Heart health inequalities in Canada: modules, theory and planning

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Abstract
It is well known that prevalence and incidence rates of cardiovascular disease (CVD) and CVD risk factors are not equally distributed among socioeconomic groups. Known risk factors account for part, but not all of unequally distributed CVD rates. Socioeconomic conditions and psychosocial dynamics may explain another pare of the increased CVD rates. Theoretically, it may be possible to lower CVD rates and CVD risk factor prevalence among lower socioeconomic status (SES) groups by using a community development (socio-environment) strategy directed towards changes in socioenvrronmental risk conditions and psychosocial risk factors, rather than CVD risk factors per Se. This article describes a protocol for such a strategy based upon the planning work of Canadian health professionals, loosely organized under a project titled ‘Heart Health Inequalities in Canada’ This protocol incorporates baseline data on CVD and CVD risk factor prevalence, but is premised on actions negotiated between community organizations and health authorities, rather than defined unilaterally by health authorities. As such, program design activities and evaluation will differ from a more general population-based risk factor reduction strategy.

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