尽管进行了数十年的社会流行病学研究,健康不平等在加拿大和其他地方仍然普遍存在和无处不在。一个原因可能是我们使用社会经济衡量标准,这通常依赖于单一的时间点暴露。为了探索研究人员将动态社会经济测量纳入心血管健康结果评估的程度,我们进行了叙述性审查。我们估计了社会经济纵向心血管研究的患病率,这些研究在2019年至2023年之间的两个或多个时间点确定了社会经济暴露。我们将心血管结局研究定义为检查冠状动脉疾病的研究,心肌梗塞,急性冠脉综合征,中风,心力衰竭,心律失常,心脏死亡,心脏代谢因子,短暂性脑缺血发作,外周动脉疾病,或高血压。社会经济风险包括个人收入,邻里收入,代际社会流动,教育,职业,保险状况,和经济安全。7%的社会经济心血管结局研究在整个随访期间测量了两个或多个时间点的社会经济状况。动态社会经济措施影响结果的假设机制集中在社会流动性上,积累,和关键时期理论。洞察力,含义,并讨论了未来的方向,其中我们强调了邮政编码数据的方式,可以在方法上更好地利用它作为一种动态的社会经济措施。未来的研究必须纳入动态的社会经济测量,以更好地揭示根本原因,干预措施,和卫生系统设计,如果要改善卫生公平。
Despite decades of social epidemiologic research, health inequities remain pervasive and ubiquitous in Canada and elsewhere. One reason may be our use of socioeconomic measurement, which has often relied on single point-in-time exposures. To explore the extent to which researchers have incorporated dynamic socioeconomic measurement into cardiovascular health outcome evaluations, we performed a narrative
review. We estimated the prevalence of socioeconomic longitudinal cardiovascular research studies that identified socioeconomic exposures at 2 or more points in time between the years of 2019 and 2023. We defined cardiovascular outcome studies as those that examined coronary artery disease, myocardial infarction, acute coronary syndrome, stroke, heart failure, cardiac arrhythmias, cardiac death, cardiometabolic factors, transient ischemic attacks, peripheral artery disease, or hypertension. Socioeconomic exposures included individual income, neighbourhood income, intergenerational social mobility, education, occupation, insurance status, and economic security. Seven percent of socioeconomic cardiovascular outcome studies have measured socioeconomic status at 2 or more points in time throughout the follow-up period, hypothesized mechanisms by which dynamic socioeconomic measures affected outcome focused on social mobility, accumulation, and critical period theories. Insights, implications, and future directions are discussed, in which we highlight ways in which postal code data can be better used methodologically as a dynamic socioeconomic measure. Future research must incorporate dynamic socioeconomic measurement to better inform root causes, interventions, and health-system designs if health equity is to be improved.