Cardiovascular Research Centre, Australian Catholic University, Melbourne, Victoria, Australia.
Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.
Int J Cardiol. 2014 Jan 1;170(3):255-7. doi: 10.1016/j.ijcard.2013.10.082. Epub 2013 Nov 1.
Cardiovascular disease (CVD) mortality rates have declined steadily over the past few decades but gender, socioeconomic and ethnic/racial disparities have not. These disparities impede cardiovascular health care reaching all those in need. The origins of disparities in CVD are numerous and wide-ranging, having largely evolved from inequalities in society. Similarly, disparities in CVD, interventions and outcomes will also vary depending on the minority or disadvantaged group. For this reason, strategies aimed at reducing such disparities must be stratified according to the target group, while keeping in mind that these groups are not mutually exclusive. There is a pressing need to move beyond what can be inferred from traditional cardiovascular risk factor profiling toward implementation of interventions designed to address the needs of these populations that will eventuate in a reduction of disparities in morbidity and mortality from CVD. This will require targeted and sustainable actions. Only by ensuring timely and equitable access to care for all through increased awareness and active participation can we start to close the gap and deliver appropriate, acceptable and just care to all, regardless of gender, socioeconomic status or ethnicity/race.
心血管疾病 (CVD) 的死亡率在过去几十年中稳步下降,但性别、社会经济和种族/民族差异并未缩小。这些差异阻碍了所有需要的人获得心血管保健服务。CVD 差异的根源很多且范围广泛,主要源于社会不平等。同样,CVD、干预措施和结果的差异也将根据少数群体或弱势群体而有所不同。出于这个原因,旨在减少这些差异的策略必须根据目标群体进行分层,同时要记住,这些群体并非互斥。现在迫切需要超越从传统心血管危险因素分析中推断出来的方法,转而实施旨在满足这些人群需求的干预措施,最终减少 CVD 发病率和死亡率方面的差异。这将需要有针对性和可持续的行动。只有通过提高认识和积极参与,确保所有人都能及时获得公平的医疗服务,我们才能开始缩小差距,为所有人提供适当、可接受和公正的医疗服务,无论其性别、社会经济地位或种族/民族如何。