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Social determinants of coronary heart disease(CHD).
 

Social determinants of coronary heart disease(CHD).

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Impact of Coronary heart disease, its social determinants and way forward

Impact of Coronary heart disease, its social determinants and way forward

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  • In both 1999–2000 and 2009–2010, the prevalence of two or more chronic conditions for adults aged 45–64 decreased with rising family incomeAmong those aged 65 and over, the percentage with two or more chronic conditions also decreased with increasing family income, but the percentage varied less by family income than among those aged 45–64.
  • In 2009–2010, 23% of adults aged 45–64 with two or more chronic conditions did not receive or delayed needed medical care in the past year due to cost, and 22% did not receive needed prescription drugs due to cost (Figure 5). For adults aged 65 and over with two or more chronic conditions, there was no change in the percentage who did not receive or delayed needed medical care in the past year due to cost, while the percentage who did not receive needed prescription drugs in the past year due to cost increased over the 10-year period.

Social determinants of coronary heart disease(CHD). Social determinants of coronary heart disease(CHD). Presentation Transcript

  • B Y A H M E D O T O K I T I , M . B , B . S , C C R P . SOCIAL DETERMINANTS OF CORONARY HEART DISEASE
  • INTRODUCTION/BASIC CONCEPTS • According to the WHO, Health is a state of complete physical, mental and social well-being. Not just the absence of disease /infirmity. • Health is not always opposite of disease. • Determinants are established scientific factor that relate to the level of health problem Ahmed Otokiti(ahmedotoks@yahoo.com)/2 013
  • NO MAN IS AN ISLAND • Every individual posses such innate identity as Genetics, Gender, Race e.t.c. These are beyond his control. • There is a constant interaction between the individual and the environment. • The environment is made up of the social and physical environment like the weather and topograhy, Geography. Ahmed Otokiti(ahmedotoks@yahoo.com)/2 013
  • NO MAN IS AN ISLAND CONT’D • The individual’s interaction is usually within a community(e.g school, neighborhood, work). • Manifested through various relationships such as family ties, religious groups, friendships e.t.c • These interactions are usually modified and influenced by such societal factors as economic policy, justice system and politics… Ahmed Otokiti(ahmedotoks@yahoo.com)/2 013
  • SOCIAL ENVIRONMENT/DETERMINANTS • Behavioral/lifestyle together with lack of medical access makes up 59% of determinants of disease • Social factors are the major determinants of health inequities(e.g poverty, poor education, low socioeconomic status) • Health inequity is the major cause of relative poor health outcome in the U.S as compared to other developed Nations. Ahmed Otokiti(ahmedotoks@yahoo.com)/2 013
  • SOCIAL DETERMINANTS OF CORONARY HEART DISEASE(CHD) • Heart disease is the leading cause of death in the U.S. • Poverty and Low socioeconomic status(SES) is associated with increase prevalence of CHD. Daviglus ML, Talavera GA(2012) Prevalence of major cardiovascular risk factors and cardiovascular diseases among Hispanic/Latino individuals of diverse backgrounds in the United States. JAMA ;308(17):1775-84 • Community affluence is also significant as poor people who live in affluent communities have reduced incidence of CHD as compared with those who don't. Abeita IM, Tuitt NR(2012) Effect of community affluence on the association between individual socioeconomic status and cardiovascular disease risk factors, Colorado. J Prev chronic Dis. :E115. Epub 2012 Jun 21 Ahmed Otokiti(ahmedotoks@yahoo.com)/2 013
  • SOCIAL DETERMINANTS OF CORONARY HEART DISEASE(CHD) CONT’D • Poverty and Low SES also affects patients ability to comply to medication worsening affliction and Disease. • The health policies and health insurance system which is not very socially responsive also further rules out the poor in obtaining adequate health care hence worsening outcome of disease Ahmed Otokiti(ahmedotoks@yahoo.com)/2 013
  • SOCIAL DETERMINANTS OF CORONARY HEART DISEASE(CHD) CONT’D • In considering the logic model as it relates to health determinants of CHD. Some specific social factors exert multiple influences, from the level of exposure to CHD up to the Disease outcome. • An example is Poverty and Low SES; Poverty prevents good dietary habit leading to exposure to CHD. Ahmed Otokiti(ahmedotoks@yahoo.com)/2 013
  • LOGIC MODEL; SOCIAL DETERMINANTS OF CHD • {CONTRIBUTING FACTORS} → {DETERMINANTS} → { DISEASE/CHD} → { OUTCOME} • ↑ ↑ ↑ ↑ • -Low SES -Obesity -Low social support -Low SES • -Poor Nutrition -Hypertension -Poverty -Health policy -Smoking -Diabetes -Health -In activity/no exercise -Hypercholesterol -Religious/cultural belief -Ethnicity/race • -Low level of education -Smoking -Ethnicity -Social protection • -Smoking -No exercise -Compliance -Justice system • -Substance abuse -community effort • -life style changes • - Ahmed Otokiti(ahmedotoks@yahoo.com)/2 013
  • PREVALENCE OF TWO OR MORE OF NINE SELECTED CHRONIC CONDITIONS AMONG ADULTS AGED 45 AND OVER, BY AGE AND PERCENTAGE OF POVERTY LEVEL: UNITED STATES, 1999–2000 AND 2009–2010 • 1Significantly different from 1999–2000, p < 0.05 SOURCE: CDC/NCHS, National Health Interview Survey.Ahmed Otokiti(ahmedotoks@yahoo.com)/2 013
  • THE PERCENTAGE OF ADULTS AGED 45–64 WITH TWO OR MORE OF NINE SELECTED CHRONIC CONDITIONS WHO DID NOT RECEIVE OR DELAYED NEEDED MEDICAL CARE IN THE PAST YEAR DUE TO COST, OR WHO DID NOT RECEIVE NEEDED PRESCRIPTION DRUGS IN THE PAST YEAR DUE TO COST, INCREASED OVER THE 10-YEAR PERIOD. • 1Significantly different from 1999–2000, p < 0.05. SOURCE: CDC/NCHS, National Health Interview Survey. Ahmed Otokiti(ahmedotoks@yahoo.com)/2 013
  • REFERENCES • Abeyta IM, T. N., Byers TE, Sauaia A. (2012). " Effect of community affluence on the association between individual socioeconomic status and cardiovascular disease risk factors, Colorado, 2007-2008. ." Prev Chronic Dis 2012;9:E115. • Daviglus ML, T. G., Avilés-Santa ML, Allison M, Cai J, Criqui MH, Gellman M, Giachello AL, Gouskova N, Kaplan RC, LaVange L, Penedo F, Perreira K, Pirzada A, Schneiderman N, Wassertheil-Smoller S, Sorlie PD, Stamler J. (2012). “ • Prevalence of major cardiovascular risk factors and cardiovascular diseases among Hispanic/Latino individuals of diverse backgrounds in the United States." JAMA 308(17): 1775- 1784. Ahmed Otokiti(ahmedotoks@yahoo.com)/2 013