Inequalities persist in France. The hearts of the most disadvantaged suffer as a result: cardiovascular disease and stroke are more frequent and more fatal in this population.
“Liberty, equality, fraternity. This is the motto of France. But in terms of equality, great progress remains to be made. In the field of health, in particular, socio-economic inequalities represent a damaging factor. The most disadvantaged classes of the population are highly exposed to cardiovascular and neurovascular pathologies. They were responsible for 900,000 hospitalizations in 2013 and are the second leading cause of death after cancer. Two studies published in the Weekly Epidemiological Bulletin (BEH), edited by Public Health France, carry out a very gloomy inventory.
Age, a risk factor
Myocardial infarction, stroke, pulmonary embolism, heart failure… Faced with cardiovascular disease, France is more unequal than its European neighbors. The record of Camille Lecoffre and her colleagues is unequivocal. It must be said that not only are these conditions more frequent in the underprivileged classes, but they are also more often fatal.
Between the best endowed and most disadvantaged quintile (20% of the workforce), myocardial infarctions are 50% more frequent. The results are almost as negative for heart failure. Age tends to worsen the situation further: the association is even stronger when patients are said to be “young”, that is, they are under 65 years of age. Heart failure is thus twice as fatal.
Source : BEH
These inequalities in the face of cardiovascular diseases can be explained by different behaviors between the most advantaged and the others. Disadvantaged classes turn more often to tobacco, alcohol and foods with poor nutritional profiles. So many factors that help the occurrence of pathologies such as arterial hypertension or type 2 diabetes, known to increase the risk of damage to the vascular system. There are also unfavorable psychosocial conditions that contribute to stress and depression.
More mortality
But the way of life is not always chosen. It can be suffered. “Atmospheric pollution, a recognized cardiovascular risk factor, is also more important in the most socio-economically disadvantaged areas”, underline the authors of the article. An unfavorable physical environment, which prevents regular physical activity.
Consequence: the poor classes do not always go to the doctor at the right time. “Later medical treatment when clinical signs of the disease appear, possibly linked to poor knowledge of the suggestive signs and less use of the health system, could also explain an increase in mortality depending on the social disadvantage, ”assume the authors of the article.
As the elderly are more fragile and care is in deficit, mortality is skyrocketing. The poorest quintile has more hospitalizations for myocardial infarction (35%), stroke (14%) and heart failure (44%). The association does not emerge in the case of pulmonary emboli.
The conclusion is simple, in the eyes of the authors of the study: efforts to reduce risk factors must be continued and deepened.
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