Heart disease and stroke burden every region of the world leading to increased inequalities in health

Heart disease and stroke are responsible for 17 million deaths each year, represent a major burden of disease in every region of the world and are contributing to an alarming increase in health inequalities, both within and between countries.

At the Sixth International Conference on Preventative Cardiology in Foz do Iguassu, Brazil (21-25 May), attended by 700 cardiologists and health professionals from around the world, Sir Michael Marmot and the World Heart Federation, called for a major revision of global health policies to take into account these growing health inequalities.

Sir Michael Marmot is Professor of Epidemiology and Public Health at University College London and Chairman of WHO’s new Commission on the Social Determinants of Health.

"Inequalities in health exist when the circumstances in which people live and work are greatly unequal. Differences in social environments, linked to differences in socioeconomic status, such as access to health care, education and working conditions, contribute to shortened life expectancy. Health policies largely ignore the social environment and as a result, health problems have persisted and inequalities have widened. To reverse this trend, efforts to control the social determinants of major diseases, such as heart disease and stroke, are greatly needed," said Sir Michael Marmot.

"In order to prevent and control the rapidly growing epidemic of heart disease and stroke, it is imperative that attention is given to health literacy and education," said Dr Valentin Fuster, President, World Heart Federation. "Lack of health awareness, particularly in developing countries and in lower socio-economic classes in developed countries, is greatly increasing the prevalence of risk factors for heart disease and stroke, such as obesity, smoking and poor diets. Obesity, for example, is increasing at an alarming rate in developing countries with high levels of poverty, particularly in Latin America and the Caribbean, and in the poorer communities in the developed world. Smoking, which is decreasing in developed economies, is on the rise in the developing world, especially in India, China, Brazil, Cuba and South Africa. One in three cigarettes smoked in the world today are smoked in China."

"If we want to do something about this burden we need to focus on treatment, but also more fundamentally on how we organise our society. Health is a marker of how well policies meet both human and social needs," said Sir Michael Marmot. "It is therefore vital that the social conditions that determine health are improved. Life expectancy differences of 48 years between countries and 20 years within countries are not acceptable. Education is important. But more importantly we must create the conditions for the world’s population to lead heart-healthy lives, improve living conditions and implement polic ies and initiatives that address health inequalities," said Sir Michael Marmot.