inequalities in CVD

Question 1

what does the Marmot review state?

Answer 1

• inequalities in healthcare arise because of social inequalities in society
• ‘if the causes of health inequalities are social, economic, cultural and political, then so should be the solutions.’
• need to tackle social causes of inequality to improve healthcare
• lack of access to high-quality care can contribute to inequality

Question 2

what are four medical risk factors for CVD?

Answer 2

• obesity
• blood cholesterol
• high BP
• diabetes

Question 3

what are four behavioural risk factors for CVD?

Answer 3

• smoking
• physical activity
• alcohol
• diet

Question 4

what are some of the recommendations of the NICE PHG 25?

Answer 4

-aims to prevent cvd at population level:

• reduce population level consumption of salt
• saturated fats
• trans fats
• reduce marketing and promotion of unhealthy foods to children
• transparency in commercial deals
• product labelling e.g. traffic light system
• health impact assessments for products
• common agricultural policy
• physically active travel promotion
• public sector catering guidance e.g. school food

Question 5

what is the difference between the high risk approach and population approach to reducing cvd prevalence?

Answer 5

• high risk only focuses on the individuals severely affected and tries to control/help them - can worsen inequality
• population approach tries to help reduce in population as a whole

*if you look at a graph of prevalence, will always have a small group of high risk people that lie far away from the mean. if you can shift the mean so that it is lower, will be helping the high risk group too.

Question 6

in the INTERHEART study, what were the 9 factors found to account for >90% of risk of first myocardial infarction?

Answer 6

• smoking
• fruit and veg
• exercise
• alcohol
• hypertension
• diabetes
• abdominal obesity
• psychosocial factors
• lipids