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Disparities in cardiovascular disease among Caribbean populations: a systematic literature review
Damian K Francis1, Nadia R Bennett2, Trevor S Ferguson3
1Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Kingston, West Indies, Jamaica. damian.francis@uwimona.edu.jm.
Insights
Cardiovascular disease (CVD) health disparities exist among Afro-Caribbean populations, with differences in prevalence for conditions like stroke. More research is needed to understand the social determinants of these health inequities.
Area of Science:
- Public Health
- Epidemiology
- Health Disparities Research
Background:
- Cardiovascular diseases (CVD) represent a leading global cause of mortality.
- Significant health disparities in CVD burden exist between developed and developing nations.
- Socially disadvantaged groups and ethnic minorities experience disproportionately poorer CVD outcomes.
Purpose of the Study:
- To systematically review the literature on cardiovascular disease health disparities in Afro-Caribbean populations.
- To identify existing knowledge gaps concerning CVD outcomes and determinants within this demographic.
Main Methods:
- A systematic literature review was conducted using MEDLINE and other research databases.
- Data were extracted from 22 peer-reviewed and grey literature articles based on an a priori protocol.
- Thematic analysis focused on CVD outcomes, age, sex, ethnicity, and socioeconomic status.
Main Results:
- Studies primarily from the UK examined CVD prevalence by ethnicity, age, and sex.
- Afro-Caribbeans showed lower prevalence of Coronary Heart Disease (CHD) and Peripheral Arterial Disease (PAD) compared to Caucasians and South East Asians.
- Strokes were more prevalent in Afro-Caribbeans, with inadequate data on morbidity/mortality across socioeconomic gradients.
Conclusions:
- Significant ethnic variations in CVD morbidity and mortality are evident.
- Substantial knowledge gaps persist regarding the social determinants of CVD disparities.
- Further research is crucial to investigate these gaps using diverse disparity indicators.
Background:
Cardiovascular diseases (CVD) are the predominant cause of death globally. The large health disparities in the distribution of the burden of disease seen in developed and developing countries are of growing concern. Central to this concern is the poor outcome which is seen disproportionately in socially disadvantaged groups and racial/ethnic minorities. The aim of the study was to conduct a systematic literature review to investigate the nature of cardiovascular disease health disparities among Afro-Caribbean origin populations and identify current knowledge gaps.
Methods:
A systematic literature review including a detailed search strategy was developed to search MEDLINE and other research databases. Using an a priori protocol peer-reviewed publications and grey literature articles were retrieved and screened and relevant data extracted by two independent review authors. Thematic analysis was done according to CVD outcomes and measures of disparity including age, sex, ethnicity and socioeconomic status.
Results:
The search retrieved 665 articles of which 22 met the inclusion criteria. Most studies were conducted in the United Kingdom and centered on the prevalence of CVD by ethnicity, age and sex. An important sub-theme identified was the disparities in health service utilization/hospital admission. Coronary Heart Disease (CHD) and Peripheral Arterial Disease (PAD) were less prevalent among Afro-Caribbeans compared to Caucasian and South East Asian ethnic groups. The prevalence of CHD ranged from 0-7% in Afro-Caribbean to 2-22% in Caucasians. Strokes were more common among Afro-Caribbeans. There are inadequate data on morbidity and mortality from CVD, particularly across the socio-economic gradient, in Afro-Caribbean populations.
Conclusions:
There are important differences in morbidity and mortality from CVD across ethnic groups. Important knowledge gaps remain in understanding the social determinants of these disparities in CVD. More research exploring these gaps by varying disparity indicators needs to be undertaken.
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