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Report Social Determinants of Health‐IntroductionHeart, stroke and vascular disease are health conditions known as heart or cardiovascular diseases.Heart diseases are the leading cause of death in the world, causing many more deaths compared toother diseases. In 2017, 27% of all deaths in Australia was related to cardiovascular conditions.(Australian Bureau of Statistics, 2018)In 2011 Coronary heart disease was responsible for 7.7% of the total burden of disease in Australia.Statistics from the Australian Institute of Health and Welfare point out that between 2015 and 2016cardiovascular diseases were the main causes of hospitalizations and the incidence in men wouldrepresent the majority, being twice as high as in women.(Australian Institute of Health and Welfare,2018)The cause of heart disease is usually a combination of risk factors such as inadequate diets, physicalinactivity, tobacco use and harmful use of alcohol. The effects of behavioural risk factors can bemanifested in individuals through high blood pressure, high glycemic index, overweight and obesitybut it is possible to prevent most diseases by using strategies to address behavioural risk factors forthe general population.There are also several underlying determinants that reflect the main forces that guide social,economic and cultural changes - globalization, urbanization and an aging population as well aspoverty, stress and hereditary factors.The present work is a study that aimed to analyse the burden of heart disease on the elderlypopulation and the socioeconomic impact in the health of this group.This study is concluded with the presentation of suggestions for public health interventions that canhelp professionals addressing health issues in the target population.1 - Social determinantsThe burden of heart disease within the elderly population in AustraliaAccording to research by the Australian bureau of Statistics, the percentage of heart disease is higherin men than in women, being in the proportion of 5.4% and men and 4.2% for women. The generalnumbers increase with old age and in the age group of 75 years, one in four people has some type ofheart disease, with the highest rates prevailing in the male population.(Australian Bureau ofStatistics, 2018)The prevalence in the elderly group is justified by considering the physiological and pathophysiologicalconditions that differentiate them from other age groups. Adding this to the socioeconomic statusand the increase in life expectancy it makes them a layer of the population with their own
characteristics and needs.Old age is a stage of life with its own characteristics and values, in which changes occur in theindividual, both in the organic structure, as in the metabolism, in the biochemical balance, in theimmunity, in the nutrition, in the functional mechanisms, in the intellectual and emotionalcharacteristics and therefore elderly is more vulnerable to degenerative diseases of insidious onsetsuch as cardiovascular. Several demographic, socio-cultural and epidemiological factors contribute toaggravate this situation, such as retirement, loss of workmates, increase in free time, changes in socialnorms, impact of age on the individual, social impact of old age, loss of economic security , rejectionby the group, distant children, increased frequency of certain illnesses, difficulties in accepting newideas that clash with traditional models of conduct and modern medicine.(Oldenburg,Mcguffog, &Turrell, 2000)Over the years, the cardiovascular system undergoes a series of changes that tend to compromisecardiac function. Statistics show that the biggest cause of mortality and morbidity is cardiovasculardisease. In addition to age, other risk factors can be added, such as high blood pressure, diabetesmellitus, smoking, physical inactivity and obesity.(The Heart Foundation, 2015)Although we are living longer, heart disease is still the deadliest and the most expensive for the healthsystem. This demonstrates that better research in prevention and care is needed. Research showsthat in recent years, death rates related to cardiovascular diseases have not significantly reduced,mainly because of the high numbers of diabetes and obesity. In addition to heart disease being themajor cause of death, it is also responsible for the poor quality of life of survivors.(IDI Heart &Institute, 2016)How the social determinants of health can explain the burden of heart disease within the elderlyIn the first decade of the 21st century, the world moves towards the perspective of focusing onpopulations, with actions directed at the societies to which individuals belong. This pendularmovement is driven by the respectable advance in the study of the relationships between the form oforganization and development of a given society and the health situation of its population. Thus, therecognition of the inadequacy of health strategies that were not aimed at attacking the social roots ofthe disease and well-being gives rise to an emphasis on the social determinants consolidated by thecreation of the WHO Commission on Social Determinants of Health, in 2005.The strong and growing evidence of the link between the socioeconomic structure and people'shealth status has contributed to the consolidation of the socio-political and cultural context asgenerators of poor health and health inequalities. These factors, also considered structural, are thefirst to influence the individual's health. However, this influence is not direct, but occurs throughmore specific determinants: General socioeconomic, cultural and environmental conditions, living andworking conditions, social and community networks, behaviours and lifestyles.(Benach et al., 2010)Aging is related to the increased risk of having chronic diseases, such as heart disease, since theincrease in longevity naturally leads to a longer period of exposure to risk factors(Fontana, 2009).However, psychosocial factors, depression and social situation can also be defined as conditions thatpotentially relate psychological phenomena to the social environment(Hemingway & Marmot,1999).It is known that these factors do not directly affect cardiac health, but act fundamentally inbehaviour, such as smoking, alcohol consumption, changes in physical activities that may affect theheart.