Coronary Heart Disease from a Population Perspective

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Abstract

In this chapter, the authors begin with an account of their understanding of the pathological basis of Coronary heart disease (CHD). It is instructive to contrast the experiences of Western Europe, North America, Eastern Europe, and Japan, focusing particularly on possible relationships between the incidence of CHD and socioeconomic differences across, and changes in, societies. In regions of the world where CHD rates are high, such as Western Europe or North America, the higher the rate of CHD, the higher the mortality from all causes. CHD, like other epidemic diseases, relates closely to social conditions. Migrants tend toward the rate of CHD of their country of adoption. It is natural, of course, to ask whether the improvements in rates of CHD, or health status more generally, are a result of greater consumption of higher quality health care. In contemporary Britain, social class differences in CHD parallel those for mortality from all causes.