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Socioeconomic status and cardiovascular health in the COVID-19 pandemic
  1. Jeremy Naylor-Wardle1,
  2. Ben Rowland1,
  3. Vijay Kunadian1,2
  1. 1Translation and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
  2. 2Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundations Trust, Newcastle Upon Tyne, UK
  1. Correspondence to Dr Vijay Kunadian, Translation and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne NE7 7DN, UK; vijay.kunadian{at}


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.

  • acute coronary syndrome
  • atherosclerosis
  • quality of health care
  • risk factors

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  • Contributors VK conceived the idea and made critical review and multiple revisions. JNW wrote the draft and multiple revisions. BR contributed to sections and critical review.

  • Funding VK is supported by the British Heart Foundation Clinical Study Grant (CS/15/7/316), Newcastle NIHR Biomedical Research Centre, and Institutional Research Grant from AstraZeneca (ISSBRIL0303).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Author note Additional references w51–93 can be found in online supplemental file 1.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.