Interventions to tackle health inequalities in cardiovascular risks for socioeconomically disadvantaged populations: a rapid review.

Yu Fu, Ge Yu, Naswa Maulana, Katie Thomson

Journal: British medical bulletin 2023;148(1):22-41

PMID: 37724711

Abstract

INTRODUCTION

Cardiovascular disease (CVD) has shown significant health inequalities for people with low socioeconomic status associated with more risk factors. This review was to synthesize interventions that targeted CVD risks and outcomes among socioeconomically disadvantaged populations and to understand the impact associated with these interventions.

SOURCES OF DATA

Cochrane CENTRAL, MEDLINE, Embase, PsycINFO and CINAHL were searched for records published in the last decade using a systematic search strategy, complemented by screening the reference lists and citation indexes. Nineteen studies were included and a narrative synthesis with the effect direction plot was undertaken in which studies, interventions, participants and outcomes were examined according to the intervention type focusing on behaviours, lifestyle, education, medication and monitoring.

AREAS OF AGREEMENT

No universal definition of disadvantaged socioeconomic status was used with common factors relating to racial/ethnic minorities, low income and low or no health insurance. Mixed effects of interventions were reported on clinical outcomes including weight, body mass index, blood pressure, glycated haemoglobin and cholesterol.

AREAS OF CONTROVERSY

Inconsistent effect was reported due to a large variety of settings, participants and intervention components although they are considered necessary to address the complex health needs of socioeconomically disadvantaged populations.

GROWING POINTS

There is inadequate evidence to determine whether any of the intervention types are effective in optimising lipids management for socioeconomically disadvantaged populations.

AREAS TIMELY FOR DEVELOPING RESEARCH

Research is needed with mixed evidence using real world evaluation and lived experience combined with health economic evaluation, on both mental and physical health outcomes.

© The Author(s) 2023. Published by Oxford University Press.

Address: Department of Primary Care & Mental Health, Institute of Population Health, University of Liverpool, 1-3 Brownlow Street, Liverpool, L69 3GL, UK.; King's Health Economics, Health Services and Population Research, Department of Psychiatry, Psychology & Neuroscience, King's College London, David Goldberg Centre 18 De Crespigny Park, London, SE5 8AF, UK.; Population Health Sciences Institute, Faculty of Medical Sciences Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne NE2 4AX, UK.; National Institute for Health Research Applied Research Collaboration, North East and North Cumbria, Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust St Nicholas Hospital Gosforth, Newcastle Upon Tyne NE3 3XT, UK.
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