Online Program

Jumping the gun: The problematic discourse on socioeconomic status and cardiovascular health in India

Tuesday, November 5, 2013 : 1:10 p.m. - 1:30 p.m.

Daniel Corsi, PhD, Harvard School of Public Health, Cambridge, MA
There has been an increased focus on non-communicable diseases (NCDs) in India, especially on cardiovascular diseases and associated risk factors. We scrutinize the prevailing narrative that cardiovascular risk factors (CVRF) and cardiovascular disease (CVD) are no longer confined to the economically advantaged groups but are an increasing burden among the poor in India. We conducted a comprehensive review of studies reporting the association between socioeconomic status (SES) and CVRF, CVD, and CVD-related mortality in India. With the exception of smoking and low fruit and vegetable intake, the studies clearly suggest that CVRF/CVD is more prevalent among high SES groups in India than among the low SES groups. Although CVD-related mortality rates appear to be higher among the lower SES groups, the proportion of deaths from CVD-related causes was found to be greatest among higher SES groups. The studies on SES and CVRF/CVD also reveal a substantial discrepancy between the data presented and the authors' interpretations and conclusions, along with an unsubstantiated claim that a reversal in the positive SES-CVRF/CVD association has occurred or is occurring in India. We conclude by emphasizing the need to prioritize public health policies that are focused on the health concerns of the majority of the Indian population. Resource allocation in the context of efforts to make health care in India free and universal should reflect the proportional burden of disease on different population groups if it is not to entrench inequity.

Learning Areas:


Learning Objectives:
Assess whether cardiovascular risk factors (CVRF) and cardiovascular disease (CVD) are an increasing burden among the poor in India.

Keyword(s): Heart Disease, Social Inequalities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: My primary area of research is in social and environmental determinants of health with a specific focus on early life experiences influencing cardiovascular disease and risk factors throughout the life course.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.