Socioeconomic considerations in the primordial prevention of cardiovascular disease.

Economic policy is an important determinant of population health; it is part of health policy. True primordial prevention of cardiovascular disease (CVD) may require regulation of the domestic and international market forces which produce and distribute CVD risk factors and their determinants. Because the market does not bear the cost of the legacy of poor health that it generates, primordial prevention of CVD may need to concern itself with societal mechanisms for holding these market forces accountable. Indeed, this approach is now an important part of the public health lexicon for preventing smoking. No program of primordial prevention of smoking could possibly ignore the national and international economic interests of the tobacco industry. We need to start thinking about primordial prevention of CVD risk factors such as low physical activity, high-fat diet, and psychosocial stress in the same way.