新冠疫情中的社会经济地位与心血管健康

Socioeconomic status and cardiovascular health in the COVID-19 pandemic.

作者信息

Naylor-Wardle Jeremy, Rowland Ben, Kunadian Vijay

机构信息

Translation and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.

Translation and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK

出版信息

Heart. 2021 Mar;107(5):358-365. doi: 10.1136/heartjnl-2020-318425. Epub 2021 Jan 15.

Abstract

The goals of this review are to evaluate the impact of socioeconomic (SE) status on the general health and cardiovascular health of individuals during the COVID-19 pandemic and also discuss the measures to address disparity. SE status is a strong predictor of premature morbidity and mortality within general health. A lower SE status also has implications of increased cardiovascular disease (CVD) mortality and poorer CVD risk factor profiles. CVD comorbidity is associated with a higher case severity and mortality rate from COVID-19, with both CVD and COVID-19 sharing important risk factors. The COVID-19 pandemic has adversely affected people of a lower SE status and of ethnic minority group, who in the most deprived regions are suffering double the mortality rate of the least deprived. The acute stress, economic recession and quarantine restrictions in the wake of COVID-19 are also predicted to cause a decline in mental health. This could pose substantial increase to CVD incidence, particularly with acute pathologies such as stroke, acute coronary syndrome and cardiogenic shock among lower SE status individuals and vulnerable elderly populations. Efforts to tackle SE status and CVD may aid in reducing avoidable deaths. The implementation of 'upstream' interventions and policies demonstrates promise in achieving the greatest population impact, aiming to protect and empower individuals. Specific measures may involve risk factor targeting restrictions on the availability and advertisement of tobacco, alcohol and high-fat and salt content food, and targeting SE disparity with healthy and secure workplaces.

摘要

本综述的目的是评估社会经济(SE)状况在新冠疫情期间对个体总体健康和心血管健康的影响,并讨论解决差异的措施。社会经济状况是总体健康中过早发病和死亡的有力预测指标。较低的社会经济状况还意味着心血管疾病(CVD)死亡率增加以及心血管疾病风险因素状况较差。心血管疾病合并症与新冠病毒感染的更高病例严重程度和死亡率相关,心血管疾病和新冠病毒感染具有共同的重要风险因素。新冠疫情对社会经济地位较低的人群和少数族裔产生了不利影响,在最贫困地区,他们的死亡率是最不贫困地区的两倍。预计新冠疫情后的急性应激、经济衰退和隔离限制也会导致心理健康下降。这可能会大幅增加心血管疾病的发病率,尤其是在社会经济地位较低的个体和脆弱的老年人群中,如中风、急性冠状动脉综合征和心源性休克等急性病症。解决社会经济状况和心血管疾病的努力可能有助于减少可避免的死亡。实施“上游”干预措施和政策有望对最大数量的人群产生影响,旨在保护和增强个体的能力。具体措施可能包括针对风险因素,限制烟草、酒精以及高脂肪和高盐食品的供应和广告,并通过健康和安全的工作场所来解决社会经济差异问题。

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