Socioeconomic status and cardiovascular health in the COVID-19 pandemic

Heart. 2021 Mar;107(5):358-365. doi: 10.1136/heartjnl-2020-318425. Epub 2021 Jan 15.


The goals of this review are to evaluate the impact of socioeconomic (SE) status on the general health and cardiovascular health of individuals during the COVID-19 pandemic and also discuss the measures to address disparity. SE status is a strong predictor of premature morbidity and mortality within general health. A lower SE status also has implications of increased cardiovascular disease (CVD) mortality and poorer CVD risk factor profiles. CVD comorbidity is associated with a higher case severity and mortality rate from COVID-19, with both CVD and COVID-19 sharing important risk factors. The COVID-19 pandemic has adversely affected people of a lower SE status and of ethnic minority group, who in the most deprived regions are suffering double the mortality rate of the least deprived. The acute stress, economic recession and quarantine restrictions in the wake of COVID-19 are also predicted to cause a decline in mental health. This could pose substantial increase to CVD incidence, particularly with acute pathologies such as stroke, acute coronary syndrome and cardiogenic shock among lower SE status individuals and vulnerable elderly populations. Efforts to tackle SE status and CVD may aid in reducing avoidable deaths. The implementation of 'upstream' interventions and policies demonstrates promise in achieving the greatest population impact, aiming to protect and empower individuals. Specific measures may involve risk factor targeting restrictions on the availability and advertisement of tobacco, alcohol and high-fat and salt content food, and targeting SE disparity with healthy and secure workplaces.

Keywords: acute coronary syndrome; atherosclerosis; quality of health care; risk factors.

Publication types

  • Review

MeSH terms

  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Cardiovascular Diseases* / epidemiology
  • Cardiovascular Diseases* / prevention & control
  • Healthcare Disparities / organization & administration*
  • Humans
  • Risk Factors
  • SARS-CoV-2
  • Socioeconomic Factors*