularly highlighted in the study of environmental links to cardiovascular health in the Paris region?

Low average level of education and low density of services Signup and view all the answers

Study Notes

Social determinants of health are social conditions influencing individuals' lives and work, shaped by power distribution, income and resource distribution at global, national and local levels.
Social determinants of CVD are largely outside healthcare systems, but affect cause-and-effect chains within the system.
Early intervention is crucial to prevent CVD, as childhood adversities can have permanent biological effects.
Focusing health education on adults is less effective due to age-related behavioral changes and biological damage.
Collective influences on CVD development are significant, suggesting that population strategies, like Geoffrey Rose's, may increase social inequalities if they disproportionally benefit the most privileged.
CVD risk factors like high blood pressure, cholesterol, smoking, diabetes, and physical inactivity are well-studied, but social determinants (working conditions, housing, social relationships) are less explored.
Social inequalities in health persist or even worsen, increasing CVD incidence in rapid social changes like the fall of the Soviet Union.
Gender differences in cardiovascular mortality exist, which aren't explained by changes in traditional risk factors but likely by societal changes (women's role in work).

Broad mechanisms (biological, behavioral, treatment availability, fall in CVD rates) are understood, but social determinants are important because:
- Social inequalities in health are persistent and increasing.
- CVD incidence increases dramatically after major social change.
- Social inequality in CVD incidence emerges in groups like the disadvantaged.

SDH shape the physical, social, economic, and personal resources individuals have to meet needs and adapt to environments.
SDH are crucial to understanding and addressing health, not just in the context of CVD
SDH can increase existing health inequalities even as improving average health outcomes.

Work and CVD

Work stress increases CVD risk (myocardial infarction) by 2 or 3 times.
Chronic stress is a predictor of CVD mortality and morbidity.
Workplace organizational structures and job strain (high workload, low control over work rhythm and decision-making) are major risk factors for chronic stress.
Psychosocial stress and stress-related measures (sense of coherence) are linked to CVD risk factors (e.g., hypertension, atherosclerosis).
Negative social interactions (conflict with supervisor) are linked to higher blood pressure, while supportive co-workers have an inverse effect.

Unemployment and Job Instability

Unemployment increases mortality risk compared to employed individuals, a factor beyond simple selection bias.
Unstable employment situations (fixed-term contracts, part-time work) contribute to cardiovascular risk.
Restructuring operations with staff cuts in organizations were correlated to an increased risk of CVD mortality, independently of the existing health factors.

Social isolation increases death risk due to myocardial infarction, more in men than women.
Social networks impact health by providing instrumental (material) and psychosocial (emotional) support.

Geographical Location

Exposure to air pollution (particulate matter, ozone, carbon monoxide etc.) is strongly linked to CVD mortality, particularly affecting lower socioeconomic groups.
Low-temperature increases in short-term myocardial infarction risk.
Proximity to green spaces reduces inequality in CVD risk, even accounting for socioeconomic differences.

Discrimination and Ethnicity

Ethnicity and racial discrimination can influence health beyond socioeconomic status and material quality of life.
Health disparities influenced by skin color, place of birth, and name are examined.

Traditional Risk Factors

Traditional risk factors (smoking, obesity) do not fully explain social gradients in health.
Traditional risk factors are still important, and are not only affected by social factors.

Risk Factors Over Time

Events and experiences in early life (womb to adulthood) have accumulative effects on health, increasing CVD risk.
Early disadvantaged conditions associated with increased risk of cardiovascular disease.

Healthcare System

Healthcare systems themselves can perpetuate health inequalities.
Healthcare system inequalities are structured by its construction (how it is organized) and omissions (failing to account for social factors).
Access to care and treatment may differ based on patients' socioeconomic status, education level.
There is a discrepancy between physician and patient experiences of the prevalence and severity of disease.

Environmental factors (e.g., social isolation, air pollution) impact gene expression and health outcomes.
A study on nuns demonstrates the impact of prolonged isolation on blood pressure, suggesting a correlation between social environment and biological factors.

Conclusion

Early intervention and addressing social determinants, such as improving nutrition and reducing socioeconomic disparities, are crucial to prevention.
Interventions should be tailored to specific cultural and social contexts.

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Description

This quiz explores the impact of social determinants on the development and prevalence of cardiovascular diseases (CVD). It highlights how social conditions, such as income distribution and working environments, can influence health outcomes. Early interventions and population-level strategies are discussed as methods to address these determinants and reduce health inequalities.

Social Determinants of Cardiovascular Diseases

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Questions and Answers

The study of Social Determinants of Health (SDH) is focused on understanding the effects of social context on health, while ignoring the mechanisms by which these determinants act on health.

The Ottawa Charter for Health Promotion emphasizes that the prerequisites for health include peace, shelter, education, food, income, a stable ecosystem, sustainable resources, social injustices, and equality.

The materialist hypothesis in health believes that socioeconomic disadvantages influence an individual's health behavior.

The term 'stress' in work-related stress is considered a precise and unambiguous concept.

Studies have consistently shown that social isolation increases the risk of death due to myocardial infarction, with men experiencing this phenomenon more than women.

Geographical location has been shown to be unrelated to atmospheric pollution, as the distribution of populations regarding pollution is random.

The socioeconomic gradient in health can only be partially explained by traditional risk factors, such as smoking, obesity, and an unhealthy diet.

The study by Geoffrey Rose focused solely on individuals, examining the factors contributing to their illnesses.

Adverse childhood experiences (ACEs) have been linked to alterations in brain structure and neurobiological stress-response systems, but these changes are not associated with consequences for health and emotional well-being.

The interaction between patients and their general practitioner (GP) is a constant factor across diverse healthcare settings and does not vary based on patient characteristics.

The study of socioeconomic inequalities in health has shown that implementing preventive strategies against traditional risk factors alone in disadvantaged groups effectively reduces health inequalities.

Including healthcare systems as a social determinant of health is a common perspective in epidemiological research.

Clinical decision rules that use traditional cardiovascular risk models are designed to mitigate social inequalities in access to healthcare.

The 'Inequalities by Omission' concept in healthcare refers to systemic failures resulting from the exclusion of social determinants in daily care processes.

The role of the healthcare system in addressing social inequalities is primarily evident in hospital settings, where there appears to be a more equitable provision of care compared to ambulatory settings.

In the context of the patient-physician interaction, older patients generally have a higher education level than younger patients, leading to increased concordance between medical professionals and patients.

The decision-making process concerning CVD management involving patients is typically influenced by the patient's socioeconomic status, age, and education level, but not by their coping style.

Studies have suggested that healthcare professionals often underestimate the health of patients with a lower level of education, potentially leading to inadequate health advice and treatment.

The cumulative effect of socioeconomic disadvantages during childhood and adolescence has been shown to predict future ill health, but only in a cross-sectional manner.

The hypothesis by Anders Forsdahl regarding the correlation between living conditions and later mortality from arteriosclerotic disease is now widely accepted, but it has been challenged and is still controversial.

The study by Barker et al. suggested that adverse influences experienced in childhood due to poor living standards can increase individuals' susceptibility to other influences encountered later in life, potentially adding to their risk of developing chronic diseases.

The Dutch Famine cohort studies, which assessed individuals born in Amsterdam during the famine, have shown that exposure to famine in early gestation is significantly linked to a higher prevalence of coronary heart disease (CHD) in adulthood, regardless of other contributing factors.

The social environment can influence gene expression but has not been shown to have any impact on the social epidemiology landscape.

The population strategy in disease prevention, as proposed by Geoffrey Rose, aims to achieve individual benefit by targeting high-risk individuals, but not by shifting the distribution curve of risk factors.

The recent trend in the use of population prevention strategies for disease has proven to significantly exacerbate social inequalities, particularly in terms of nutrition.

Which of the following is NOT included as a prerequisite for health in the Ottawa Charter for Health Promotion?

What is the term used to describe the situation where social determinants are not included in daily care procedures, potentially leading to a perpetuation of health disparities?

Name the British epidemiologist who introduced a double level of reflection between individuals and populations, focusing on the factors that explain why a certain individual is sick and why a population is sick?

Which specific social factor has been shown to contribute to a higher prevalence of heart disease among individuals who experienced famine exposure in early gestation?

What is the term used for the social and personal experiences that a person encounters during childhood that can have long-term consequences for their health and well-being?

Which two social factors are particularly highlighted in the study of environmental links to cardiovascular health in the Paris region?

Study Notes