Coronary artery disease (CAD), also called coronary heart disease (CHD), ischemic heart disease (IHD), myocardial ischemia, or simply heart disease, involves the reduction of blood flow to the heart muscle due to build-up of atherosclerotic plaque in the arteries of the heart. It is the most common of the cardiovascular diseases. Types include stable angina, unstable angina, and myocardial infarction. A common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw. Occasionally it may feel like heartburn. Usually symptoms occur with exercise or emotional stress, last less than a few minutes, and improve with rest. Shortness of breath may also occur and sometimes no symptoms are present. In many cases, the first sign is a heart attack. Other complications include heart failure or an abnormal heartbeat.
Cardiovascular disease (CVD) is any disease involving the heart or blood vessels. CVDs constitute a class of diseases that includes: coronary artery diseases, heart failure, hypertensive heart disease, rheumatic heart disease, cardiomyopathy, arrhythmia, congenital heart disease, valvular heart disease, carditis, aortic aneurysms, peripheral artery disease, thromboembolic disease, and venous thrombosis.
Health equity arises from access to the social determinants of health, specifically from wealth, power and prestige. Individuals who have consistently been deprived of these three determinants are significantly disadvantaged from health inequities, and face worse health outcomes than those who are able to access certain resources. It is not equity to simply provide every individual with the same resources; that would be equality. In order to achieve health equity, resources must be allocated based on an individual need-based principle.
The Whitehall Studies investigated social determinants of health, specifically the cardiovascular disease prevalence and mortality rates among British civil servants. The initial prospective cohort study, the Whitehall I Study, examined over 17,500 male civil servants between the ages of 20 and 64, and was conducted over a period of ten years, beginning in 1967. A second cohort study, the Whitehall II Study, was conducted from 1985 to 1988 and examined the health of 10,308 civil servants aged 35 to 55, of whom two thirds were men and one third women. A long-term follow-up of study subjects from the first two phases is ongoing.
The social determinants of health (SDOH) are the economic and social conditions that influence individual and group differences in health status. They are the health promoting factors found in one's living and working conditions, rather than individual risk factors that influence the risk for a disease, or vulnerability to disease or injury. The distributions of social determinants are often shaped by public policies that reflect prevailing political ideologies of the area.
The Black Report was a 1980 document published by the Department of Health and Social Security in the United Kingdom, which was the report of the expert committee into health inequality chaired by Sir Douglas Black. It was demonstrated that although, in general, health had improved since the introduction of the welfare state, there were widespread health inequalities. It also found that the main cause of these inequalities was economic inequality. The report showed that the death rate for men in social class V was twice that for men in social class I and that gap between the two was increasing, not reducing as was expected.
Richard Gerald Wilkinson is a British social epidemiologist, author, advocate, and left-wing political activist. He is Professor Emeritus of social epidemiology at the University of Nottingham, having retired in 2008. He is also Honorary Professor of Epidemiology and Public Health at University College London and Visiting Professor at University of York. In 2009, Richard co-founded The Equality Trust. Richard was awarded a 2013 Silver Rose Award from Solidar for championing equality and the 2014 Charles Cully Memorial Medal by the Irish Cancer Society.
Social medicine is an interdisciplinary field that focuses on the profound interplay between socio-economic factors and individual health outcomes. Rooted in the challenges of the Industrial Revolution, it seeks to:
- Understand how specific social, economic, and environmental conditions directly impact health, disease, and the delivery of medical care.
- Promote conditions and interventions that address these determinants, aiming for a healthier and more equitable society.
The Acheson Report, fully titled the Independent Inquiry into Inequalities in Health Report, was a report published in 1998 by a United Kingdom inquiry headed by Donald Acheson.
While epidemiology is "the study of the distribution and determinants of states of health in populations", social epidemiology is "that branch of epidemiology concerned with the way that social structures, institutions, and relationships influence health." This research includes "both specific features of, and pathways by which, societal conditions affect health".
Jeremiah Noah Morris was a Scottish epidemiologist who established the importance of physical activity in preventing cardiovascular disease.
Kate Elizabeth Pickett is a British epidemiologist and political activist who is Professor of Epidemiology in the Department of Health Sciences at the University of York, and was a National Institute for Health and Care Research Career Scientist from 2007 to 2012. She co-authored The Spirit Level: Why More Equal Societies Almost Always Do Better and is a co-founder of The Equality Trust. Pickett was awarded a 2013 Silver Rose Award from Solidar for championing equality and the 2014 Charles Cully Memorial Medal by the Irish Cancer Society.
The social determinants of health in poverty describe the factors that affect impoverished populations' health and health inequality. Inequalities in health stem from the conditions of people's lives, including living conditions, work environment, age, and other social factors, and how these affect people's ability to respond to illness. These conditions are also shaped by political, social, and economic structures. The majority of people around the globe do not meet their potential best health because of a "toxic combination of bad policies, economics, and politics". Daily living conditions work together with these structural drivers to result in the social determinants of health.
Lenore Hilda Manderson is an Australian medical anthropologist. She is Professor of Medical Anthropology in the Faculty of Medicine, Nursing and Health Sciences, and the School of Political and Social Inquiry, Faculty of Arts, at Monash University, Australia.
Neena Modi is a British physician and Professor of Neonatal medicine at Imperial College London. She is the current president of the UK Medical Women’s Federation, and past president of the Royal College of Paediatrics and Child Health, serving in this role from April 2015 to April 2018. She is one of only four women to ever hold this position.
EuroHealthNet is a non-profit partnership of organisations, agencies and statutory bodies working to contribute to a healthier Europe by promoting health and health equity between and within European countries. EuroHealthNet promotes health through its partnership framework by supporting members’ work in the EU and associated states through policy and project development, networking, and communications.
Otto Herbert Wolff, was a German born medical scientist, paediatrician and was the Nuffield Professor of Child Health at Great Ormond Street Hospital. Wolff was notable for being one of the first paediatricians in Britain to set up a clinic for obese children. Later research into plasma lipids with Harold Salt pioneered the techniques of lipoprotein electrophoresis. He later conducted research into the role of lipid disturbance in childhood as a precursor of coronary artery disease and his recognition in 1960 of the rare condition of abetalipoproteinaemia. Wolff was also co-discoverer of the Edwards syndrome in abnormal chromosomes.
Archana Singh-Manoux is a research professor and director at the French Institute of Health and Medical Research (INSERM), Université de Paris, Paris, France, and an honorary professor at the Institute of Epidemiology & Health, Faculty of Population Health Science at the University College London (UCL), London, UK.
Health politics or politics of health is an interdisciplinary field of study concerned with the analysis of social and political power over the health status of individuals.
The COVID-19 pandemic has had an unequal impact on different racial and ethnic groups in the United States, resulting in new disparities of health outcomes as well as exacerbating existing health and economic disparities.
