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心血管健康的种族和社会经济决定因素:一项综合综述。

Racial and Socioeconomic Determinants of Cardiovascular Health: A Comprehensive Review.

作者信息

Borkowski Pawel, Borkowska Natalia, Mangeshkar Shaunak, Adal Bisrat H, Singh Nikita

机构信息

Internal Medicine, Albert Einstein College of Medicine, Jacobi Medical Center, New York, USA.

Pediatrics, SPZOZ (Samodzielny Publiczny Zakład Opieki Zdrowotnej) Krotoszyn, Krotoszyn, POL.

出版信息

Cureus. 2024 May 2;16(5):e59497. doi: 10.7759/cureus.59497. eCollection 2024 May.

Abstract

Cardiovascular diseases (CVDs) are the leading cause of death globally. Their prevalence and mortality rates continue to rise. This narrative review explores well-known risk factors for CVDs such as dyslipidemia, hypertension, diabetes, obesity, and smoking, and their prevalence among different racial and ethnic groups. In addition, we expand the discussion to include the impact of socioeconomic status (SES) on cardiovascular outcomes. The data demonstrate that non-Hispanic Black and Hispanic populations not only exhibit higher rates of hypertension, obesity, diabetes, and smoking but also face systemic barriers linked to lower SES, which worsen their cardiovascular outcomes. These barriers include a lack of education, lower income, higher rates of unemployment, and poor living conditions. Beyond these commonly studied factors, these groups also suffer from higher levels of food and housing insecurity and a lack of adequate insurance coverage, all of which contribute to poorer health. Additionally, there is a higher prevalence of mental health disorders, such as depression and anxiety, among these populations. This further compounds the risks and adverse outcomes associated with CVDs. It is essential to conduct further research into how SES and race influence cardiovascular health and to refine risk assessment methods. Concentrating on these aspects would make it possible to create interventions designed to meet the needs of diverse communities and strategies that could potentially reduce morbidity and mortality from CVD across populations. Moreover, this review advocates for integrating comprehensive socioeconomic data into cardiovascular health strategies, which is crucial for developing effective public health initiatives.

摘要

心血管疾病(CVDs)是全球首要死因。其患病率和死亡率持续上升。本叙述性综述探讨了心血管疾病的知名风险因素,如血脂异常、高血压、糖尿病、肥胖和吸烟,以及它们在不同种族和族裔群体中的患病率。此外,我们将讨论范围扩大到包括社会经济地位(SES)对心血管结局的影响。数据表明,非西班牙裔黑人和西班牙裔人群不仅高血压、肥胖、糖尿病和吸烟率较高,而且面临与较低社会经济地位相关的系统性障碍,这使他们的心血管结局恶化。这些障碍包括缺乏教育、收入较低、失业率较高和生活条件差。除了这些常见的研究因素外,这些群体还面临更高程度的食品和住房不安全以及缺乏足够的保险覆盖,所有这些都导致健康状况较差。此外,这些人群中精神健康障碍(如抑郁症和焦虑症)的患病率较高。这进一步加剧了与心血管疾病相关的风险和不良后果。有必要进一步研究社会经济地位和种族如何影响心血管健康,并完善风险评估方法。关注这些方面将有可能制定旨在满足不同社区需求的干预措施以及可能降低全人群心血管疾病发病率和死亡率的策略。此外,本综述主张将全面的社会经济数据纳入心血管健康策略,这对于制定有效的公共卫生举措至关重要。

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