scholarly journals Developmental Origins of Cardiovascular Disease: Understanding High Mortality Rates in the American South

2021 ◽  
Vol 18 (24) ◽  
pp. 13192
Author(s):  
Garrett T. Senney ◽  
Richard H. Steckel
Keyword(s):  
Cardiovascular Disease ◽  
World War Ii ◽  
American South ◽  
Healthcare Access ◽  
Mortality Rates ◽  
Economic Transformation ◽  
Physical Growth ◽  
Developmental Origins ◽  
The American South ◽  
Cvd Mortality

While many social scientists view heart disease as the outcome of current conditions, this cannot fully explain the significant geographic disparities in cardiovascular disease (CVD) mortality rates in the USA. The developmental origins hypothesis proposes that CVD vulnerability is created by poor conditions in utero that underbuilds major organs relative to those needed to process lush nutrition later in life. The American South underwent an economic transformation from persistent poverty to rapid economic growth in the post-World War II era. We use state-level data on income growth and current conditions to explain variation in CVD mortality rates in 2010–2011. Our proxy for unbalanced physical growth, the ratio of median household income in 1980 to that in 1950, has a large systematic influence on CVD mortality, an impact that increases dramatically with age. The income ratio combined with smoking, obesity, healthcare access, and education explain more than 70% of the variance in CVD mortality rates.

Who benefits from social investment? The gendered effects of family and employment policies on cardiovascular disease in Europe

2019 ◽  
Vol 73 (3) ◽  
pp. 206-213 ◽  
Author(s):  
Katherine Ann Morris ◽  
Jason Beckfield ◽  
Clare Bambra
Keyword(s):  
Cardiovascular Disease ◽  
Early Childhood ◽  
Early Childhood Education ◽  
Government Spending ◽  
Parental Leave ◽  
Mortality Rates ◽  
Social Investment ◽  
Investment Policies ◽  
Childhood Education ◽  
Cvd Mortality

BackgroundIn the context of fiscal austerity in many European welfare states, policy innovation often takes the form of ‘social investment’, a contested set of policies aimed at strengthening labour markets. Social investment policies include employment subsidies, skills training and job-finding services, early childhood education and childcare and parental leave. Given that such policies can influence gender equity in the labour market, we analysed the possible effects of such policies on gender health equity.MethodsUsing age-stratified and sex-stratified data from the Global Burden of Disease Study on cardiovascular disease (CVD) morbidity and mortality between 2005 and 2010, we estimated linear regression models of policy indicators on employment supports, childcare and parental leave with country fixed effects.FindingsWe found mixed effects of social investment for men versus women. Whereas government spending on early childhood education and childcare was associated with lower CVD mortality rates for both men and women equally, government spending on paid parental leave was more strongly associated with lower CVD mortality rates for women. Additionally, government spending on public employment services was associated with lower CVD mortality rates for men but was not significant for women, while government spending on employment training was associated with lower CVD mortality rates for women but was not significant for men.ConclusionsSocial investment policies were negatively associated with CVD mortality, but the ameliorative effects of specific policies were gendered. We discuss the implications of these results for the European social investment policy turn and for future research on gender health equity.

Abstract P060: Reduction of Cardiovascular Mortality in the United States Population, 1988-2004: A Larger Contribution of Declining Exposures to Cadmium and Lead Compared to Traditional Cardiovascular Risk Factors

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Adrian Ruiz-Hernandez ◽  
Ana Navas-Acien ◽  
Roberto Pastor-Barriuso ◽  
Josep Redon ◽  
Eliseo Guallar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Mortality ◽  
Blood Lead ◽  
Mortality Rates ◽  
Lead And Cadmium ◽  
The Us ◽  
Urine Cadmium ◽  
Cadmium And Lead ◽  
Cvd Mortality

Introduction: Lead and cadmium exposures have markedly declined in the US following the banning of lead in gasoline and the implementation of tobacco control, air pollution reduction, and hazardous waste remediation policies since the mid 1970s. While lead and cadmium have been proposed as cardiovascular disease risk factors, little is known about their potential contribution to the decline in cardiovascular mortality in US adults. Hypothesis: We assessed the hypothesis that lead and cadmium exposure reductions partly explain the decreasing trend in cardiovascular mortality that occurred in the US from 1988-1994 to 1999-2004, after controlling for traditional cardiovascular risk factors including smoking, obesity, physical inactivity, hypertension, diabetes, chronic kidney disease, and dyslipidemia. Methods: Cohort study of 15,421 men and women ≥40 years old participating in the National Health and Nutrition Examination Survey (NHANES) 1988-1994 and 1999-2004. We implemented a mediation approach with additive hazard models to estimate the reductions in cardiovascular disease (CVD) mortality rates over time explained through changes in urine cadmium and blood lead concentrations. Results: After adjusting for age, sex, race and smoking, urine cadmium and blood lead concentrations decreased by 20.4 and 38.2%, respectively, between 1988-1934 and 1999-2004. Age-adjusted CVD mortality rates in the US decreased from 712.0 to 356.8 /100.000 person-years comparing 1988-1994 to 1999-2004. Changes in traditional CVD risk factors explained 16% of this decline. The observed reductions in urine cadmium and blood lead levels explained an additional 27.6% of this decline. Conclusions: The net impact of declining cadmium and lead exposures on mortality changes in the US was larger compared to traditional risk factors. These findings support that reducing cadmium and lead exposures resulted in a major public health achievement. The general population, however, remains exposed to cadmium and lead at concentrations that have been associated to CVD in the US population. Preventive strategies to enable additional reductions in exposure to cadmium and lead are needed.

Epidemiology of cardiovascular disease: the scale of the problem

2011 ◽  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Time Trends ◽  
Mortality Rates ◽  
Lifestyle Changes ◽  
Prevention Strategies ◽  
Preventive Actions ◽  
The World ◽  
Cvd Prevention ◽  
Cvd Mortality

• The epidemic of cardiovascular disease (CVD) has been and still is very dynamic and heterogeneous when comparing time trends and mortality rates in different places of the world.• Age-standardized CVD mortality rates have declined in some countries, mainly due to a better management of the essential risk factors.• Unfavourable trends in CVD incidence are found and foreseen in developing countries due to demographic and to adverse lifestyle changes.• Comprehensive CVD prevention strategies are needed to promote primary prevention and better implementation of effective preventive actions in patients with established CVD.

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