Public Health Reviews

, Volume 33, Issue 2, pp 601–622 | Cite as

Social Determinants of Cardiovascular Diseases

  • Thierry LangEmail author
  • Benoit Lepage
  • Anne-Cécile Schieber
  • Sébastien Lamy
  • Michelle Kelly-Irving
Open Access


Social determinants of health can be understood as the social conditions in which individuals live and work; conditions that are shaped by the distribution of power, income and resources, as much on a global and national level as on a local level. Social determinants of cardiovascular diseases are found largely outside the healthcare and preventative healthcare systems; but it is important to think in terms of chains of cause and effect, which enable us to see these determinants at work within the system of curative and preventative care, including the management of traditional risk factors. Taking a dynamic perspective on these social determinants of health, and in particular viewing them in a biological and epidemiological context, emphasizes the fact that intervention as early in life as possible is desirable in order to prevent cardiovascular diseases. It is important to act early, before childhood adversities in these critical periods are permanently or irrevocably recorded in the body. In terms of behaviour, focussing health education on adults runs counter to the fact that, with age, it is increasingly difficult to change our behaviour and to overcome biological damage already inflicted. In an area where attention has long been focussed on individual risk factors, underlining the fact that these factors act from infancy allows us to highlight the collective influences on the development of these diseases. Reflecting on health determinants in this way suggests that perhaps the population strategy proposed by Geoffrey Rose may lead to an increase in social inequalities if the modest decrease in risk factors, for example in terms of nutrition, involves the population categories initially most privileged.


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Copyright information

© BioMed Central London 2011

Authors and Affiliations

  • Thierry Lang
    • 1
    Email author
  • Benoit Lepage
    • 1
  • Anne-Cécile Schieber
    • 1
  • Sébastien Lamy
    • 1
  • Michelle Kelly-Irving
    • 1
  1. 1.Département d’Epidémiologie et santé publique, UMR Inserm-Université Paul Sabatier 1027, Institut Fédératif d’Etudes et de Recherche Interdisciplinaires Santé Société (IFERISS)Faculté de Médecine, 37, Allées Jules GuesdeToulouseFrance

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