Socioeconomic Factors and Dietary Interventions for Cardiovascular Disease Prevention

The 5-A Day Campaign

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Socioeconomic factors

Socio-economic factors “include employment, income and education” (Kumar, 2017). While “education, especially health literacy and knowledge influences lifestyle choices, CVDs has higher rates in blue-collar employment, such as trades and labour” which are strongly associated with unhealthy behaviours like smoking, drinking and high-fat consumption (Australian Institute of Health and Welfare, 2015). Large differences between countries and within-country in CHD/stroke burden exists as people of low-income countries have higher burden compared to people in high-income countries, and low socioeconomic status individuals have a higher burden than high socioeconomic status individuals in the same country (Glymour, Clark and Patton, 2014).\

The 5-A Day Campaign

The 5-A Day Campaign is a dietary intervention centred on recommendation from the WHO to eat a minimum of 5 portions (400g) of fruits and vegetable per day to reduce the risk of health problems like heart disease and stroke (NHS, 2018). The intervention is pathogenic based as the focus is for heart disease and stroke prevention. Because the dietary advice and information is determined and provided by WHO professionals, the intervention is authoritative (top-down approach) and expert-led which demonstrates the top horizontal spectrum of Beattie's model of health promotion (Beattie, 1991). Meanwhile, the intervention focus on individuals which exemplifies the left vertical spectrum of Beattie's model. Furthermore, the intervention fits best with the health persuasion quadrant of Beattie's model and health education sphere of Tannahill model. While health persuasion strategy of Beattie's model involves interventions directed at individual and led by professionals and assumes that the experts and professionals know best (Naidoo and Wills, 2016), health education in Tannahill model involves communication to enhance well-being and prevent ill-health by influencing knowledge and attitudes (Tannahill, 1985), which is the dietary advice on fruits and vegetable in this intervention.

“Advancing our Health: Prevention in the 2020s” is the current policy of the UK to ensure a proactive, predictive, and personalised prevention decade (Department of Health and Social Care and cabinet (DHSC), 2019). The policy has the ambition: “to go 'smoke-free' in England by 2030; with smokers quitting or moving to reduced-risk products like e-cigarettes, to reduce the population’s salt intakes to 7g per day, to promote an active lifestyle by encouraging more people to switch from driving to public transport, cycling and walking”. The above steps fit the behavioural causal factors to reduce smoking, high cholesterol intake and physical inactivity. This is remarkable as “80% of premature deaths from CHD/Stroke can be avoided by controlling the risk factors of tobacco, unhealthy diet and physical inactivity” which are behavioural (WHO, 2019).

Effects of Tobacco Taxation and Pricing on Smoking Behavior in High Risk Populations:

Low socioeconomic status associated with higher risk of second heart attack or stroke.

Socioeconomic Determinants of Cardiovascular Disease: Recent Findings and Future Directions.

Ethical Issues in Health Promotion and Communication Interventions Communication and Social Change,

Cardiovascular Disease and Its Determinants: Public Health Issue.

International Journal of Environmental Research and Public Health,

Psychosocial perspectives in cardiovascular disease.

Environmental Determinants of Cardiovascular Diseases Risk Factors:

Lifestyle changes in coronary heart disease—Effects of cardiac rehabilitation programs with focus on intensity,

Perceived environmental barriers to physical activity in young adults in Dhaka City, Bangladesh

What is World Heart Day?