[Social determinants and epidemiology of cardiovascular diseases].

Recent approaches to studies of social determinants and social epidemiology of cardiovascular diseases are reviewed. This approach originating in some industrialized countries has so far been neglected in Croatia in spite of previous experiences and existence of sociomedical tradition. The possible explanations are considered. Obvious health problems related to the standard of living, poverty, high unemployment, work insecurity, unjustified inequality of income, and other forms of discrimination in health are not tackled. The social determinants important for health are defined and at least five categories identified, i. e. broad cultural and economic circumstances, structural determinants and social position, intermediate determinants reflected in lifestyles, available social network and social capital, and finally discrimination in health care are recommended to include in epidemiological research and design of health interventions. The following measures are proposed as necessary in the current situation: 1) changes in scope and orientation of epidemiological and clinical research; 2) intensification of information for the public, experts and politicians on the role of social determinants; and 3) amplification of health interventions avoiding patterns of the predominant neoliberal approaches (blaming the victim), as well as administrative egalitarian approaches (teaching people to become victims waiting for elderly brother to provide solutions).