Evaluating the incidence of Coronary Artery Disease using the Social-Ecological Model

A social-ecological model of health examines the multifaceted determinants that affect one’s health on different levels. The model is categorized into four levels: individual, interpersonal, community and societal (CDC, 2021). It is important to recognize that changes must be made on multiple levels to achieve improvements in health for an individual, community and the population.

The second leading cause of death in Canada is due to coronary artery disease also known as CAD (Government of Canada, 2017). This occurs when the coronary arteries are narrowed which results in reduced blood flow to the heart.

(CDC, 2021)

Coronary artery disease often leads to heart attacks and cardiac arrest which contribute to our mortality rate substantially (Heart & Stroke, 2021). According to the Government of Canada (2017), 1 in 12 Canadians ages 20 or over live with heart disease and every hour 12 Canadians ages 20 or over diagnosed with heart disease die.

I am going to utilize the social-ecological model to evaluate the factors that contribute to CAD using the framework of this model.

(Safe States, 2021)

The individual level consists of biological and personal characteristics that affect one’s health (CDC, 2021). Examples of individual factors that contribute to the development of CAD include:

· genetics – family history

· co-morbidities – diabetes, high blood pressure

· overweight

· unbalanced diet

· poor lifestyle choices – smoking, excessive alcohol consumption

· sedentary lifestyle

· age

· gender

· socioeconomic status – affecting access to healthy foods, safe drinking water, medical services (Heart & Stroke, 2021).

The interpersonal level of the model takes a closer look at the social relationships (peers, partners, and family members) that affect one’s health and influence behaviour (CDC, 2021). Examples of these relationship-based factors that would contribute to CAD include:

· unbalanced familial diet habits

· a social circle that does not promote healthy life-style behaviours

· poor social support systems – strong family support promotes routine health check-ups and compliance to treatments (Jin et al., 2020).

The community level explores the settings where people have social relationships and examines the characteristics of these environments which affect health (CDC, 2021). The settings include workplaces, schools, and neighbourhoods. An example of this in relation to CAD was shown by Diez Roux et al. (2001), they found that disadvantaged neighbourhoods had higher incidences of CAD. This may be a result of limited access to nutritious foods, unsafe surroundings prohibiting outdoor physical activities and limited access to medical services in the neighbourhood.

The final level known as the societal level focuses on initiatives and policies that are put in place to help create a climate where disease prevention is encouraged (CDC, 2021). Heart health awareness campaigns can be shared through social media and mass media platforms to promote warning signs of heart attacks, prevention methods and cardiovascular risk factors (Jin et al., 2020). It is through education and knowledge that one can make positive changes to their health.

References

Centers for Disease Control and Prevention. (2021). Coronary Artery Disease. [Image]. CDC.

https://www.cdc.gov/heartdisease/coronary_ad.htm

Centers for Disease Control and Prevention. (2021, October 22). The Social-Ecological Model: A Framework for Prevention. CDC. https://www.cdc.gov/violenceprevention/about/social-ecologicalmodel.html

Diez Roux, A. V., Merkin, S. S., Arnett, D., Chambless, L., Massing, M., Nieto, F. J., Sorlie, P., Szklo, M., Tyroler, H. A., & Watson, R. L. (2001). Neighbourhood of residence and incidence of coronary heart disease. The New England Journal of Medicine, 345(2), 99-106. https://doi.org/10.1056/NEJM200107123450205

Government of Canada. (2017, February 10). Heart Disease in Canada. Canada. https://www.canada.ca/en/public-health/services/publications/diseases-conditions/heart-disease-canada.html

Heart & Stroke Foundation of Canada. (2021). Coronary Artery Disease. Heart & Stroke. https://www.heartandstroke.ca/heart-disease/conditions/coronary-artery-disease

Jin K., Neubeck, L., Koo, F., Ding, D., & Gullick, J. (2020). Understanding Prevention and Management of Coronary Heart Disease Among Chinese Immigrants and Their Family Carers: A Socioecological Approach. Journal of Transcultural Nursing, 31(3), 257-266. https://doi.org/10.1177/1043659619859059

Safe States. (2021). Figure 1. Social Ecological Model. [Image]. Safe States. https://www.safestates.org/page/SRPFSEM