Socioeconomic Determinants of Health and Cardiovascular Outcomes in Women JACC Review Topic of the Week

被引:72
作者
Lindley, Kathryn J. [1 ]
Aggarwal, Niti R. [2 ]
Briller, Joan E. [3 ]
Davis, Melinda B. [4 ]
Douglass, Paul [5 ]
Epps, Kelly C. [6 ]
Fleg, Jerome L. [7 ]
Hayes, Sharonne [8 ]
Itchhaporia, Dipti [9 ]
Mahmoud, Zainab [1 ]
Moraes De Oliveira, Glaucia Maria [10 ]
Ogunniyi, Modele O. [11 ]
Quesada, Odayme [12 ]
Russo, Andrea M. [13 ]
Sharma, Jyoti [14 ]
Wood, Malissa J. [15 ]
机构
[1] Washington Univ, Dept Med, Cardiovasc Div, Sch Med, 660 S Euclid Ave,Box 6068, St Louis, MO 63110 USA
[2] Mayo Clin, Dept Cardiovasc Dis, Rochester, MN USA
[3] Univ Illinois, Dept Med, Div Cardiol, Chicago, IL USA
[4] Univ Michigan, Dept Internal Med, Div Cardiovasc Med, Ann Arbor, MI 48109 USA
[5] Wellstar Atlanta Med Ctr, Div Cardiol, Atlanta, GA USA
[6] Inova Heart & Vasc Inst, Falls Church, VA USA
[7] NHLBI, Bldg 10, Bethesda, MD 20892 USA
[8] Mayo Clin, Dept Cardiovasc Med, Rochester, MN USA
[9] Hoag Mem Hosp, Jeffrey M Carlton Heart & Vasc Inst, Newport Beach, CA USA
[10] Univ Fed Rio de Janeiro, Rio De Janeiro, Brazil
[11] Emory Univ, Sch Med, Div Cardiol, Atlanta, GA 30322 USA
[12] Christ Hosp, Heart & Vasc Inst, Womens Heart Ctr, Cincinnati, OH 45219 USA
[13] Rowan Univ, Dept Med, Cardiovasc Div, Cooper Med Sch, Camden, NJ USA
[14] Piedmont Heart Inst, Div Cardiol, Atlanta, GA USA
[15] Harvard Med Sch, Corrigan Minehan Heart Ctr, Massachusetts Gen Hosp, Boston, MA 02115 USA
关键词
rurality; sociodemographic; socioeconomic; women; race; DISEASE RISK-FACTORS; MYOCARDIAL-INFARCTION; PHYSICAL-ACTIVITY; AFRICAN-AMERICANS; UNITED-STATES; LOW-INCOME; CARE; PREVALENCE; MORTALITY; HYPERTENSION;
D O I
10.1016/j.jacc.2021.09.011
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Socioeconomic disparities in cardiovascular risk factors and outcomes exist among women, particularly those of minority racial or ethnic backgrounds. Barriers to optimal cardiovascular health begin early in life-with inadequate access to effective contraception, postpartum follow-up, and maternity leave-and result in excess rates of myocardial infarction, stroke, and cardiovascular death in at-risk populations. Contributing factors include reduced access to care, low levels of income and social support, and lack of diversity among cardiology clinicians and within clinical trials. These barriers can be mitigated by optimizing care access via policy change and improving physical access to care in women with geographic or transportation limitations. Addressing structural racism through policy change and bolstering structured community support systems will be key to reducing adverse cardiovascular outcomes among women of racial and ethnic minorities. Diversification of the cardiology workforce to more closely represent the patients we serve will be beneficial to all women. (J Am Coll Cardiol 2021;78:1919-1929) (c) 2021 the American College of Cardiology Foundation. Published by Elsevier. All rights reserved.
引用
收藏
页码:1919 / 1929
页数:11
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