Sozioökonomische Risikofaktoren und Belastungen bei koronarer Herzkrankheit // Socio-economic risk-factors and coronary artery disease
Journal für Kardiologie - Austrian Journal of Cardiology 2020; 27 (3-4): 90-93
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Keywords: Arbeitsbelastung, Arbeitslosigkeit, Berentung, Koronare Herzkrankheit, Migration, Myokardinfarkt, Psychokardiologie, sozioökonomischer Status, CAD, coronary artery disease, heart attack, immigration, job strain, psychocardiology, retirement, SES, socio-economic status, unemployment
Biological, behavioral, and psychosocial risk factors have a measurable and significant effect on cardiovascular health. The connections between these factors are strong. This paper reviews the current state of knowledge on the impact of social risk-factors on the incidence and outcomes of coronary artery disease (CAD).
Socio-economic status (SES) is a considerable risk-factor for the development of CAD. Socially disadvantaged individuals have a higher risk. Bad income level and educational attainment have been consistently associated with CAD in high-income countries.
Chronic Job strain influences health, especially concerning the heart. The two theoretical models for work-stress and their consequences for medical interventions are described.
Unemployment status is an important risk factor for overall mortality and morbidity especially for CAD. More as 90 days of joblessness increases the risk of CAD. During the first year of unemployment the probability of getting a heart attack is remarkably high.
Studies have found negative effects of retirement on heart function as well as positive effects. Differences in cardiovascular health after retirement represent the complex relationship between health and being retired, depending on the individual meaning of job-withdrawal.
Immigration is a similar topic concerning inconsistent research findings. A mortality advantage of migrants from certain countries of origin has been described, the so-called “Healthy Migrant Effect”. Conversely, other studies show that immigration-related factors were associated with a higher risk of developing CAD. Migrants are a non-homogeneous group with many differences in their lifestyle, health beliefs and access to health care compared to the autochthonous populations.
The knowledge of these socioeconomic factors is essential for doctors to understand their patients not only from a somatic point of view but also in their entirety.
Kurzfassung: Die koronare Herzkrankheit (KHK) ist eine typische psychokardiologische, d.h.
bio-psycho-soziale Erkrankung. Somatische, psychische und soziale Faktoren sind eng miteinander verbunden und beeinflussen gemeinsam die Entstehung und den Verlauf der Erkrankung. In diesem Beitrag wird die soziale Ebene im Überblick dargestellt.