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Poverty and Heart Disease
Heart disease has a reputation as a “first-world problem,” the inevitable result of a fatty diet and little to no exercise. Despite this common correlation, the link between poverty and heart disease is becoming increasingly visible. As of 2015, 80% of global deaths from cardiovascular disease were in low to middle-income countries (LMIC). According to The World Health Organization, 37% of premature deaths (<70 years old) in LMIC’s caused by non-communicable diseases are attributable to cardiovascular disease.

Heart Disease and Poverty

Prior to 1990, most deaths in LMIC’s were caused by communicable diseases like HIV, malaria and ebola, or complications from malnutrition. As urban areas grow in developing nations, lower physical activity and access to mass-produced and nutritionally-poor food contribute to the rise in heart disease-related deaths.

Heart disease is often the result of atherosclerosis, a build-up of plaque in the arteries of the cardiovascular system, or thickening that narrows the space for blood to flow. Heart attacks, stroke, arrhythmias and physiological deformities of the heart result from these blockages and can be fatal.

Major factors leading to heart disease include a poor diet, tobacco use, high blood pressure and high blood sugar. Additionally, a lack of diagnostic tools in LMIC may contribute to increased mortality from cardiovascular disease. A delayed diagnosis can result in irreparable cumulative damage and adverse cardiovascular events. Similarly, distributing affordable medications for managing heart disease in LMIC’s (ACE inhibitors, statins, beta-channel blockers and aspirin) is an ongoing challenge.

Non-communicable diseases like heart disease are often contributing factors to continued or extreme poverty due to lost wages, incapacitation and the generational effects of losing caregivers and wage earners. Patients in LMIC’s who survive heart attacks and strokes may need years of costly follow-up care and medication. The increases the likelihood that the dual burden of poverty and heart disease will prove fatal.

A New Baseline

Establishing effective preventative care in LMIC’s is one of the biggest obstacles to reducing cardiovascular disease. Lifestyle changes such as smoking cessation, dietary guidance and increased exercise can make a significant difference. Health professionals should recommend these changes to those screened as at-risk or suffering from high blood pressure.

The World Health Organization (WHO) has programs designed to treat and prevent cardiovascular disease globally. The WHO launched the Global Hearts Initiative in 2016 to provide support to governments in their efforts to prevent heart disease. The approach is multi-faceted and includes improvements to the health care sector, the nutritional quality of food and more.

The World Heart Federation (WHF) is an NGO focused on global cardiovascular care and outreach. Founded in 1978, it is internationally recognized as an authority on preventing, treating and diagnosing cardiovascular disease in children. The WHF provides training and networking opportunities to public health officials and caregivers worldwide, emphasizing practical methods of prevention and treatment.

Moving forward into a world where most people live in cities, vital infrastructure and basic medical services are necessary to improve the quality of life in developing nations and impoverished communities globally. Combating the rising incidence of heart disease is a major battle inequitably affecting the world’s poor. Cardiovascular screening, patient education and dietary guidance are all important steps in the right direction.

Katrina Hall
Photo: Flickr

The Rise of Cardiovascular Disease in India
In recent years, India has been faced with a rapid increase in cardiovascular disease. Between the 2005 and 2016, the rate of premature death due to heart disease in India rose by over 41 percent. The risk of stroke has similarly increased, and cardiovascular disease in India is now extremely prevalent.

Cardiovascular Disease in India

In fact, cardiovascular disease is now the leading cause of death in the country, with a quarter of all deaths attributed to it. This is greater than the average rate of cardiovascular disease-related deaths across the globe. The high rate of cardiovascular disease resulting in high mortality is a growing concern in the country.

There are many risk factors attributed to cardiovascular disease. A significant portion of mortality from cardiovascular disease is brought on by smoking, which has a high prevalence among young adults and lower-income households.

Another risk factor for cardiovascular disease is a lack of nutrition from fruits and vegetables in a diet. Approximately half of all people in India consume one serving of fruit or less a week. In addition to the loss of nutrition from fruit and vegetables, there has been a significant rise in the consumption of unhealthy foods such as fat, particularly among Indians of the lowest incomes.

Treatment

Part of the larger problem of rising cardiovascular disease is treatment. People who have limited or insufficient education are less likely to identify the symptoms of hypertension that could lead to cardiovascular disease.

This population is also much less likely to treat hypertension. In addition, higher smoking rates are correlated to lower education levels. Lack of information and access to treatment significantly increases the danger of the development and fatal progression of cardiovascular disease.

In the face of these growing problems with cardiovascular disease in India, health improvement efforts have begun in earnest. These efforts include a foundation known as Swasth India. Swasth India sets up healthcare centers in low-income housing within urban areas. They provide physicians, diagnostics and treatment. The cost of care in these medical centers is significantly less than the average cost of the same care in the market.

Services and Organizations

In fact, the majority of services are provided at half the market rate. The medical centers also promote awareness on topics such as the management of hypertension. Swasth India provides affordable and easy-to-access treatment for people who would not ordinarily have access or be able to pay for the tests and medication they receive.

Another enterprise working to end the danger of cardiovascular disease in India is known as the Global Hearts Initiative. The Global Hearts Initiative was launched in 2016 in an effort to address the worldwide growth of cardiovascular disease. The initiative’s three focuses are:

  • The reduction of tobacco use
  • The reduction of salt intake
  • The improvement of management of cardiovascular disease within healthcare systems

The Global Hearts Initiative’s main purpose is to help countries implement new protocols and improve access to necessary health care. India is among the 14 countries focused on by the Global Hearts Initiative.

A Healthier World

Swasth India and the Global Initiative show that in spite of the daunting rise of cardiovascular disease in India and the high rates of mortality, efforts in play continue to improve lives.

Many people who ordinarily would not have access to information and care for cardiovascular disease are given the opportunity of treatment and methods of prevention through these initiatives. The increase of cardiovascular disease is a negative worldwide development, but progress continues to be made to offset such an occurrence and strive for a better, healthier world.

– Lindabeth Doby
Photo: Flickr