Determinantes socioeconómicos y factores de riesgo cardiovascularun estudio en Canarias

  1. Darias Curvo, Sara
Revista:
Revista Atlántida: Revista Canaria de Ciencias Sociales

ISSN: 2171-4924

Año de publicación: 2009

Número: 1

Páginas: 93-114

Tipo: Artículo

Otras publicaciones en: Revista Atlántida: Revista Canaria de Ciencias Sociales

Resumen

La salud es un estado dinámico influido por factores relacionados con las circunstancias individuales y del entorno. Las condiciones sociales en las que vive un individuo constituyen factores determinantes de gran parte de las desigualdades en salud que existen entre países y dentro de los mismos. En este sentido podemos considerar las enfermedades cardiovasculares como ejemplo de la incidencia de estos factores en los que la edad, el género, estatus socioeconómico, etnicidad y región geográfica constituyen diferencias importantes en la exposición a los denominados factores de riesgo cardiovascular (FRC). El principal objetivo de este estudio consiste en determinar la relación estadística entre factores de riesgo cardiovascular considerando la hipertensión arterial, diabetes, hipercolesterolemia, consumo de tabaco, consumo de alcohol, obesidad y actividad física con los determinantes socioeconómicos de la salud medidos a través del nivel de estudios, nivel de ingresos y actividad económica. Los resultados principales muestran que existe una interrelación entre los FRC y nivel socioeconómico especialmente en mujeres, afectando principalmente el consumo de alcohol y el consumo de tabaco.

Referencias bibliográficas

  • AGUIAR BAUTISTA, A., ALEMÁN SÁNCHEZ, J.J. & BARRETO MÉNDEZ, J. et al. (2000). In Gobierno de Canarias. Consejería de Sanidad y Consumo. Servicio Canario de Salud. (Ed.), Programa de prevención y control de la enfermedad cardiovascular en atención primaria. Tenerife: Gobierno de Canarias.
  • AHNQUIST, J., FREDLUND, P. & WAMALA, S.P. (2007). Is cumulative exposure to economic hardships more hazardous to women’s health than men’s? A 16-year follow-up study of the swedish survey of living conditions. Journal of Epidemiology and Community Health, 61(4), 331-336.
  • AHNQUIST, J., LINDSTROM, M. & WAMALA, S.P. (2008). Institutional trust and alcohol consumption in sweden: The swedish national public health survey 2006. BMC Public Health, 8, 283.
  • AVENDANO, M., BOSHUIZEN, H.C., SCHELLEVIS, F.G., MACKENBACH, J.P., VAN LENTHE, F.J. & VAN DEN BOS, G.A.M. (2006). Disparities in stroke preventive care in general practice did not explain socioeconomic disparities in stroke. Journal of Clinical Epidemiology, 59(12), 1.285-1.294.
  • AVENDANO, M., KAWACHI, I., VAN LENTHE, F., BOSHUIZEN, H.C., MACKENBACH, J.P., VAN DEN BOS, G. A., et al. (2006). Socioeconomic status and stroke incidence in the US elderly: The role of risk factors in the EPESE study. Stroke; a Journal of Cerebral Circulation, 37(6), 1.368-1.373.
  • BAIGENT, C., KEECH, A., KEARNEY, P.M., BLACKWELL, L., BUCK, G., POLLICINO, C., et al. (2005). Efficacy and safety of cholesterol lowering treatment: Prospective meta-analysis of data from 90056 participants in 14 randomised trials of statins. Lancet, 366, 1.267-12.78.
  • BEN SHLOMO, Y., WHITE, I.R. & MARMOT, M. (1996). Does the variation in the socioeconomic characteristics of an area affect mortality? BMJ, (312), 1.013-1.014.
  • BENACH, J., GIMENO, D., BENAVIDES, F.G., MARTINEZ, J.M. & TORNE MDEL, M. (2004). Types of employment and health in the european union: Changes from 1995 to 2000. European Journal of Public Health, 14(3), 314-321.
  • BERKMAN, L.F. & KAWACHI, I. (2000). In BERKMAN L.F., KAWACHI I. (Eds.), Social epidemiology. Oxford: Oxford University Press.
  • BLAZEK, J. & DZUROVA, D. (2000). The decline of mortality in the czech republic during the transition: A counterfactual case study. In G. A. Cornia, & R. Paniccia (Eds.), The mortality crisis in transitional economies. (). Oxford: Oxford University Press.
  • BORRELL, C., GARCÍA-CALVENTE, M.M. & MARTÍ BOSCÁ, J.V. (2004). La salud pública desde la perspectiva de género y clase social. Gac Sanit, 18(1), 1-6.
  • BORRELL, C., AZLOR, E., RODRÍGUEZ-SANZ, M., PUIGPINOS, R., CANO-SERRAL, G., PASARIN, M.I., et al. (2008). Trends in socioeconomic mortality inequalities in a southern european urban setting at the turn of the 21st century. Journal of Epidemiology and Community Health, 62(3), 258-266.
  • BORRELL, C., ESPELT, A., RODRÍGUEZ-SANZ, M. & NAVARRO, V. (2007). Politics and health. Journal of Epidemiology and Community Health, 61(8), 658-659.
  • BORRELL, C., MUNTANER, C., BENACH, J. & ARTAZCOZ, L. (2004). Social class and self-reported health status among men and women: What is the role of work organisation, household material standards and household labour? Social Science & Medicine (1982), 58(10), 1.869-1.887.
  • BORRELL, C. & PASARIN, M. . (2004). Desigualdad en salud y territorio urbano. Gac.Sanit., 18(1), 1-4.
  • BORRELL, C., PLASENCIA, A., PASARIN, I. & ORTUN, V. (1997). Widening social inequalities in mortality: The case of Barcelona, a southern european city. Journal of Epidemiology and Community Health, 51(6), 659-667.
  • BOSMA, H., MARMOT, M.G., HEMINGWAY, H., NICHOLSON, A.C., BRUNNER, E. & STANSFELD, S. (1997). Low job control and risk of coronary heart disease in whitehall II (prospective cohort), study. BMJ, 314, 555-65.
  • BRUNNER, E. (1997). Stress and the biology of inequality. BMJ, 314, 1472-1476.
  • BRUNNER, E. (2000). Toward a new social biology. In L.F. BERKMAN, & I. KAWACHI (Eds.), Social epidemiology. (pp. 306-31). Oxford: Oxford University Press.
  • CARROLL, D., DAVEY SMITH, G. & BENNETT, P. (1996). Some observations on health and socioeconomic status. J Health Psychol, 1, 23-29.
  • CARVALHO FREITAS, O., RESENDE DE CARVALHO, F., MARQUES NEVES, J., KARINE VELUDO, P., SILVA PARREIRA, R., MARAFIOTTI GONÇALVES, R., et al. (2001). Prevalence of hypertension in the urban population of catanduva, in the state of sao paulo, brazil. Arq Bras Cardiol, 77(1), 16-21.
  • CHARAFEDDINE, R. & BODEN, L.I. (2008). Does income inequality modify the association between air pollution and health? Environmental Research, 106(1), 81-88.
  • CHUNG, H. & MUNTANER, C. (2006). Political and welfare state determinants of infant and child health indicators: An analysis of wealthy countries. Soc Sci Med, 63(3), 829-42.
  • CORTÉS, I., ARTAZCOZ, L., RODRÍGUEZ-SANZ, M. & BORRELL, C. (2004). Desigualdades en la salud mental de la población ocupada. Gac Sanit, 18(5), 351-359.
  • CSDH-WHO. (2007). A conceptual framework for action on the social determinants of health (Discussion Paper. Copenhagen: WHO.
  • DAVEY SMITH, G. (1997). Socio-economic differentials. In D. Kuh, & Y. Ben Shlomo (Eds.), A life course approach to chronic disease epidemiology. (pp. 242-273.). Oxford: Oxford University Press.
  • DAVEY SMITH, G., BEN-SHLOMO, Y. & LYNCH, J. (2002). Life course approaches to inequalities in coronary heart disease risk. In S. STANSFELD, & M. MARMOT (Eds.), Stress and the heart (pp. 20-49). London: BMJ Books.
  • DAVEY SMITH, G., BLANE, D. & BARTLEY, M. (1994). Explanations for socioeconomic differentials in mortality: Evidence from britain and elsewhere. European Journal of Public Health, 4, 131-44.
  • DAVEY SMITH, G. & HARDING, S. (1997). Is control at work the key to socioeconomic gradients in mortality? Lancet, 350, 1.369-1.370.
  • DIEZ-ROUX, A.V., LINK, B.G. & NORTHRIDGE, M.E. (2000). A multilevel analysis of income inequality and cardiovascular disease risk factors. Social Science & Medicine, 50, 673-687.
  • DOMINGUEZ-BERJON, M.F., BORRELL, C., BENACH, J. & PASARIN, M.I. (2001). Measures of material deprivation in small area studies. [Medidas de privacion material en los estudios de areas geograficas pequenas] Gaceta Sanitaria / S.E.S.P.A.S, 15 Suppl 4, 23-33.
  • DROOMERS, M., CAROLA, T.M. & MACKENBACH, J.P. (2002). Why do lower educational people continue smoking? explanations from longitudinal GLOBE study. Health Psychology, 21(3), 263-272.
  • ELSTAD, J.I. (1998). The psycho-social perspective on social inequalities in health. In M. BARTLEY, D. BLANE & G. DAVEY SMITH (Eds.), The sociology of health inequalities (pp. 39-58). Oxford: Balckwell.
  • FERNÁNDEZ, E., SCHIAFFINO, A., BORRELL, C., BENACH, J., ARIZA, C., RAMÓN, J.M., et al. (2006). Social class, education, and smoking cessation: Long-term follow-up of patients treated at a smoking cessation unit. Nicotine & Tobacco Research : Official Journal of the Society for Research on Nicotine and Tobacco, 8(1), 29-36.
  • FOESSA. (1994). V Informe Sociológico sobre la Situación Social en España. Madrid: FOESSA.
  • FRANCO, A., ÁLVAREZ-DARDET, C. & RUIZ, M.T. (2004). Effect of democracy on health: Ecological study. British Medical Journal, 329(7480), 1.421-1.423.
  • GRAHAM, I. e. a. (2007). European guidelines on cardiovascular disease prevention in clinical practice: Executive summary. European Journal of Cardiovascular Prevention and Rehabilitation, 14(2), 1-40.
  • GUTIERREZ-FISAC, J.L., REGIDOR, E., BANEGAS, J.R. & RODRÍGUEZ ARTALEJO, F. (2005). Prevalence of obesity in the spanish adult population: 14 years of continuous increase. [Prevalencia de obesidad en la población adulta española: 14 años de incremento continuado] Medicina Clínica, 124(5), 196-197.
  • Informe de la secretaría de la comisión sobre determinantes sociales de la salud.(2008). No. EB124/9). Ginebra: OMS.
  • JOLLY, K. & GILL, P. (2008). Ethnicity and cardiovascular disease prevention: Practical clinical considerations. Current Opinion in Cardiology, 23(5), 465-470.
  • JOZAN, P. & FOSTER, D.P. (1999). Social inequalities and health: Ecological study of mortality in budapest, 1980-83 and 1990-93. BMJ, 318, 914-925.
  • KAPLAN, G.A., PAMUK, E.R., LYNCH, J.W., COHEN, R.D. & BALFOUR, J.L. (1996). Inequality in income and mortality in the united states: Analysis of mortality and potential pathways. BMJ, 312, 999-1.003.
  • KAPLAN, G.A., SHEMA, S.J. & LEITE, C.M.A. (2008). Socioeconomic determinants of psychological well-being: The role of income, income change, and income sources during the course of 29 years. Annals of Epidemiology, 18(7), 531-537.
  • KELAHER, M., PAUL, S., LAMBERT, H., AHMAD, W. & SMITH, G.D. (2008). The impact of different measures of socioeconomic position on the relationship between ethnicity and health. Annals of Epidemiology, 18(5), 351-356.
  • KENNEDY, B.P., KAWACHI, I., GLASS, R. & PROTHROW-STITH, D. (1998). Income distribution, socioeconomic status and self rated health in the united states: A multilevel analysis. BMJ, 31, 917-921.
  • KRIEGER, N., SMITH, K., NAISHADHAM, D., HARTMAN, C. & BARBEAU, E.M. (2005). Experiences of discrimination: Validity and reliability of a self report measure for population health research on racism and health. Soc Sci Med, 61, 1.576-1.596.
  • LOSTAO, L., REGIDOR, E., AÏACH, P. & DOMÍNGUEZ, V. (2001). Social inequalities in ischaemic heart and cerebrovascular disease mortality in men: Spain and france, 1980-1982 and 1988- 1990. Social Science & Medicine, 52, 1.879-1.887.
  • LYNCH, J. W., DAVEY SMITH, G., KAPLAN, G.A. & HOUSE, J.S. (2000). Income inequality and mortality: Importance to health of individual income, psycho-social environment, or material conditions. BMJ, 320, 1.200-4.
  • LYNCH, J.W., KAPLAN, G.A. & SALONEN, J.T. (1997). Why do poor people behave poorly? variation in adult health behaviours and psycho-social characteristics by stages of the socioeconomic lifecourse. Soc Sci Med, 44, 809-19.
  • LYNCH, J., KRAUSE, N., KAPLAN, G.A., TUOMILEHTO, J. & SALONEN, J.T. (1997). Workplace conditions, socioeconomic status, and the risk of mortality and acute myocardial infarction. Am J Public Health, 87, 617-22.
  • MACINKO, J., SHI, L., STARFIELD, B. & WULU, J. (2003). A critical review of the literature medical care research and review. J Income Inequality and Health, 60(4), 407-452.
  • MACKENBACH, J.P. (2005). In UK Presidence of the EU (Ed.), Health inequalities: Europe in profile. Roterdam, Holland: UK Presidence of the EU.
  • MANHEM, K., DOTEVALL, A., WILHEMSEN, L. & ROSENGREN, A. (2000). Social gradient in cardiovascular risk factors and symtoms of swedish men and woman: The goteborg MONICA study 1995. J Cardiovascular Risk, 7, 359-368.
  • MARMOT, M. & BOBAK, M. (2000). International comparators and poverty and health in europe. BMJ, 321, 1.124-1.128.
  • MARMOT, M., BOSMA, H., HEMINGWAY, H., BRUNNER, E. & STANSFELD, S. (1997). Contribution of job control and other risk factors to social variation in coronary heart disease incidence. Lancet, 350, 235-239.
  • MARMOT, M. (1993). Epidemiological approach to the explanation of social differentiation in mortality: The whitehall studies. Soz Praventivmed, 38, 271-9.
  • MARMOT, M. & WILKINSON, R. (2006). Social determinants of health (Second Edition ed.). New York: Oxford University Press.
  • MAZIAK, W., RASTAM, S., MZAYEK, F., WARD, K.D., EISSENBERG, T. & KEIL, U. (2007). Cardiovascular health among adults in syria: A model from developing countries. Annals of Epidemiology, 17(9), 713-720.
  • MCISAAC, S. & WILKINSON, R.G. (1997). Income distribution and cause-specific mortality. European Journal of Public Health, 7, 45-53.
  • NAVARRO, V., MUNTANER, C., BORRELL, C., BENACH, J., QUIROGA, A., RODRÍGUEZ-SANZ, M., et al. (2006). Politics and health outcomes. Lancet, 368(9540), 1.033-1.037.
  • NAVARRO, V. & SHI, L. (2001). The political context of social inequalities and health. International Journal of Health Services, 31, 1-21.
  • NUSSELDER, W.J., LOOMAN, C.W., FRANCO, O.H., PEETERS, A., SLINGERLAND, A.S. & MACKENBACH, J.P. (2008). The relation between non-occupational physical activity and years lived with and without disability. Journal of Epidemiology and Community Health, 62(9), 823-828.
  • OMS. (2008). Informe de la secretaría de la comisión sobre determinantes sociales de la salud. No. EB124/9). Ginebra: OMS.
  • PAOLI, P. & MERLILIÉ, D. (2001). Third european survey on working conditions 2000. Luxembourg: Office for Official Publications of the European Communities.
  • PEASEY, A., BOBAK, M., KUBINOVA, R., MALYUTINA, S., PAJAK, A., TAMOSIUNAS, A., et al. (2006). Determinants of cardiovascular disease and other non-communicable diseases in central and eastern europe: Rationale and design of the HAPIEE study. BMC Public Health, 6, 255.
  • RÍOS, D.A., ABDULAH, D.R., WEI, J.Y. & HAUSDORFF, J.M. (2001). Disparate effects of socioeconomic status on physical function and emotional well-being in older adults. Aging (Milano), 13, 30-37.
  • RODRÍGUEZ-ARTALEJO, F. & BANEGAS, J.R. (2007). Cardiovascular risk in clinical decision making. Current Hypertension Reports, 9(5), 339-341.
  • SALIDO, O. (1999). Las oportunidades de las mujeres en una estructura social cambiante. Proyecto WRAMSOC. Unidad de políticas comparadas (CSIC). No. Documento de Trabajo 02-05)Universidad Complutense de Madrid y UPC-CSIC.
  • SHKOLNIKOV, V.M., LEON, D.A., ADAMETS, S., ANDREEV, E. & DEEV, A. (1998). Educational level and adult mortality in russia: An analysis of routine data 1979-94. Soc Sci Med, 47, 357-369.
  • SOLAR, O., IRWIN, A., & VEGA, J. (2004). Equity in health sector reform and reproductive health: Measurement issues and the health system context. Geneva: WHO Health Equity Team working paper.
  • STARFIELD, B. (2007). Pathways of influence on equity in health. Social Science & Medicine, 64, 1.355-1.362.
  • STARFIELD, B., SHI, L. & MACINKO, J. (2005). Contribution of primary care to health systems and health. Milbank Quaterly, 83(3), 457-502.
  • STELMACH, W., KACZMARCZYK-CHALAS, K., BIELECKI, W., STELMACH, I. & DRYGAS, W. (2004). How income and education contribute to risk factors for cardiovascular disease in the elderly in a former communist country. Public Health, 118, 439-449.
  • SUBRAMANIAN, S.V. & KAWACHI, I. (Epidemiologic Reviews). Income inequality and health: What have we learn so far? 2004, 26, 78-91.
  • The INCLEN Multicentre Collaborative Group. (1996). Body mass index and cardiovascular disease risk factors in seven asian and five latin american centres: Data from the international clinical epidemiology network (INCLEN). Obes Res, 4, 221-228.
  • UNDP: United Nations Development Programme. (2000). Human development report 2000: Human rights and human development. New York: Oxford University Press.
  • VEGA, J. & IRWIN, A. (2004). Tackling health inequalities: New approaches in public policy. Bulletin of the World Health Organization, 82(7), 482.
  • WAMALA, S.P. (2001). Large social inequalities behind women’s risk of coronary disease. unskilled work and family strains are crucial factors. [Stora sociala skillnader bakom kvinnors risk for kranskarlssjukdom. Okvalificerat jobb och slitningar i familjen avgorande faktorer] Lakartidningen, 98(3), 177-181.
  • WAMALA, S.P., LYNCH, J. & KAPLAN, G.A. (2001). Women’s exposure to early and later life socioeconomic disadvantage and coronary heart disease risk: The stockholm female coronary risk study. International Journal of Epidemiology, 30(2), 275-284.
  • WILKINSON, R. & MARMOT, M. (2003). Social determinants of health: The solid facts. Copenhagen: WHO Regional Office for Europe.
  • WILKINSON, R.G. (1990). Income distribution and mortality: A «natural» experiment. Sociology of Health and Illness, 12, 165-168.
  • WILKINSON, R.G. (1997). Health inequalities: Relative or absolute material standards? BMJ, 314, 591-595.
  • WILKINSON, R.G. (1999). Health, hierarchy, and social anxiety. Annals of the New York Academy of Sciences, 896, 48-63.