A large number of studies show
that cardiovascular disease and its
traditional risk factors are associated
with socioeconomic conditions.
However, their etiological role in
the development of cardiovascular
outcomes is not always well understood.
In particular, it is unclear
whether socioeconomic factors
should be considered as traditional
risk factors for CVD, as confounders,
or as risk modifiers. In
this article, after examining whether
socioeconomic conditions meet the
criteria for the three definitions,
we argue that none of them fully
captures the complexity of their contribution
in shaping the epidemic
of heart disease across and within
societies. We argue instead that socioeconomic
factors are the “causes
of the causes” of heart disease.
Implications for research and interventions
to reduce heart disease
are discussed
