"Poverty and the many stresses that come with social disadvantage have long been linked to cardiovascular disease, but how we live, work, and play has a great impact on heart health for people from a broad range of economic and cultural backgrounds," explains David Siscovick, MD, MPH, Senior Vice President for Research at The New York Academy of Medicine and Chair of the American Heart Association's (AHA) Council on Epidemiology and Prevention.
In his commentary on the AHA's new scientific statement on the Social Determinants of Risk and Outcomes for Cardiovascular Disease Siscovick explains that the social determinants of health are multi-dimensional and multi-level, yet we have few studies that examine the social determinants in large, diverse populations. More extensive research and new interventions are needed, he adds, if we are to reach the AHA's goal of increasing the proportion of the population in ideal cardiovascular health by 2020.
"From recent studies of the general population, we know that approximately 50 percent of children lose ideal cardiovascular health by adolescence because they are overweight or obese. Among women, overweight and obesity impact pre-conception health and potentially the long-term heart health of mothers and offspring. This tells us there's much more at work here than poverty alone."
While socioeconomic position and access to care play a significant role in cardiovascular health; Siscovick points to a need to learn about the interplay of complex issues such as social support and social networks; race, ethnicity and culture; residential environment; patient abilities and beliefs, education, housing, health literacy, and other factors.
"The [AHA] statement underscores the need for better metrics on the social determinants as well. Of particular interest to clinicians, the statement emphasizes the benefits of including information on socioeconomic position in cardiovascular risk prediction models."
Siscovick calls for a new approach to population health that closely examines all populations with an eye toward eliminating disparities in cardiovascular health, advancing prevention, and promoting healthier aging.
An internist and researcher with more than 650 peer-reviewed publications to his credit, Siscovick focuses broadly on the epidemiology and prevention of cardiovascular disease across the lifespan and multi-sectorial social determinants of health. He is available to journalists to discuss how, why, and what is needed to address the social determinants of health as they relate to cardiovascular disease.
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