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Wilder B, Pinedo A, Abusin S, Ansell D, Bacong AM, Calvin J, Cha SW, Doukky R, Hasan F, Luo S, Oktay AA, Palaniappan L, Rana N, Rivera FB, Fayaz B, Suliman AA, Volgman AS. A Global Perspective on Socioeconomic Determinants of Cardiovascular Health. Can J Cardiol 2024:S0828-282X(24)00583-X. [PMID: 39095016 DOI: 10.1016/j.cjca.2024.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 07/24/2024] [Accepted: 07/25/2024] [Indexed: 08/04/2024] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of mortality in the world. From 2005 to 2008, the World Health Organization (WHO) planned an initiative to reduce the mortality rate of CVD by 2030 by addressing health, finance, transport, education, and agriculture in these communities. Plans were underway by many countries to meet the goals of the WHO initiative. However, in 2020, the COVID-19 pandemic derailed these goals, and many health systems suffered as the world battled the viral pandemic. The pandemic made health inequities even more prominent and necessitated a different approach to understanding and improving the socioeconomic determinants of health (SDOH). WHO initiated a special initiative to improve SDOH globally. This paper is an update on what other regions across the globe are doing to decrease, more specifically, the impact of socioeconomic determinants of cardiovascular health. Our review highlights how countries and regions such as Canada, the United States, India, Southeast Asia, the Middle East, and Africa are uniquely affected by various socioeconomic factors and how these countries are attempting to counter these obstacles by creating policies and protocols to facilitate an infrastructure that promotes screening and treatment of CVD. Ultimately, interventions directed toward populations that have been economically and socially marginalized may aid in reducing the disease and financial burden associated with CVD.
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Affiliation(s)
- Bart Wilder
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Alejandro Pinedo
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Salaheldin Abusin
- Division of Cardiology, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - David Ansell
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Adrian Matias Bacong
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Palo Alto, California, USA; Stanford Center for Asian Health Research and Education (CARE), Stanford University, Palo Alto, California, USA
| | - James Calvin
- Stanford Center for Asian Health Research and Education (CARE), Stanford University, Palo Alto, California, USA; Department of Medicine, Western University, London, Ontario, Canada
| | | | - Rami Doukky
- Division of Cardiology, Department of Medicine, Cook County Health, Chicago, Illinois, USA
| | - Faisal Hasan
- Division of Cardiology, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Shengyuan Luo
- Section of Cardiology, Department of Internal Medicine, Johns Hopkins Medicine, Baltimore, Maryland, USA
| | - Ahmet Afşin Oktay
- Division of Cardiology, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Latha Palaniappan
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Natasha Rana
- Division of Cardiology, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | | | - Basmah Fayaz
- Division of Cardiology, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | | | - Annabelle Santos Volgman
- Division of Cardiology, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA.
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Hassoy H, Ergin I, Yararbas G. Trends in socioeconomic inequalities in smoking in Turkey from 2008 to 2016. BMC Public Health 2021; 21:2128. [PMID: 34800999 PMCID: PMC8605534 DOI: 10.1186/s12889-021-12200-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 11/09/2021] [Indexed: 11/15/2022] Open
Abstract
Background Smoking inequalities in Turkey were previously demonstrated in an early stage of the smoking epidemic model. This paper aimed to assess the trends for socioeconomic inequalities in smoking in Turkey over the years in the context of the smoking epidemic model using data from the Global Adult Tobacco Survey (GATS) Turkey 2008–2012-2016. Methods Cross-sectional data were analyzed to calculate the association of smoking with, wealth, education, occupation and place of residence using age-standardized prevalence rates, odds ratios, relative index of inequality (RII) and slope index of inequality (SII). The analysis was performed separately for age groups (younger: 20–39 years/older: 40 and above years) and sex. Results Younger women with higher wealth and older women with higher wealth and education smoked more. For both age groups, smoking was increased for working class and urban women. Relative wealth inequalities in smoking narrowed and then showed a reversal for younger women (RII2008 = 3.37; 95% CI:1.64–3.40; RII2012 = 2.19; 95% CI:1.48–3.24; RII2016 = 0.80; 95% CI:0.58–1.10, p-for trend < 0.0001). Relative educational inequalities in smoking for older women also showed a narrowing (RII2008 = 21.45; 95% CI:11.74–39.19; RII2012 = 15.25; 95% CI:9.10–25.55; and RII2016 = 5.48; 95% CI:3.86–7.78, p-for trend < 0.0001). For older women, a similar narrowing was observed for wealth (RII2008 = 3.94; 95% CI:2.38–6.53; RII2012 = 2.79; 95% CI:1.80–4.32; and RII2016 = 1.34; 95% CI:0.94–1.91, p-for trend = 0.0001). The only significant trend for absolute inequalities was for younger women by wealth. This trend showed a narrowing and then a reversal (SII2008 = 0.14; 95% CI:0.09–1.20; SII2012 = 0.12; 95% CI:0.06–0.18; and SII2016 = -0.05; 95% CI:-0.12–0.02, p-for trend = 0.0001). Unlike women, smoking in men showed inverse associations for wealth and education, although not statistically confirmed for all years. Smoking was increased in working classes and unemployed men in 2012 and 2016. Inequalities did not show a trend in relative and absolute terms for men. Conclusions For smoking inequalities in Turkey, a transition to the next stage was observed, although the previously defined Southern European pattern also existed. Low socioeconomic women deserve special attention as well as stressors at work and drivers of smoking at urban settings. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12200-x.
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Affiliation(s)
- Hur Hassoy
- Department of Public Health, Ege University Faculty of Medicine, Izmir, Turkey
| | - Isil Ergin
- Department of Public Health, Ege University Faculty of Medicine, Izmir, Turkey.
| | - Gorkem Yararbas
- Institute on Drug Abuse, Toxicology and Pharmaceutical Science, Ege University, Izmir, Turkey
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