Cardiovascular disease in rich and poor countries - what's the difference?
Cardiovascular disease (CVD) is the leading cause of death worldwide. The two biggest killers are coronary heart disease (CHD) and stroke. In part 1 we saw that women and men experience cardiovascular disease differently, but there are also differences in how women and men in low-income and high-income countries are affected.
Conditions such as cardiovascular disease are often thought of as 'diseases of affluence' that don't affect poorer countries. But in 2017 mortality rates were times higher in low-income countries than high-income countries for women, and times higher for men.
Note: all rates are per 100,000 people (age-standardised). The higher the rate, the more deaths that occurred.
decreased rateincreased rate
mortality rates for women in low-income countries1
mortality rates for women in high-income countries2
Conditions such as cardiovascular disease are often thought of as 'diseases of affluence' that don't affect poorer countries. But in 2017 mortality rates were times higher in low-income countries than high-income countries.
1. a Gross National Income (GNI) per capita of less than US$996 (in 2017)
2. a GNI per capita above US$12,055 (in 2017)
What are the socioeconomic impacts of disease?
Poverty is closely linked with chronic, or Non-Communicable Diseases (NCDs) such as CVD, CHD and stroke. People experiencing vulnerability and social disadvantage get sicker and die sooner than people of higher social positions. This is partly because they are at greater risk of being exposed to harmful products such as tobacco, or unhealthy dietary practices. They may also have limited access to health services.
The rapid rise in NCDs is predicted to impede poverty reduction initiatives in low-income countries. NCDs often require lengthy and expensive treatment, and healthcare costs can quickly drain household resources.
Breadwinners may lose their income as a result of experiencing one or more NCDs, and other family members may have to give up their jobs in order to act as carers, leading to a family's finances deteriorating catastrophically.
CVDs such as CHD and stroke are a major cause of premature death and disability in India, and many people in rural villages have little or no access to adequate healthcare. In Andhra Pradesh, where the average income is around US$50 per month, heart disease is now the most common cause of premature death and disability among people of working age, and a key contributor to both household and regional poverty.
While health service coverage is patchy, wireless networks now reach over 80% of India's population, so The George Institute has trialled a mobile based service that targets high-risk patients with both treatment and monitoring. Called SMARThealth India (for Systematic Medical Appraisal, Referral and Treatment) it has the potential to revolutionise the delivery of essential healthcare to those who previously had little or no access.